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When to Make a Mountain Out of a Mole

by Dr. Payal Adhikari – July 31, 2013

Chicago summer is finally here!  As the thermometer hits the 90s and bikinis make their debut, your skin and its moles become more noticeable than the covered days of winter.  Moles can be cute (Hey hey, Cindy Crawford!), but they can also be dangerous.  It’s important to know when it’s time to get those buggers checked out.

To make learning easier, doctors often use memory games – Fortunately, there’s an easy one to help distinguish benign (safe) moles from potentially dangerous, a.k.a. cancerous, ones…It’s the ABCDEs.

Asymmetry – Most benign moles are symmetrical, i.e. if you draw a line through the center of the mole, each side would look like mirror image of the other side.

Border irregularity – Benign moles usually have smooth borders, while potentially dangerous ones have irregular, jagged, or blurry edges.

Color – Simple moles are usually homogenous in color; They may lighten or darken, but are one hue at any given point in time.  Cancerous moles are more likely to have multiple colors at the same time.

Diameter – Rule of thumb: Smaller = better.  Generally, any mole larger than 6mm in diameter (the size of a pencil eraser tip) should be evaluated.

Evolution – While generally change is good, change is bad in the assessment of moles.  Pay attention to how your moles look, and if the appearance changes, it’s time to get it checked out.

Skin Exam: So now that you’re a dermatologist-in-training, it’s time to do a thorough skin evaluation. All you need is a well-lit area with mirrors and your naked self.  Start from the top and work your way downward.  Check EVERYWHERE, including your scalp, underarms, between your fingers and toes, and your private areas.  Use a hand mirror for the hard to see places. Take note of all moles, and keep a diary of their characteristics (location, size, shape, color, borders, etc). Repeat the exam regularly, and get checked out if you notice any of the ABCDEs above.

While most moles are harmless, new studies show that they don’t all follow the ABCDE rules – So if you do find any, it’s prudent to see a dermatologist for a baseline visit.  Remember that melanoma (skin cancer) is related to sun exposure, so always protect your skin – See my Cheeky “Sun-Soaked and Screened” article for tips!


Normal mole – Small, symmetrical, smooth borders, one color.

Abnormal mole – Larger than 6mm diameter, asymmetrical with irregular borders, variation in colors.

Abnormal mole – Larger than 6mm diameter, asymmetrical with irregular borders, variation in colors.

About the Author: Dr. Payal Adhikari

Payal is a pediatrician at Child and Adolescent Health Associates in the Gold Coast and loves all things healthy. Born and raised in Chicago, she moved to Singapore for high school and returned to her favorite Chi-city to attend Northwestern University.