Melanoma is the most dangerous form of skin cancer, but the numbers on early detection are striking. Five-year relative survival is greater than 99% when the disease is still confined to the skin, compared with 36% once it has spread to distant organs such as the lungs, liver or brain, according to the American Cancer Society. Those figures are based on people diagnosed between 2015 and 2021.
Skin cancer is the most common cancer in the country. The American Academy of Dermatology estimates that one in five Americans will develop it in their lifetime, and roughly 234,680 new cases of melanoma are projected for 2026.
The good news is that suspicious moles are something you can look for yourself. Both the ACS and the AAD recommend using the ABCDE rule during a monthly at-home skin check.
The ABCDE rule, letter by letter
A - Asymmetry. One half of the mole does not match the other. A benign mole is usually roughly symmetrical, so an off-balance shape is worth a second look, per the ACS guidance on melanoma signs.
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B - Border. The edges are irregular, ragged, notched or blurred, rather than smooth and clearly defined.
C - Color. The color is not the same all over. A single spot may include different shades of brown or black, or patches of pink, red, white or blue.
D - Diameter. The spot is larger than 6 millimeters across, about the size of a pencil eraser. Melanomas can sometimes be smaller than this, so a small spot with other warning signs still deserves attention.
E - Evolving. The mole is changing in size, shape or color. New symptoms such as itching or scabbing also count as evolution and should be checked by a clinician, notes the Cleveland Clinic.
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Other signs the ABCDE rule can miss
Not every melanoma fits neatly into those five letters. The ACS points to several other changes that warrant a dermatologist visit: a sore that does not heal, pigment spreading from the edge of a spot into surrounding skin, a new itchiness, tenderness or pain, and any scaling, oozing, bleeding or a lump appearing on the surface of a mole.
There is also the so-called ugly duckling sign, a spot that simply looks different from all the others on your skin. On a body with dozens of freckles and moles, the one that stands out from the crowd is often the one to show a doctor.
How to check yourself, and when to make an appointment
The Cleveland Clinic recommends examining your skin about once a month, ideally after a bath or shower. Use a full-length mirror and a hand mirror to see the back, scalp, soles of the feet and between the toes.
Book an appointment with a board-certified dermatologist if you notice a new spot that looks different from the others, or one that is changing, itching or bleeding, the AAD advises. A mole that meets any single ABCDE criterion is reason enough to have it checked. Dermatologists warn that some skin cancers do not look like moles at all, so any persistent, unexplained skin change is worth a professional opinion.
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The math is unambiguous. A spot caught while melanoma is still localized carries a five-year survival rate above 99%. That number is the reason a five-minute check in the bathroom mirror is worth doing.
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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.