The Early Signs of Skin Cancer You Should Never Ignore

In my years specialising in dermato-oncology, the cases that concern me most are not the complex ones — they’re the patients who waited. Skin cancer, particularly melanoma, is almost always curable when diagnosed early. The five-year survival rate for localised melanoma is over 98%. For distant-stage melanoma, it drops to 30%. Early detection is everything.

The ABCDE rule

The ABCDE criteria are the simplest tool you have for self-monitoring your moles. A — Asymmetry: one half does not match the other. B — Border: irregular, ragged, or blurred edges. C — Colour: variation within the same lesion (brown, black, red, white, or blue). D — Diameter: larger than 6mm (roughly the size of a pencil eraser), though melanomas can be smaller. E — Evolving: any change in size, shape, colour, or any new symptom like bleeding or itching. Any mole that satisfies one or more of these criteria warrants professional examination.

What about non-melanoma skin cancers?

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are far more common than melanoma and rarely life-threatening — but they should not be ignored. BCC typically appears as a pearly or waxy bump, or a flat flesh-coloured lesion, often on sun-exposed areas. SCC often looks like a firm red nodule or a flat lesion with a scaly, crusted surface. Any non-healing sore or wound that bleeds, crusts, and re-opens repeatedly over more than 4 weeks should be assessed.

Who should get screened?

I recommend annual full-body dermoscopic examinations for: anyone with a personal or family history of skin cancer; people with fair skin, light eyes, or red/blonde hair; those with more than 50 moles; people with a history of significant sunburns, especially in childhood; and anyone who uses or has used tanning beds. If you’re not in a high-risk group, a self-examination monthly plus a professional check every 2–3 years is reasonable.

How to perform a self-examination

Use a full-length mirror and a hand mirror. Examine your entire body systematically — scalp, face, neck, chest, arms (including underarms and palms), abdomen, back, buttocks, legs (including soles and between toes), and genitals. Photograph suspicious lesions with a ruler for size reference and monitor over 4–6 weeks. If anything changes, book an appointment immediately.