Can you pick a melanoma? Inked skin needs closer attention.


Can you pick the melanoma in the above TATTOO?


Patients will generally ask “What should I be looking for?”. Here is Dr INK’s quick tour of melanoma diagnosis and finding the clues to an abnormal looking mole.

The first sign of a melanoma is usually the appearance of a new spot, or a change in an existing freckle or mole. The change may be in size, shape or colour and is normally noticed over several weeks or months.

Melanoma can be deadly so its important that Australia’s remain vigilant and learn to recognize signs of abnormal moles so we can diagnose and cut them out before they spread.

 The ABCDE guidelines provide a very useful way to monitor your skin and detect the early signs of melanoma. So here is what to look for?

 Asymmetrical skin lesion. Both sides of the lesion are not the same.

 Border of the lesion is irregular. You can detect a scalloped or poorly circumscribed border.

 Colour: Melanomas usually have multiple colours. You may see shades of tan and brown, black, red, white or blue.

Diameter: Moles greater than 6mm are more likely to be melanomas than smaller moles.

Enlarging: Enlarging or evolving. You notice the mole increasing in size.

Unfortunately not all melanomas follow these rules and some are very difficult to pick. In particular, a type of melanoma called nodular melanoma is a fast-growing, aggressive form of melanoma, which has poorer treatment outcomes and survival. These melanomas often begin as a red nodule. While their appearance can be mistaken for a pimple, they are much firmer to touch.

 The Addition of the EFG helps identify these lesions.


Elevated: the lesion is raised above the surrounding skin.

Firm: the nodule is solid to the touch.

Growing: the nodule is increasing in size.

 How Doctors use Dermatoscopy to see more.

A skin Doctor should carry a dermatoscope just like they carry a stethoscope. It’s an essential tool for skin medicine.


The use of a dermatoscope in clinical practice has been shown to increase diagnostic accuracy and is considered the standard of care in assessing patients with pigmented skin lesions.  Skin Doctors have the ability to magnify moles 100x and  clinical training in dermatscopy gives them the ability to look for clues and patterns in the moles that improve their ability to diagnose.

When in Doubt, cut it out.

Unfortunately, the surgeons do have it right on this one. Doctors often aren’t sure themselves in many cases and in any cases of uncertainty a biopsy should be performed. Skin Biopsy for pigmented lesions should involve cutting it out and sending it to pathology for a diagnosis.

Get started today – skin check tips and how to be systematic in self examination.

•   Stand in front of a full length mirror in a well lit room. Good lighting is important.

•   Be systematic and start at the top and work your way down your body.

•   Move to your face and neck, not forgetting your ears, nostrils and lips.

•   Be sure to check both the top and underneath of your arms. Don’t forget your fingernails.

•   As you move down your body don’t forget to check places where the sun doesn’t shine! Melanoma can be found in places that do not have exposed skin. Such as under your feet!

•   Ask a partner or family member to help especially with checking your scalp and back.

 Is there an APP for this?

As awareness of melanoma has increased and consumers have taken a more active role in their own health care, the technological world has responded with multitude of  smartphones APPS which can even turn into diagnostic medical instruments with software designed to “autodiagnose” skin cancers.

 More simple apps, allow you to monitor changes on your skin , even can remind you to take photographs every few months and compare them to identify any changes and have the ability to share them with dermatologists for diagnosis. This process is called teledermascopy and could enable specialists to assist in diagnosis of skin cancers for those who are rural and remote.

 As we navigate the waters of technology and medicine, a very important warning should be made about APPS. Yes they often cost money but experts have also raised questions about their accuracy. There is a chance they can be falsely reassuring and could lead to delayed diagnosis.

 In the meantime, the best we can do is regularly check our skin using the ABCDE and additional EFG rules, and show any suspicious mole to a GP or a dermatologist.


If your uncertain about your moles and would like a BULK BILL SKIN CHECK by our Doctors, make an appointment at E4 SKIN on 1300 e4 HEALTH or speak with the medical team at Dr INK.


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