Seeing your GP | Melanoma skin cancer

See your doctor if you develop a new mole or notice a change in an existing mole or area of your skin (including under your nail).

Even if you’re worrying about what this might be, you shouldn’t delay seeing them. Your worry is unlikely to go away if you don’t make an appointment. You won’t be wasting your doctor’s time. It might not be cancer. But if it is, the earlier a cancer is picked up, the more likely it can be treated successfully.

Getting the most out of your GP appointment

It can be difficult to remember everything you want to say and ask when you see the doctor. These tips will help you get the most out of your appointment.

Tips

• Make a note of when you first noticed the abnormal area of skin and if there have been any changes.
• Write down any questions that you have while you think of them.
• Bring a friend or relative – they could also ask questions and help you remember what the GP says.
• Tell your GP if you are worried about cancer in particular.
• Ask the GP to explain anything you don’t understand.
• Ask the GP to write things down for you if you think this might help.

What happens during your GP appointment

Your doctor will look at your mole or abnormal area of skin. They might:

• measure it with a ruler or against a marker scale
• take a photo so they can record any changes
• examine it closely with a dermatoscope (like a magnifying glass)

There are particular features of moles that they look out for, such as changes in size, colour and shape. And if there is any inflammation, bleeding or itching.

Depending on this, your doctor might:

• reassure you
• refer you to a skin specialist (dermatologist), or pigmented lesion clinic if there’s one in your area
• take a photograph and refer you to a teledermatology clinic

A pigmented lesion clinic is a dermatology clinic that specialises in picking up suspicious moles and diagnosing melanoma.

Teledermatology is a new pathway for referral, where a digital picture is taken and assessed by the skin specialist.

Ask your GP to explain if they don’t think you need a referral. They might ask you to come back in a couple of weeks or months so they can monitor your mole or abnormal area of skin. Go back any time if you notice any further changes.

Questions for your GP

• Do I need to see a specialist, is it urgent?
• When will I see them?
• Will I find out about my appointments by post or telephone?
• Will I need tests? What will they involve?

If they don’t think you need a referral

• Can you explain to me why I don’t need to see a specialist?
• Do I need to see you again?
• What changes should I look out for?

What happens next

Make sure you know what happens next. Make another appointment if you notice any more changes to your mole or skin, or you are still concerned.

How to find a GP

If you don’t have a GP, you can find a doctor’s surgery in your local area by going to:

Making a GP appointment

To make an appointment to see your GP you:

• can telephone your GP practice
• book an appointment online through your GP practice website (if they have one)
• may be able to use the NHS App

Try different times of the day if it’s difficult to get through by phone. It could be particularly busy at the beginning of the day. You don’t have to tell the receptionist what you want to see the doctor for, although sometimes it might help to explain your situation.

You might be able to go in person to book an appointment at some GP practices. But at the moment most practices do not provide this service. It may help to see if your GP practice has a website. This will explain the best way to get an appointment.

The receptionist at your GP’s practice may offer you a telephone or video appointment first. Your GP will ask you to make another appointment if they need to see you again. You may be asked to attend in person, especially if they need to examine you. The receptionist will give you a date and time for this.

Accept a booked appointment, even if you think it’s a long time to wait. You could ask about cancellations if you are able to get to the practice at short notice. Do check that they have the right contact details for you, including your telephone number and email. 

• Suspected cancer: recognition and referral
  National Institute of Health and Care Excellence (NICE), June 2015

• Scottish referral guidelines for suspected cancer
  The Scottish Government, 2019

Last reviewed: 

25 Mar 2020

Next review due: 

23 Mar 2023

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Risks and causes of melanoma skin cancer

Your risk of developing melanoma depends on many things including lifestyle factors and some medical conditions. In the UK, around 85 out of 100 melanomas (around 85%) are caused by too much ultraviolet radiation. 

Melanoma skin cancer is the 5th most common cancer overall in the UK. The number of people diagnosed with melanoma has increased over the last few decades. 

Anything that can increase your risk of cancer is called a risk factor. Those that lower the risk are called protective factors.

Having one or more risk factors doesn’t mean that you will definitely get melanoma.

Age

The risk of melanoma increases with age. So it’s more common in older people. In the UK, more than 25 out of 100 people (more than 25%) diagnosed with melanoma are aged 75 and over. But, younger people can also develop it. Compared to most other cancer types, it’s also quite common in younger people. 

Ultraviolet light

Ultraviolet light (radiation) is the main environmental factor that increases the risk of developing melanoma. Ultraviolet light comes from the sun or sunbeds. In the UK, around 85 out of 100 melanomas (around 85%) are caused by too much ultraviolet radiation. 

Intermittent sun exposure

Some people are exposed to strong sunlight every now and then, like holidaying in a hot country. They are more at risk of melanoma than people who are very regularly exposed to sunlight, like people who work outdoors.   

In the UK, most people are not exposed to the sun for the whole year. But the number of people getting melanoma has increased considerably in the UK since it became popular to holiday abroad for a few weeks each year and get a sun tan.

It is also important to be careful during hot spells in the UK.

Sunburn

Sunburn increases the risk of melanoma.

People who have had sunburn are more likely to get melanoma than those who have not. The risk is higher if you have had sunburn several times in your life. This increase in risk is seen with sunburn at all ages, not just in childhood. 

Sunbeds

Research shows that the type of ultraviolet light used in sunbeds (UVA) can cause all types of skin cancer. The International Agency for Research into Cancer (IARC) has classified using sunbeds as a cause of melanoma.

People have an increased risk of melanoma if they’ve ever used a sunbed. And the risk is highest for people who use a sunbed before the age of 35. Sunbed use by under-18s is banned in Scotland, England and Wales, and Northern Ireland. 

Using a sunbed to get a tan before you go on holiday can also increase the risk of melanoma. There is no such thing as a safe tan. 

Sunscreen

It is difficult to study how sunscreen affects the risk of melanoma. This is partly because people who use sunscreen may stay longer in the sun because they think they are protected. So they actually get more exposure to ultraviolet light overall.

The best way to enjoy the sun safely and protect your skin is to use a combination of shade, clothing (including sunglasses) and sunscreen. 

Shade and clothing are more effective than sunscreen at protecting your skin. Sunscreens shouldn’t be used to spend longer in the sun, but they can be useful for protecting the parts of skin not covered by clothing or shade.

Skin colour and freckling

Your skin type and colour affect your risk of developing melanoma. If you tend to burn in the sun, you’re more at risk. 

People who are very fair skinned, especially with fair or red hair, are more at risk of developing melanoma. So are people with a lot of freckles. People with darker skins can still get melanoma but they have more natural protection against it.

It’s rare for black people in the UK to get melanoma. If African or Asian people do get melanoma, it’s most often a type of melanoma that develops on the soles of the feet or the palms of the hands (acral lentiginous melanoma). This type of melanoma can also grow under the nail.

Moles

The more moles you have on your body, the higher your risk of melanoma. One study found that melanoma risk was higher in people with more than 100 common moles, compared with people with fewer than 15 moles.

This doesn’t mean you will definitely get melanoma if you have lots of moles. But it does mean you should be very careful about exposing yourself to the sun. And you should keep an eye on all your moles.

People who have lots of unusually shaped or large moles (atypical mole syndrome) have a higher risk of melanoma than the general population. A large mole is one greater than 5mm in diameter.

Birthmarks

Birthmarks are coloured marks on the skin and there are many different types. Different types of birthmarks are made up of different types of cells.

Most birthmarks, such as the common port wine stains and strawberry marks, carry no risk of developing into a cancer. But a very rare type, called a giant congenital melanocytic naevus, can develop into a melanoma if it is larger than 20cm.  

Doctors recommend that you check all birthmarks regularly for any signs of change. But they recommend removing large congenital birthmarks at an early age if possible.

If it’s not possible to remove the birthmark, it needs to be checked regularly. UK guidelines recommend that people who have large congenital melanocytic naevi should have regular checks by a skin specialist (dermatologist).

Family history and genetic factors

Your risk of melanoma is higher if you have a close relative who has had melanoma. This is probably partly because we tend to share the same sort of colouring and skin type as our close relatives.

Your risk is highest if:

• your relative had melanoma when they were younger than 30 
• more than one first degree relative (brother, sister, mother, father, child) have had melanoma

Genetic factors

Some families tend to have large numbers of moles, or moles that are unusual (atypical moles). The atypical moles tend to be an irregular shape or colour and may be larger than usual. 

An inherited condition called familial atypical multiple mole melanoma syndrome (FAMMM) increases your risk of getting melanoma.  

People with FAMMM have:

• many moles, some of which are unusual (atypical) and often different sizes
• at least one close relative who’s had melanoma (a close relative is a parent, brother, sister, child, aunt, uncle or grandparent)

Some families with FAMMM are also at a higher risk of developing pancreatic cancer.

Scientists think that around 10 out of 100 cases of melanoma (10%) might be linked to inherited faulty genes. A gene called CDKN2A is known to cause FAMMM. For the small number of families who carry these genes, sun protection is even more important.

Other medical conditions

Research has shown that some medical conditions increase your risk of getting melanoma. 

Inflammatory bowel disease (IBD)

Inflammatory bowel disease includes illnesses like Crohn’s disease and ulcerative colitis. The risk of melanoma skin cancer is higher in people with these diseases. 

Treatment for inflammatory bowel disease might include drugs that suppress the immune system, which we know can increase the risk of some cancers. But the research shows an increase in melanoma risk even when people have not taken these drugs.

Weakened immune system

Your immune system protects the body against illness and infection. Studies have shown that people with weakened immunity are more likely to develop melanoma.

You might have a weakened immune system due to:

• HIV or AIDS infection
• medicines to suppress the immune system (immunosuppressants) – for example, after an organ transplant

Body weight

Some studies show an increased risk of melanoma in men with a higher body mass index (BMI). This wasn’t seen in women.

But any study looking at the risk factors for melanoma needs to take into account how much time the people have spent in the sun. It might be that women with a larger body mass index have less sun exposure than women with a lower body mass index. So this could be why their risk is lower.

Other possible causes

Stories about potential causes are often in the media and it isn’t always clear which ideas are supported by evidence. There might be things you have heard of that we haven’t included here. This is because either there is no evidence about them or it is less clear.

For detailed information on skin cancer risks and causes

• Melanoma skin cancer risk
  Cancer Research UK
  Accessed March 2020

• International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans
  Volumes 1 to 119.
  Accessed by Cancer Research UK, September 2017.

• The fraction of cancer attributable to known risk factors in England, Wales, Scotland, Northern Ireland, and the UK overall in 2015.
  KF Brown KF and others 
  British Journal of Cancer 2018. 

• Estimating the attributable fraction for melanoma: a meta-analysis of pigmentary characteristics and freckling.
  CM Olsen  and others
  Int J Cancer 2010;127:2430-45.

• Familial melanoma by histology and age: Joint data from five Nordic countries.
  M Fallah and others
  Eur J Cancer. 2014 Apr;50(6):1176-83.

• Inflammatory Bowel Disease Is Associated With an Increased Risk of Melanoma: A Systematic Review and Meta-Analysis.
  S Singh and others
  Clin Gastroenterol Hepatol 2013 doi: 10.1016/j.cgh.2013.04.033.

• The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact [email protected] with details of the particular issue you are interested in if you need additional references for this information.

Last reviewed: 

18 Mar 2020

Next review due: 

18 Mar 2023

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species, which are dangerous, melanoma prevention

I heard that some moles can turn into skin cancer, and it is important to detect this at an early stage. Because of this, I twitch about every dubious mole – new or old. How to understand that a mole is malignant, and then where to turn for help?

Valentina

This material was updated on 08/31/2021

Some moles can indeed develop melanoma, one of the types of skin cancer. This is signaled by a change in the size, shape and color of the mole, as well as inflammation of the skin around it: redness, itching or soreness. If you notice something similar, you should contact an oncologist.

Anastasia Gorbunova

medical journalist

Author profile

Let me explain in more detail what melanoma can look like, what increases the risk of its development and how to conduct a self-diagnosis at home.

What are moles

Moles are pigmented formations. If the moles are large, then they are usually called birthmarks, and if they protrude above the surface of the skin, then they say that they are “on a leg”. In fact, they are all one and the same. In medical literature, a mole is called a nevus.

Nevi – MSD International Medical Guide

Moles may appear as a cluster of small nodules, evenly or unevenly pigmented spots, with a clear or indistinct border, with a halo without pigmentation around or without it, as one large nodule protruding above the skin. The color of moles varies: light, dark brown, closer to black, or with red patches. The photographs below show different types of moles.

Moles usually occur in children or adolescents, rarely in adulthood. During puberty, new moles appear frequently, and existing ones may grow and darken. Sometimes moles change with age: they become softer and flabby, or, conversely, more dense and less pigmented.

How a mole can be dangerous

Only one of several thousand moles degenerates into melanoma, a type of skin cancer. But this is still possible.

Melanoma – International Medical Guide MSD

An increased risk of developing melanoma is noted in people who have more than 50 moles, and there is also a tendency to the appearance of new ones in adulthood, especially after 30 years. The likelihood of melanoma also increases if you are often in the sun with bare skin and without sunscreen, sunbathing in a solarium, or if you have had sunburn in the past.

In addition to melanoma, there are other types of cancer, such as squamous cell carcinoma or basal cell carcinoma. These are different skin cancers, and they have different treatment tactics, outcomes and prognosis. Skin melanoma is less common but develops rapidly, so it is important to detect it as early as possible.

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Which moles are normal

All are normal except melanoma. Melanoma is distinguished by some signs by which you will understand which moles are dangerous.

Which moles are dangerous

The external signs that distinguish melanoma from an ordinary mole are easy to remember with the help of the abbreviation ACCORD:

How to check your moles yourself

all moles: this will help you notice changes in time. It is best to undress completely and use a large full-length mirror along with a small hand mirror: through the reflection in the reflection, it is convenient to view the back of the neck, scalp, back and buttocks.

In order not to forget anything, examine the body in this order:

1. Front of the body, back, then sides with arms raised up.
2. Arms: shoulders, forearms, armpits and palms.
3. Legs: thighs, shins, buttocks, feet and area between the toes.
4. Head and neck. Hair will need to be divided into sections with a thin comb.

The main reason to be wary is the appearance of new moles if you are over 30 years old, or changes in existing ones. The risk is increased if there is a family history of skin cancer. To assess whether any changes have occurred, photograph the moles during the examination and fix the date, and then compare the photos taken in different months.

Atypical nevi – international medical reference MSD

For suspicious moles, you can additionally get a special card – this is such a schematic illustration of the body where you can mark their location and record information about color, shape and size. The American Academy of Dermatology offers a checklist for this with a map of moles.

American Academy of Dermatology Mole Checklist and MapPDF, 5.5 MB

Number 1 is the characteristic signs that you should pay attention to when examining moles. Number 2 shows how to conduct a self-examination. And under the number 3, it is proposed to fill out a map of moles and enter information about them in the table. Source: American Academy of Dermatology Examination Guide and Mole Map

What to do if there are doubtful formations

If you notice at least a couple of signs of the degeneration of a mole, you should consult a doctor. The same should be done if a large birthmark has changed its shape or color. It is best to go to an oncodermatologist so that he immediately examines the moles using a dermatoscope – a device with high magnification.

But such an examination can also be carried out by a regular dermatologist. Just check with the clinic before making an appointment if dermatoscopy is included in the list of services. You can go to any paid clinic, and according to the CHI policy, you can get an examination for free at the cancer center. If the mole needs to be removed, it can be done in the same place, in the cancer center, according to the MHI.

A painful, itchy, or bleeding mole is another reason to see a doctor as soon as possible. The oncologist will examine the mole and, if necessary, prescribe a biopsy – a tissue study that will show if there are malignant cells there. This will help determine the next steps: whether the mole needs to be removed and in what way.

/cancer-screening/

How to detect cancer early

How to prevent melanoma

The American Cancer Society recommends avoiding UV exposure. The risk of developing skin cancer is increased by exposure to the sun or artificial light sources such as tanning lamps.

Can melanoma be prevented – American Cancer Society Blog Article

Ultraviolet acts as a mutagen that causes skin cells to divide randomly – this is how melanoma develops. To be on the safe side, follow these guidelines:

1. Minimize exposure to bright midday sun to 30 minutes or less. In summer, in areas with a temperate or sharply continental climate, it is better to go outside only before 10 am and after 3 pm.
2. Wear sun-blocking clothing: sleeved shirts, long dresses and trousers, hats or baseball caps, and sunglasses.
3. Use sunscreen with SPF 30 or higher. A cream or spray should be applied half an hour before going outside and reapply after two hours and every time after swimming or playing sports, even if the product says that it is waterproof.

Another risk factor is mechanical injury. Moles that protrude above the surface of the skin are sometimes damaged due to rubbing of clothing or when they are accidentally caught on something. Injuries can lead to the degeneration of a mole into a malignant tumor.

Skin Biopsy – Mayo Clinic Blog Article

To avoid this, uncomfortable moles are removed with a laser or scalpel. Sometimes beauty salons offer mole removal services, but it is better to carry out the procedure in specialized rooms with doctors: they will immediately examine the tissues of the removed mole to make sure that there were no malignant cells in it.

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Moles: should we be afraid?

Almost everyone has some number of moles, which usually appear in childhood and adolescence.

Almost everyone has some number of moles that usually appear during childhood and adolescence. The medical name is nevus (naevus maternus), a malformation of the skin, in which certain parts of it differ in color and / or a special warty appearance of the surface.

Many skin and subcutaneous neoplasms are quite common, and a careful examination by an oncologist is sufficient for a preliminary diagnosis. Most skin tumors are benign, but malignant tumors are also not uncommon, so early and accurate diagnosis is extremely important.

To provoke a mole to rebirth, of course, a push, an irritant is needed. The strongest irritant of all possible is excessive exposure to the sun.
Ultraviolet irradiation in high doses causes irreversible changes in skin cells, greatly increasing the risk of their degeneration. For each person, the critical amount of insolation is purely individual. It is not easy to determine this line, so it is better to just remember that prolonged exposure to the sun is harmful to the body. The skin is forced to protect itself from ultraviolet radiation. Excessive tanning is inevitable burns that “hit” the skin’s immunity.

The second common cause of tumor development is trauma to the mole. Therefore, if you touched it with your fingernail, inadvertently damaged it with a washcloth, with some sharp object, especially if these injuries are permanent (for example, from underwear), be sure to see a doctor. Teach your children from childhood to take care of small marks on the skin.
Because birthmarks are very common and melanomas are rare, prophylactic mole removal is not warranted. Look at the mole at an angle, take a magnifying glass: a uniform color, a smooth edge, a transition of the “skin pattern” from an area with a normal color to a pigmented area, the presence of hair is a good sign.

However, if the mole suddenly increases in size (especially if there are uneven edges), darkens, becomes inflamed, becomes mottled, starts to bleed, ulcerates, itches or hurts, the “lacquer” surface of the mole, the special pattern of the edge – alarm!
Having found possible signs of degeneration of a mole, be sure to consult an oncologist.

It is important to remember that all removed moles are subject to mandatory morphological (histological) examination, because the final diagnosis for the morphologist. Only he, through a microscope, knows the danger in person.

Signs of malignant transformation of pigmented neoplasms according to the “BLOW” scheme:

• Growth acceleration
• Diameter over 6 mm
• Asymmetry, irregular shape
• Multicolour, change in color of one of the sections

More than a hundred oncological diseases are known to science, but melanoma among them is the recognized “insidious and evil queen”. The insidiousness and aggressiveness of this type of skin cancer is unparalleled. Once having arisen, the disease can imperceptibly develop in the superficial layers of the skin for 5–50 (!) years. Then, having chosen the weakest place on the skin – a mole or a pigment spot, single cells of a ripening tumor begin to grow in depth.

In order not to start the problem, you just need to be a little more attentive to yourself and not miss the first alarming symptoms. About how serious your concerns are, you need to consult with an oncologist. Self-treatment of age spots and moles is dangerous, but self-examination is welcome!
If you have even a slight suspicion, you should visit an oncologist. In such situations, correspondence consultations and consultations of cosmetologists are unacceptable!

What are moles?

Lentigo (marginal) is a flat, evenly pigmented brownish-brown to black patch resulting from an increase in the number of melanocytes at the border of the epidermis and dermis (skin layers). Compared to freckles, lentigines are darker and less common; moreover, their color does not increase and the number does not increase under the influence of solar radiation.
Epidermal-dermal nevi – usually flat, but sometimes slightly raised above the level of the skin. Coloring from light brown to almost black, sizes – from 1 to 10 mm. Birthmarks on the palms, soles, and genital area are usually epidermal-dermal.
Complex nevi – more often have a dark color due to the accumulation of melanocytes and to some extent rise above the level of the skin.
Intradermal nevi elevated above skin level; their color varies from flesh to black, and the surface may be smooth, hairy, or warty.
Sutton’s nevi are pigmented birthmarks (usually complex and intradermal nevi) surrounded by a ring of depigmented (unstained) skin. Sutton’s nevi disappear spontaneously, and only in rare cases give rise to malignant melanomas.
Dysplastic nevi are pigmented spots of irregular shape and indistinct borders, slightly elevated above the level of the skin, their color varies from reddish-brown to dark brown on a pink background.