Mole Check

Mole Check at The Cadogan Clinic is the UK’s most comprehensive for the diagnosis and treatment of skin cancer; and is the only mole check approved by the British Skin Foundation. 

Moles are often harmless, but they can be irritating and catch on clothing and jewellery alike. Occasionally, they can be a sign of cancer. The NHS and NICE guidelines recommend having your moles checked by an expert every six months – at a minimum. If you’ve had a mole removed, it’s every three months.  

Below is a helpful checklist you can go through at home, but it’s always recommended to book in with a doctor if you have any changes to your moles or freckles or if you suspect any of them may be cancerous.  

The good news is that skin cancers from moles that are found and removed early are almost always curable and early diagnosis matters. A person with a melanoma of less than 0.75mm thick can expect to have a 95% cure rate. 52% of the melanoma we find are discovered by monitoring and identifying the tiniest of changes each time you come in with our mole-mapping service. Changes can be monitored both externally and internally for signs that aren’t visible to the naked eye.

Book in with one of our doctors at the Cadogan Clinic if you’re worried about any of the moles or freckles you have, and you can rest assured that we will be able to give you a comprehensive diagnosis. 

 

 

What makes our mole check service different?

Dermatology Gallery

Skin Lumps and Warts

Benign Dermatofibroma - Persisting asymptomatic nodule. Recommend excision on cosmetic grounds as will never go away spontaneously.

Benign vascular nodule - Developed at site of minimal trauma; needs surgical removal as bleeds easily.

Benign vascular nodule - On face of elderly lady, for surgical removal.

Warty benign basal cell papilloma (seborrhoeic keratosis) - Slowly growing on trunk of 70 year old man; removed by curettage.

Warty benign basal cell papilloma (seborrhoeic keratosis) - Flesh-coloured growth on trunk of 75 year old man

Seborrhoeic warts / keratoses - On a patient

Seborrhoeic warts / keratoses - On a patient

Solar keratoses - Extensive scalp solar keratoses suitable for PDT

Rapidly growing nodule - Below left eye in 70 year old man. Needs excision for cure and for histology to differentiate between a keratoacanthoma and a basal cell cancer

Hand warts - Can be treated with Cryotherapy

Plantar warts - Potentially suitable for cryotherapy

Melanomas

Lentigo maligna - Black discolouration on background brown lentigo on nasal bridge–needs excision to prevent spread.

Melanoma - Melanoma on a patient

Lentigo maligant melanoma - Slowly growing brown stain on cheek of elderly lady

Malignant melanoma - Well demarcated black plaque on sun damaged trunk of 35 year old

Malignant melanoma - Well demarcated black plaque on sun damaged skin

Melanoma - Change in the pigmentation of a previously brown mole

Nodular melanoma - A large pigmented nodule

A nodular melanoma - Enlarging pigmented plaque

Subungual melanoma - Persisting black toenail originally thought due to trauma

A nodular melanoma - Persisting oozing nodule with pigmentation

Amelanotic melanoma - Vascular nodule on the foot

Large malignant melanoma - On upper back of very sundamaged skin

Other Skin Cancers

Basal cell cancer - Slowly growing nodule on sun exposed skin of 68 year old man showing telangiectasia (blood vessels) diagnostic of a basal cell cancer

Multiple cancers - Multiple scaly patches consistent with multiple cancers on sun-exposed neck of elderly woman

Basal cell cancer - Scaly area which never heals on right side of forehead of 72 year old. Need excising to prevent further enlargement.

Basal cell cancer - Slowly growing area on sun damaged facial skin of 35 year old surfer. Basal cell cancer needing Mohs and reconstruction to prevent further growth.

Pigmented basal cell cancer - On sun exposed skin of 72 year old. Could be mistaken for a melanoma due to the black pigment.

Squamous Cell Cancer - Sore ear thought to be infection in 78 year old man but due to a squamous cell cancer

Bowen’s disease on the hand - An early skin cancer

Psoriasis

Psoriasis - Symmetrical well defined erythematous plaques on the knees

Psoriasis - Well demarcated scaly plaques on elbows of a 4 year old

Psoriasis - Scaly itchy scalp with well demarcated edge due to psoriasis

Psoriasis - Well demarcated scaly rash of psoriasis in a child on an unusual location

Small Plaque Psoriasis - Widespread rash with well demarcated pink scaly patches

Psoriasis - Psoriasis on the forehead and scalp

Moles

Large congenital mole - Atypical pigmentation in a child - needs monitoring

Protruding benign mole - Excise on cosmetic grounds

Hair bearing benign flesh coloured facial naevus -

Halo naevus - This is benign and occurs more frequently in patients with vitiligo

Large naevi with irregular pigmentation - Dysplastic naevi which need monitoring /excision to prevent progression

Unusual mole on sole of foot - For dermoscopic monitoring

Halo - Less intense pigmentation surrounding a normal mole

Benign Mole - Benign mole on a patient

Benign Mole - Benign mole on a patient

Acne

Acne Scarring - Acne Scarring

Acne - Acne on a male patient

Acne - Acne on the forehead, can be treated with Roaccutane.

Acne - Acne on the cheek, can be treated with Roaccutane.

Autoimmune

Alopecia - Alopeca areata

Allergies

Urticaria - Urticaria or hives

Pigmentation

Actinic Lentgines - On the patient's hand

Sun Damage - On the patient's chest

Actinic Lentgines - On the patient's hand

Extensive Actinic Lentigines - Forehead with extensive actinic lentigines sun freckling

Vitiligo - On a patient

Vascular

Vascular Papule - Vascular papule on patients face

Superficial Leg Vessels - Close up of superficial leg vessels amenable to sclerotherapy or laser.

Eczema

Dry Eczematous Skin - Dry eczematous skin on a patient

Flexural Eczema - Flexural eczema on a patients arm

Frequently Asked Questions

There are many ways that you can reduce your risk of skin cancer.

+ Limit your exposure to UV radiation
+ Use broad-spectrum sunblock when exposed to the sun. Broad spectrum will help protect against both UVA and UVB rays
+ Use a minimum of SPF 30 in your sunblock, ensure the UVA protection is adequate as denoted by UVA and apply thickly and frequently
+ Avoid the use of sunbeds (Using sunbeds for the first time below the age of 35 increases the risk of developing melanoma by nearly 60%
+ Perform a monthly skin self-examination looking for ABCDE of moles

 ABCDE Checklist for suspicious features:

+ Asymmetry: Moles that are an irregular shape and have two different halves.
+ Border: Moles with a ragged border.
+ Colours: Moles that have a mix of two or more colours.
+ Diameter: Moles that are larger than 6mm (1/4 inch) diameter.
+ Evolution: A mole which has changed in size or shape over time.

When performing your monthly skin checks ensure you are doing it after a bath or shower, in a well-lit room, with the aid of a full-length mirror looking for any changes in moles thoroughly.

You can also self-assess yourself for risk of melanoma. The Melanoma Risk Factor Assessment checklist can tell you if you would benefit from a mole check by a dermatologist, or from more regular self-examinations.

The Melanoma Risk Factor Assessment:

+ Have you ever been sunburnt badly?
+ Does your skin burn first and then tan? Do you tan at all?
+ Do you have any outdoor hobbies?
+ Have you ever used sunbeds?
+ Have you ever lived anywhere abroad that was very hot/sunny?
+ Have you ever had a job where you worked outdoors?
+ Has anyone in your family ever had melanoma?
+ Do you wear sunblock when exposed to the sun?

If you notice any changes to a mole or a patch of skin, it is important to seek the advice of your GP or a dermatologist as soon as possible. If your regular GP has any concerns about the changes in your moles, they will refer you to a consultant dermatologist for further examination.

A dermatologist will perform a full skin examination to check all of your moles. If the dermatologist has any concerns about any unusual moles or patches of skin, they will either go on to remove (excise) the mole or take a sample of a suspicious patch of skin (biopsy) to send in for analysis.

It is important to note that not all changes to moles are the results of skin cancer. It is normal for moles to change in size, number or appearance over time, even some disappearing entirely. Hormonal changes, like those that occur with puberty or pregnancy, can also cause moles to increase in number or to become darker. 

Mole mapping and Dermoscopy begins with a consultation and full clinical examination by a Consultant Dermatologist. The Dermatologist begins by identifying and marking any suspicious moles and ones which warrant monitoring.

Next, the patient will be taken through the process of having whole body photography and dermoscopy of any moles that the dermatologist has marked. For the photography, the patient will stand on a mat at a fixed distance to allow for reproducible images to be taken by the camera on the mole mapping machine. Close up dermoscopy images are then taken of any moles identified by the dermatologist for monitoring using a hand-held dermoscope, which uses polarised light for accurate imaging.

All dermoscopy images are uploaded to the patients’ medical profile to allow the dermatologist to view the moles in detail. This completes the initial clinical examination.

There will be a follow-up appointment booked by the dermatologist in order to have the dermoscopic images repeated to see if there have been any changes in the moles.

In about 4-6 months’ time, a follow-up appointment will be booked so that the process can be carried out in reverse order, with a repeat dermoscopy of the moles being monitored. During this appointment, the Consultant Dermatologist will review any changes in the moles in the before and after photos.

If there is a need for excision of any moles that have changed to prevent further progression, this will be performed under local anaesthetic and the specimen sent to the laboratory for a full histological diagnosis.

Melanoma is caused when skin cells, or melanocytes, begin to grow abnormally. The single most preventable cause is too much exposure to ultraviolet radiation (UVR) from sunlight and there is also evidence that the use of sunbeds can cause skin cancer.

There are certain people who have a predisposition to skin cancer or are more at risk:

+ People who burn easily in the sun

+ People with past episodes of sunburn, often with blister formation and often in childhood

+ People with many moles (more than 50)

+ People who have first-degree family members who have melanomas

+ People with a weakened immune system due to diseases (e.g. HIV), or those on drugs that suppress the immune system (e.g. organ transplant patients)

 

Melanomas may develop as either a new mole or occur as changes in a pre-existing mole. It is the fifth most common form of skin cancer in the UK, with approximately 13,000 cases being reported each year.

More than a quarter of those cases are in people under 50 years old, which is quite young in comparison to other cancers. More than 2000 people in the UK die every year from melanoma.

Melanoma is a cancer of the pigment cells (melanocytes) in the skin. It is a very serious skin cancer that has the ability to metastasise or spread to other organs of the body. It can develop anywhere on the body, yet the most common places are on areas of the body that have been overly exposed to the sun.

Melanoma is the fifth most common form of cancer in the UK and rates of melanoma have been increasing steadily since the mid-1970s, more than any of the ten other most common cancers in both men and women. This is the deadliest form of skin cancer.

There are several types of melanomas, including:

+ Superficial Spreading Melanomas – these account for around 70% of all reported cases of melanoma in the UK. They are moles that spread radially and often have an irregular edge. In the radial growth phase, they usually remain confined to the skin and have not spread, but if they begin to grow deeper they can then metastasise to other parts of the body. If you have a mole with an irregular edge, get it examined by a doctor.

+ Lentigo Maligna Melanomas – these account for around 10% of all reported cases of melanoma in the UK. They often begin looking like a freckle on the face of the elderly and enlarge slowly. If they start to grow downwards and become nodular or change shape or pigmentation it is likely that melanoma has developed.

+ Acral Lentiginous Melanoma – these are a rare type of melanoma, accounting for only 5% of all reported cases. They occur on the palms of hands, the soles of feet or around a finger/toenail.

+ Amelanotic Melanoma – these are another rare type of melanoma, accounting for only 5% of all reported cases in the UK. They may have little or no colour or may be pink or greyish spots on the skin.

Computerized mole mapping is a tool to record moles and detect new moles. This is done in combination with Dermoscopy.

It is used to monitor changes in existing moles, detect any progression and pick up skin cancers, especially malignant melanomas, early.

It is important to note that 52% of malignant melanomas are identified through early changes.

The more moles you have, the harder it is to perform accurate self-examinations. This leads to a higher likelihood that one or more moles will change without you noticing.

This type of mole mapping is objective, therefore vital in the prevention of skin cancer.

Skin cancer is on the rise. It is one of the most common forms of cancer in the world. There are two categories, non-melanoma skin cancer and melanoma.

The term ‘non-melanoma’ refers to basal cell cancers and squamous cell cancer.  In the UK alone there are more than 100,000 new cases of non-melanoma skin cancer diagnosed each year.

+ Basal Cell Cancer (BCC) – a BCC starts in the basal layer, the lowest layer of the epidermis and is the most common type of skin cancer, accounting for 75% of all cases.

- BCC usually appears as a small, pinkish or pearly white lump with tiny surface blood vessels

- It also can appear as a red, dry/scaly patch of skin

- There may be brown or black spots/pigmentation within the patch

- The lump grows slowly, becoming bigger and may begin to crust over and bleed

- It can also develop into a non-healing ulcer

 

+ Squamous Cell Cancer (SCC) – SCC starts in the upper layers of the epidermis and is the second most common form, accounting for 25% of all cases.

- SCC usually appears as a firm pink lump with a crusted surface

- There may be a spiky horn protruding from the top

- There may be surface scale and rough patches on the lump

- It will be tender to the touch, bleeding easily

- It may develop into an ulcer

 

Melanoma is the least common form of skin cancer, with less than 7000 cases diagnosed each year, but it is the deadliest. It can develop anywhere on the body but most commonly on areas of the body that have been overexposed to the sun. Melanoma is the 5th most common cancer in the UK.

 

There are several types of melanomas, including:

+ Superficial Spreading Melanomas – these account for around 70% of all reported cases of melanoma in the UK. They are moles that spread radially and often have an irregular edge. In the radial growth phase, they usually remain confined to the skin and have not spread, but if they begin to grow deeper they can then metastasise to other parts of the body. If you have a mole with an irregular edge, get it examined by a doctor.

+ Lentigo Maligna Melanomas – these account for around 10% of all reported cases of melanoma in the UK. They often begin looking like a freckle on the face of the elderly and enlarge slowly. If they start to grow downwards and become nodular or change shape or pigmentation it is likely that melanoma has developed.

+ Acral Lentiginous Melanoma – these are a rare type of melanoma, accounting for only 5% of all reported cases. They occur on the palms of hands, the soles of feet or around a finger/toenail.

+ Amelanotic Melanoma – these are another rare type of melanoma, accounting for only 5% of all reported cases in the UK. They may have little or no colour or may be pink or greyish spots on the skin.

Finding skin cancer early saves lives because we are able to stop the metastasis, or spreading, of cancer to other organs or parts of the body. Skin cancer that is detected early is almost always curable.

If caught late, there is a higher chance that it has already spread through the body and affecting other organs. Thin melanomas, less than 1mm, have a 95% 5-year survival rate whereas thick melanomas, more than 4mm, have a 15-20% 5-year survival rate. Recent advances in treatment with immunotherapy have however improved these survival rates.

Performing a self-examination is key to detecting change. You can easily check yourself regularly for new growths or irregular moles - follow the ABCDE mole mapping guide.

ABCDE Mole Checklist

+ Asymmetry: moles that are an irregular shape and have two different halves.
+ Border: moles with a ragged border.
+ Colours: moles that have a mix of two or more colours.
+ Diameter: moles that are larger than 6mm (1/4 inch) diameter.
+ Evolution: A mole which has changed in size or shape over time.

If you notice anything irregular when performing a self-examination, it is crucial that you have a follow-up check by your doctor.

We have some of the best dermatologists and plastic surgeons in the UK, as well as our mole mapping system, rapid diagnostic services and our “see and treat” service for mole removal. You are guaranteed that Cadogan Clinic is the best choice for accurate and quick diagnosis and treatment.

+ Consultant Dermatologist Led: every Mole Check patient is seen by one of our consultant Dermatologists and not a nurse.
+ Mole Map: each patient leaves with a comprehensive computer controlled Mole Map of their entire body.
+ Long Term Monitoring: our Mole Mapping technology and our Dermatologist led approach allows us to spot even the subtlest of changes and moles over time.
+ Dermoscopy: any mole that a Dermatologist is concerned about will be examined on the spot under a high powered dermatology microscope.
+ Treatment: we have 3 fully staffed operation theatres on site for the rapid, same day removal of worrisome moles.
+ Plastic Surgeons: for the removal of bigger or deeper moles, or those in more visible places, a Consultant Plastic Surgeon can undertake the procedure to minimise any scarring risk.
+ Mohs: we are one of the only clinics in the UK to offer Mohs surgery on site. This is recognised by NICE as the optimal approach to skin cancer removal.

Book in with one of our doctors at the Cadogan Clinic if you’re worried about any of the moles or freckles you have, and you can rest assured that we will be able to give you a comprehensive and fast diagnosis.

A mole or naevus is made up of naevus cells, which extend right through the skin. Therefore, if removal is to be complete, it will leave a hole. Whichever way this heals, there will be a scar. It is our job to minimize this scar.

If the mole is tiny, leaving the hole to heal on its own, may be best. Usually, the hole is refashioned in order to allow stitching in the direction which gives the least scarring, usually in the line of skin tension, for example, the smile lines on the face. Face stitches can be removed early before they themselves cause extra scars, but elsewhere we might use buried dissolving sutures reinforced with tape to again avoid stitch marks.

If the mole is only a problem because it is raised, then sometimes they can be snipped or lasered off. Remember, however, that although the skin is now flat, half the naevus is still there. It might regrow with pigment or look like a mottled scar. This is not often acceptable on the face. Hairy moles need to be completely removed to stop regrowth of the hair from deep hair follicles. A suspicious mole that is thought could be malignant should be cut out to provide tissue for diagnosis under the microscope.

Whichever method is used, we need to keep the skin clean to avoid infection and a worse scar. Antibiotics should not be used to avoid infection, being reserved for treatment of infection.

Some areas of the body make for worse scars than others and some people are more prone to scarring. We now have a genetic test (BILHI) to determine if you are likely to get a bad scar, a keloid. The Cadogan Clinic is the first place in the UK to offer this.

Not everyone needs a mole check, but who does?

Any mole that changes need consideration. If it grows, changes colour bleeds, itches. It should be checked by a doctor. Probably it is just traumatised or there is an inflamed hair follicle within it, but of course, for a few, it may be becoming malignant. An expert will examine the mole naked eye and probably with a dermascope (dermatoscope). If there is doubt, then it will be removed with a margin of normal tissue and checked under the microscope. If it turns out to be a melanoma, we often need to come back to remove a bit more tissue in order to have a calculated safe margin.

If moles become malignant, they become melanomas, one of the 3 main types of skin tumour and also the most dangerous. They used to carry a dreadful prognosis, but now at the Cadogan Clinic, we cure nearly all of them, simply because we see them early, identify them and remove them early.

At the Cadogan Clinic, we understand that there are 5 reasons to remove moles –

! -moles that are malignant.

2- moles that might be malignant

3- moles that develop an infection, usually due to a folliculitis (infection of a hair follicle)

3- moles that worry you, so that you must keep coming back for checks.

4- moles that you do not like the look of.

These are all good reasons but check with your insurance company, if you expect reimbursement. They may not consider the reason in their opinion to be medical.

If you have many moles or have had other melanomas or suspicious moles, you may need a general mole check by your dermatologist. You may be recommended to undergo mole mapping. If you have one suspicious mole, you are at risk of having others. Then if you just have very many moles they should be checked regularly. It is said that if you have 11 or more moles of the forearm or 100 overall, then you need regular checks.

Skin cancer is one of the most common cancers in the UK but the good news is that if the signs and symptoms are spotted early it will be much easier to treat. If you have moles on your face and body, it’s a good idea to keep a check on them and monitor any changes for your own peace of mind. At Cadogan Cosmetics we have some of the best dermatologists and plastic surgeons in the country as well as our mole mapping system, rapid diagnostic services including 24-hour histology results and our “see and treat” service for mole removal.

Most people have moles which remain perfectly fine throughout their lifetime but if you notice signs that a mole has changed in any way, it is wise to have it checked by a dermatologist or doctor during a mole check to make sure it is not cancerous. This kind of skin cancer includes melanomas, basal cell carcinomas, and squamous cell carcinomas. Moles can also be precancerous lesions, changes that are not
cancer but could become cancer over time. The good news is that skin cancer can be cured if it’s found and treated early. Contact the Mole Clinic at Cadogan Clinic for more information.

Bleeding moles can occur when they have been irritated or scratched – moles catching on clothing, being cut by a razor, makeup application, scratching an insect bite and hair removal are all very common triggers. However, a more serious concern for a bleeding mole is skin cancer.
There are definite signs that a mole could be a melanoma and individuals should seek immediate advice from a dermatologist. If you have a new mole or a change in your moles such as bleeding, changes in shape, size or colour, itchy or painful moles- it's imperative that you seek medical advice at the earliest possible stage.

Consumers should be vigilant in having moles checked annually or as advised by your dermatologist if you have a history of previously abnormal naevi (moles) or skin cancer. An early diagnosis is crucial in managing this potentially life-threatening disease; skin cancer which is detected and removed early is almost always curable. Just the tiniest of change in a mole is a sign to visit your dermatologist for a Mole Check.
The Cadogan Clinic offers a revolutionary Mole Package service which includes a mole and lesion check, removal and rapid histology results and advice. With a team of industry-leading consultants using the most cutting-edge techniques at the state-of-the-art facility, Cadogan Clinic's Mole Check is the only service of its kind to be approved by the British Skin Foundation.

The most effective way of monitoring moles at home is by regularly following the ABCDE rule. This is an excellent way of supporting annual mole checks with a medical professional. If you notice any of the signs below you should immediately seek medical advice.

A – Asymmetry Where one half of the mole does not match the other
B – Border Check the outline of your mole – a melanoma may have edges that are ragged, notched, blurred or irregular, plus the pigment may have spread into surrounding skin.
- Colour Is the colour uneven? You might see shades of black, brown and tan, or areas of white grey, red, pink or blue
- Diameter – Do you see a change in the size of your mole? Has it increased? Typically, melanomas are at least 6mm in diameter – (same size as the end of a pencil)
E – Evolving – Does the mole look different from the others and / or is changing in size, colour or shape?

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