Table of ContentsView AllTable of ContentsABCDEsAsymmetryBorderColorDiameterEvolvingOdd MolesHow It SpreadsEnd StagePreventionWhen to Seek Care
Table of ContentsView All
View All
Table of Contents
ABCDEs
Asymmetry
Border
Color
Diameter
Evolving
Odd Moles
How It Spreads
End Stage
Prevention
When to Seek Care
The ABCDEs of melanoma stand for Asymmetry, Border irregularity, Color variation, Diameter larger than a pencil eraser (1/4 inch), and Evolving in size, shape, or color. Early-stage melanoma may look like amolethat changes in appearance, with uneven borders or multiple colors.
You can live with melanoma for months or even years without realizing it, asearly stagesoften go unnoticed. However, melanoma can become life-threatening if it spreads to other parts of the body. Regular skin checks and early detection are key to improving survival rates.
1:50The ABCDE Rule of Melanoma
1:50
The ABCDE Rule of Melanoma
What Are the ABCDEs of Melanoma?
The ABCDEs of melanoma are a common way to remember the signs of early melanoma. Look out for these signs:
You don’t have to have all the ABCDEs for a mole to be melanoma. Even if a mole only exhibits one or a few of these characteristics, it could still be a sign of melanoma.
Can Melanoma Occur Without a Mole?Not all melanomas begin as moles. In fact, about 20% to 30% of melanomas begin in moles while the rest begin in seemingly normal skin. Some types of melanoma may be confused for acne, age spots, or another benign (non-cancerous) lesion.
Can Melanoma Occur Without a Mole?
Not all melanomas begin as moles. In fact, about 20% to 30% of melanomas begin in moles while the rest begin in seemingly normal skin. Some types of melanoma may be confused for acne, age spots, or another benign (non-cancerous) lesion.
A = Asymmetry
Skin Cancer Foundation
Unlike healthy moles, melanomas are not symmetrical. One half does not match the other half in:
In this picture, the left side is much thicker and darker than the right.
B = Border
While a normal mole has a smooth, consistent border, the border of a melanoma can be:
The pictured melanoma has a scalloped and notched border.
C = Color
The color of melanoma isn’t consistent. It can have shades of:
In this picture, the right side is dark black and the left side is tannish-red.
D = Diameter
Melanomas grow. Normal moles don’t. Melanomas tend to be larger, with a diameter of more than 6 mm. For perspective, 6 mm is just under 1/4 inch or about the size of a pencil eraser.
E = Evolving
This photo contains content that some people may find graphic or disturbing.See PhotoAmelanotic nodular melanoma.https://dermnetnz.org/topics/amelanotic-melanoma-images/?stage=Live
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
https://dermnetnz.org/topics/amelanotic-melanoma-images/?stage=Live
The “E” in the ABCDE guide stands for “evolving.” That’s because melanomas change in size, shape, color, and thickness over time. Different types of melanomas grow at different speeds, so it’s important to monitor your skin carefully and frequently for subtle changes.
Ugly Duckling
Most normal moles on your body resemble one another. So along with checking for irregularities in spots on your skin, you should also check for any spots that look different than neighboring moles.
Other Warning Signs
How Quickly Does Melanoma Spread?
Some types of melanoma, such asnodular melanoma, can grow from nothing to pencil eraser-size in a matter of weeks.Other types of melanoma, such aslentigo maligna, can grow for five to 20 years without being recognized.
The rate of spread varies depending on factors like the type and thickness of the melanoma, and the overall health of the affected individual. Early detection and treatment are crucial for improving outcomes and preventing further spread.
What Organs Does Melanoma Spread to First?
When Is Melanoma Too Late?
Melanoma is difficult to cure when it reaches stage IV. By this stage, the melanoma will have spread to other parts of the body, including distant lymph nodes and organs.
Approximately 50% of people with stage IV melanoma develop metastasis to the brain. The prognosis for brain metastasis is quite poor, with a median overall survival of about three months.
Overall, about 15% to 28% of people diagnosed with stage IV melanoma survive five years after their diagnosis.
How to Check Yourself for Skin Cancer
The American Cancer Society recommends doing a skin self-exam once a month, especially if you are at a higher risk of skin cancer. This includes:
Before you start the self-exam, make sure you have the following:
Then, follow these steps to do the self-exam:
Trust your instincts. Don’t hesitate to see a healthcare provider if something seems off.
When to See a Healthcare Provider
The appearance of a new, unusual spot or mole should also be checked out. Such changes can be signs of melanoma andother forms of skin cancer, includingbasal celland squamous cell carcinomas.
Summary
Normal moles are symmetrical, small, and usually flat. They have a smooth border and consistent coloration. Melanomas are often asymmetrical, larger than 6mm, and elevated. They have irregular borders and inconsistent coloring. Melanomas change over time. Normal moles don’t.
You should keep an eye on your moles. But don’t trust your health to a self-exam. If anything about a mole seems off or changes, get it checked. An early melanoma diagnosis meansearly treatmentwhich gives you a better outlook.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Cancer Institute.Moles to melanoma: Recognizing the ABCDE features.
Garrison Z, Hall C, Fey R, et al.Advances in early detection of melanoma and the future of at-home testing.Life (Basel). 2023 Apr;13(4):974. doi:10.3390/life13040974
American Academy of Dermatology Association.Skin cancer incidence rates.
National Cancer Institute.Melanoma cells are more likely to spread after a stopover in lymph nodes.
Skin Cancer Foundation.Melanoma warning signs.
American Cancer Society.Signs and symptoms of melanoma skin cancer.
Coroiu A, Moran C, Davine J, et al.Patient-identified early clinical warning signs of nodular melanoma: a qualitative study. BMC Cancer. 2021 Apr;21(1):371. doi:10.1186/s12885-021-08072-4
Menzies S, Liyanarachchi S, Coates E, et al.Estimated risk of progression of lentigo maligna to lentigo maligna melanoma.Melanoma Res. 2020 Apr;30(2):193-197. doi:10.1097/CMR.0000000000000619
City of Hope.Metastatic melanoma.
Hu HP, Archer C, Yip D, Peters G.Clinical predictors of survival in real world practice in stage IV melanoma.Cancer Rep. 2023 Feb;6(2):e1691. doi:10.1002/cnr2.1691
American Cancer Society.How to do a skin self-exam.
American Academy of Dermatology.Moles: Overview.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
