A mole that has looked the same for years may not need urgent attention. A mole that is changing, bleeding, itching or simply looks unlike the others should not be watched and waited on. If you are asking when should a mole be checked, the safest answer is: book a clinical assessment promptly when you notice a new, changing or unusual spot.

Australia has one of the highest rates of skin cancer in the world. Early detection can make a life-changing difference, particularly with melanoma, which can spread to other parts of the body if it is not treated early. Most spots are not melanoma, but no online checklist or mirror examination can diagnose a suspicious lesion. A GP or trained skin cancer clinician can examine it properly and decide whether monitoring, photography, dermoscopy or removal is needed.

When should a mole be checked urgently?

Arrange an appointment as soon as possible if a mole is new or has changed in size, shape, colour, surface or sensation. This applies even if the change seems small. Melanoma can develop in an existing mole, but it can also begin as a new spot on otherwise normal-looking skin.

The ABCDE guide is a useful way to identify changes worth checking:

• A – Asymmetry: one half does not match the other.
• B – Border: edges are uneven, blurred, scalloped or poorly defined.
• C – Colour: there is more than one colour, or the spot becomes darker, black, red, blue, white or grey.
• D – Diameter: it is larger than about 6 mm, although melanomas can be smaller.
• E – Evolving: it is changing, or behaving differently through itching, tenderness, crusting or bleeding.

The final point, evolving, is often the most useful. A harmless mole usually remains stable. A spot that is noticeably different from a photo taken a few months ago, catches on clothing, repeatedly scabs or does not heal deserves medical review.

Do not wait for a mole to become painful. Many early melanomas do not hurt. Likewise, do not assume a small lesion is safe, or that a spot cannot be serious because it is flat. Skin cancers vary widely in appearance.

The ugly duckling sign

Your skin has its own pattern. You may have many freckles or moles that look broadly alike, but one spot may stand out as darker, larger, more irregular or just different. Clinicians call this the ugly duckling sign.

Trust that observation. If one lesion does not fit your usual pattern, arrange a skin check. This can be especially valuable for people with many moles, where applying a simple size rule to every spot is not practical.

A mole is not the only spot that needs checking

Melanoma is often associated with dark moles, but it is not always brown or black. Some melanomas can appear pink, red, skin-coloured or pale. A spot that looks like a pimple, dry patch, eczema flare or minor injury but persists should be assessed.

Other skin cancers also need timely attention. Basal cell carcinoma may look like a pearly or shiny lump, a sore that crusts and heals repeatedly, or a pink patch. Squamous cell carcinoma can present as a tender, scaly, thickened or crusted area that grows over time. These are common on sun-exposed sites such as the face, ears, scalp, neck, forearms and lower legs, but can occur elsewhere.

Check areas you may not see easily, including your scalp, back, buttocks, soles, between toes and under nails. Ask a partner, family member or hairdresser to mention any new or changing spot they notice. Melanoma can occur on skin that receives little sun, so a lesion should not be dismissed because it is under clothing.

Who should have regular skin checks?

A suspicious mole should be checked at any age and with any skin type. However, some Australians have a higher likelihood of developing skin cancer and may benefit from planned, regular full-body checks rather than relying only on self-examination.

Your risk may be higher if you have had melanoma or another skin cancer before, have a close relative with melanoma, have many moles or atypical moles, or have fair skin that burns easily. A history of blistering sunburns, especially in childhood, also increases concern. So does significant cumulative UV exposure from outdoor work, farming, construction, sport, fishing or frequent recreational time outdoors.

People who use immunosuppressive medicines, including some transplant recipients, need individual advice from their treating team and GP. Their skin cancer risk can be substantially increased. Older adults are also more likely to develop skin cancers due to lifetime UV exposure, although melanoma is not limited to older Australians.

People with skin of colour can develop skin cancer too, and it may be detected later when warning signs are overlooked. New or changing lesions on the palms, soles, under nails, lips and mucosal areas should be taken seriously. Dark skin is not a reason to delay a skin check.

How often you should book a routine skin examination depends on your personal risk. Some people may be advised to attend every six to 12 months, while others may only need to book when they notice a change. A clinician who knows your history can recommend a schedule that makes sense for you. More frequent checks are not automatically better for everyone, but delayed assessment of a concerning lesion is never a good trade-off.

What to do before your appointment

You do not need to diagnose the spot before booking. When you make the appointment, say that you have noticed a new or changing mole, bleeding lesion or non-healing sore. This helps the practice understand why you are attending.

If possible, take a clear photo in good light, with a ruler or familiar object nearby to show scale. Earlier photos can be useful for comparison, but do not let photography replace an appointment. Avoid picking, scratching or trying to remove the lesion yourself. Home treatments can cause irritation and may make assessment more difficult.

At the consultation, the clinician will ask when you first noticed the spot, whether it has changed and about your skin cancer history. They may use a dermatoscope, a handheld device that allows a closer look at structures beneath the skin surface. If a lesion is concerning, you may need a biopsy or excision. Only laboratory testing of tissue can confirm whether a spot is cancerous.

Keep checking, but do not rely on self-checks alone

A monthly skin self-check is a practical habit, particularly for higher-risk people. Use a full-length mirror and a hand mirror, and work methodically from scalp to soles. Notice what is normal for you so that change is easier to recognise.

Self-checks have limits. Some lesions are subtle, hidden or difficult to interpret, and not every melanoma follows the textbook ABCDE pattern. Think of self-examination as an early-warning habit, not a substitute for professional care.

Sun protection remains essential even if you have never had a suspicious mole. Use shade, protective clothing, a broad-brimmed hat, sunglasses and SPF 50+ broad-spectrum, water-resistant sunscreen as part of your everyday UV routine. Sunscreen is one layer of protection, not permission to spend longer in intense sun.

When should a mole be checked if you are unsure?

If you are uncertain, book the check. You are not wasting a clinician’s time by asking about a changing spot. Skin cancer can be highly treatable when found early, while a delay can mean more extensive treatment and greater risk.

Knowledge can save your life, but action is what turns concern into protection. Take a photo if you can, make the appointment, and let a qualified clinician assess the mole properly.