When to Worry About a Spot on Your Skin: Trust Your Gut

We’ve all been there: standing in front of the mirror, catching sight of a new freckle or mole, and wondering, “Is that normal?” It’s natural to feel a twinge of concern, especially given the seriousness of skin cancer like melanoma.

You may have heard of the famous ABCDEs of Melanoma—a powerful tool that outlines the signs of potential trouble: Asymmetry, Border irregularity, Color variation, Diameter (larger than 6 mm), and Evolution. And while knowing these criteria is a valuable starting point, frankly, I don’t expect you to be evaluating every single mole on your body against this five-point checklist. That’s a dermatologist’s job!

As a healthcare professional, I believe the most practical and effective advice for my patients boils down to a single principle: Trust Your Gut.

The Single Most Important Rule: E is for Evolution

Out of all the ABCDEs, E for Evolution (Change) is the one I want you to focus on.

Melanoma is dangerous because it often changes rapidly. The most important thing you can do as a patient is to be a good observer of your own skin. You are the person who sees your skin every day—you are uniquely positioned to spot a subtle change that a doctor might not notice on an annual visit.

The practical advice I give every patient is this:

If, one day, you look at a spot on your skin—whether it’s a mole, a bump, or just a patch of discoloration—and it strikes you as concerning because you don’t remember it looking that way before, go with your gut and see a dermatologist.

This “gut feeling” is often your best defense. It’s an instinctive signal that something has evolved or changed.

What Does “Evolution” Look Like?

Evolution doesn’t just mean a change in size. It can refer to any change in the physical attributes or symptoms associated with a spot:

• Color Change: A spot that has gone from light brown to very dark brown, black, or has developed multiple colors (red, white, blue).

• Size Change: A mole that has grown noticeably larger or thicker over weeks or months.

• Shape Change: A spot that used to be a simple circle but is now asymmetrical or has an irregular border.

• Symptom Change: A spot that starts to bleed, itch, become painful, or refuse to heal.

• Feeling Different: A mole that suddenly feels raised, rough, or firm.

Why Your Gut is Your Best Tool

Think of your skin check as a personal inventory. When you spot something new or different, it breaks the pattern of familiarity. You don’t need to memorize the $6\text{mm}$ diameter of a pencil eraser; you just need to realize, “I feel like this spot didn’t used to be this color or size.”

The bottom line is simple: When in doubt, check it out.

Even if you come in and the spot is completely benign (which is true most of the time!), we are always happy to check it. We can perform a quick, non-invasive examination called a dermoscopy, and if necessary, schedule a simple biopsy to put your mind at ease.

Don’t ignore that feeling of unease. Your vigilance is a powerful tool in catching skin cancer early, when it is most treatable. Schedule a screening today.