A mole that changes is the single most important sign of melanoma. If a spot on your skin is growing, changing colour, developing an uneven border, itching, or bleeding, book a professional skin assessment rather than waiting to see what happens next.
Most moles are harmless. The ones that matter are the ones that behave differently from the rest of your skin, and that difference is something you can learn to spot at home.
Melanoma is a cancer that starts in the pigment-producing cells of your skin, called melanocytes. It accounts for a small share of all skin cancers, but it causes the majority of skin cancer deaths because it can spread beyond the skin if it goes unrecognised.
Two things are worth understanding about how it behaves:
At Pinkal Medical Aesthetics, we focus on documenting what your skin looks like now so that any future change becomes obvious rather than debatable.
Pro tip: Take a phone photo of any spot you are unsure about, with a coin or ruler beside it for scale. Photograph it again in four weeks under the same lighting. Change over weeks is far more informative than a single anxious look in the mirror.
Yes, melanoma is serious, and yes, timing changes almost everything about how it is managed. That combination is why clinicians push so hard on early detection rather than on reassurance.
Melanoma is measured in millimetres of depth, and depth drives prognosis. A thin melanoma that has not yet grown down into the deeper skin layers is generally treated with a relatively straightforward surgical excision. Once it grows deeper or reaches lymph nodes, treatment becomes considerably more involved.
Put plainly:
Stage found Typical clinical picture What treatment often involves
Very early, thin
Confined to the upper skin layers
Local excision with clear margins
Intermediate depth
Grown deeper into the dermis
Wider excision, possible lymph node assessment
Advanced or spread
Involves nodes or distant sites
Systemic therapy, specialist oncology care
Survival statistics for early-stage melanoma are strong, which is the encouraging half of the message. The difficult half is that "early" is a window, not a permanent state.
Melanoma is not rare in Canada, which is exactly why routine skin awareness matters here. The Canadian Cancer Society reported roughly 9,000 new melanoma diagnoses nationally in 2022, and incidence has trended upward over recent decades.
Ontario carries a meaningful share of that total simply because of population size. CBC has also covered a London, Ontario melanoma survivor who credits persistence in getting a mole examined with catching the disease at stage 3. That is a local, real example of the same pattern we see clinically: the patients who do best are usually the ones who did not talk themselves out of getting checked.
Real-world scenario: A 47-year-old patient notices a small dark spot on the back of the shoulder. A partner mentions it looks different from last summer. Because it is on the back, the patient has never had a clear view of it. That single second opinion from someone else is often what initiates an assessment.
The earliest signs of melanoma are usually visual and subtle: asymmetry, uneven colour, a border that blurs into surrounding skin, and any change over time. You do not need medical training to notice these. You need a system.
The ABCDE framework remains the most practical self-check tool available for spotting early signs of skin cancer. Use it on every mole you can see.
Letter What it means What to look for
A
Asymmetry
Draw an imaginary line through the middle. If the halves do not match, note it.
B
Border
Edges look ragged, notched, blurred, or bleed into nearby skin.
C
Colour
More than one shade in one spot: brown, black, tan, red, white, or blue-grey.
D
Diameter
Larger than 6 mm, roughly a pencil eraser. Smaller melanomas do exist.
E
Evolving
Any change in size, shape, colour, elevation, or sensation.
How clinicians actually weight these: E carries the most practical value. A single asymmetrical mole is common. An asymmetrical mole that was symmetrical last year is a reason to be seen.
Your moles should look like siblings, and melanoma often looks like the odd one out. This is the second framework worth learning, and it catches cases the ABCDE rule can miss.
Example: A patient with dozens of medium-brown, round moles has one flat, blue-grey, slightly oval spot on the calf. Individually it may not fail the ABCDE test. As an outlier among 40 near-identical neighbours, it earns a closer look.
Melanoma is not always about appearance. Sometimes the first clue is how a spot feels or behaves. Any of the following warrants an in-person assessment rather than monitoring at home:
Where people commonly miss things: the scalp under hair, behind the ears, the back, between toes, the soles of the feet, and the buttocks. These are the areas where a documented full-body imaging record adds the most value over self-checks alone.
Pro tip: Set a recurring monthly reminder on your phone and do your skin check right after a shower, in good light, with a hand mirror for your back. Consistency beats thoroughness, because you are looking for change, not perfection.
Ultraviolet radiation is the single largest modifiable cause of melanoma, working alongside genetic and skin-type factors you cannot change. Understanding both halves helps you judge your own risk honestly.
UV damage accumulates, and intermittent intense exposure appears especially relevant to melanoma risk. That distinguishes melanoma somewhat from other skin cancers linked more closely to steady lifetime sun exposure.
Practical implications for Southwestern Ontario:
Certain profiles justify more structured screening rather than casual self-monitoring. Risk factors stack, so several mild factors can add up.
Risk factor Why it matters
Fair skin, light eyes, red or blond hair
Less melanin means less natural UV protection
Many moles, or several atypical moles
More melanocytes and more baseline abnormality to track
Family history of melanoma
Suggests inherited susceptibility in some families
Personal history of skin cancer
Previous diagnosis raises the likelihood of another
History of blistering sunburns or tanning bed use
Cumulative and intense UV damage
Weakened immune system
Reduced immune surveillance of abnormal cells
Outdoor occupation or extensive outdoor recreation
Higher lifetime and intermittent UV exposure
Important caveat: melanoma can occur in people with none of these risk factors, and it occurs in people with darker skin tones. Low risk is not zero risk.
Melanoma is the most serious skin cancer, but basal cell and squamous cell carcinomas are far more common, and they look different. Knowing the distinction helps you describe what you are seeing accurately.
Type Common appearance Typical behaviour
Melanoma
Dark, uneven, changing mole or new pigmented spot
Can spread beyond the skin if not addressed early
Basal cell carcinoma
Pearly or waxy bump, flat scaly patch, sore that keeps returning
Usually grows slowly and locally, rarely spreads
Squamous cell carcinoma
Firm red nodule, scaly crusted patch, non-healing ulcer
Locally invasive, spreads in a minority of cases
The practical takeaway: you do not need to self-diagnose which one you have. Any new, changing, or non-healing skin lesion is worth a clinical assessment. Sorting out the type is our job, not yours.
Yes, an existing mole can develop into melanoma, though many melanomas appear as entirely new spots instead. Both pathways are real, which is why you monitor both your existing moles and your overall skin.
What this means for how you check:
Real-world scenario: A patient asks us to remove eight harmless-looking moles "just to be safe." A more useful approach is usually a documented baseline of all of them, so we can identify which one is actually changing rather than excising seven that never would have.
Check your own skin once a month, and consider a professional skin assessment annually if you carry any meaningful risk factors. Frequency should scale with your personal risk profile, not with anxiety levels.
A reasonable framework:
Self-checks have real limits. They rely on memory, and memory is unreliable for small visual changes. Comparing a mole to a standardised photograph from six months ago is measurably easier than comparing it to a recollection.
Not sure whether what you are seeing matches these signs? A professional mole check and digital skin imaging assessment gives you a documented answer instead of an ongoing question.
We offer nurse practitioner-led skin assessment with digital mole mapping, so you can get a documented baseline of your skin without waiting on a specialist referral. Suitability for any assessment or procedure depends on your individual consultation.
You can book a skin assessment directly, without a family physician referral. For many patients in Southwestern Ontario, access is the actual barrier, not willingness.
What digital mole mapping provides:
Mole mapping is a monitoring and documentation tool. It supports clinical judgment; it does not replace biopsy, which remains the only way to confirm a diagnosis.
Pinkal Gandhi leads the clinic as a nurse practitioner, which shapes how we run assessments. In practice, that means longer appointments, direct explanation of what we are seeing, and a low threshold for onward referral when something needs specialist attention.
We will tell you plainly when a spot looks benign, when it needs monitoring, and when it needs a dermatologist or physician. We do not manage melanoma treatment, and we will not pretend otherwise.
We see patients from London and the surrounding communities, including St. Thomas, Woodstock, Strathroy, Ingersoll, and the wider Middlesex County area, where local access to timely skin screening is often limited.
Note on cost and coverage: Provincial coverage for skin assessments depends on the type of service and where you receive it. Ask us directly about current fees for mole mapping before you book, so there are no surprises.
Early-stage melanoma that has not spread beyond the skin is often treated successfully with surgical removal, and long-term outcomes are generally favourable. Outcomes depend on depth, location, and individual factors, so only your treating clinician can speak to your specific case.
On darker skin, melanoma more often appears on the palms, soles, under the nails, or inside the mouth. Watch for new dark patches in these areas or a dark streak under a nail, and get any change assessed promptly.
Coverage depends on the setting and the type of assessment provided, and it varies between physician visits and private clinic services. Contact us before booking and we will confirm the current fee structure for your specific appointment.
A regular skin check is a visual examination at one point in time. Mole mapping adds standardised photographic documentation, which makes small changes between visits far easier to detect than relying on memory.
A spot that has looked the same for many years is generally less concerning than one that has recently changed. That said, if you have never had it assessed, one baseline appointment can settle the question permanently.
If a spot on your skin has changed, do not spend another month watching it. A single assessment either resolves your concern or catches something while it is still straightforward to treat.
This article provides general information and does not constitute medical advice, diagnosis, or treatment. Please seek an in-person assessment for any skin change that concerns you, and seek prompt care for bleeding, rapid growth, pain, or a sore that will not heal.