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The ABCDE Rule: How to Notice a Suspicious Mole

Five features that can help you notice a changing mole and seek medical assessment promptly.

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The ABCDE rule can help you notice skin changes that deserve professional assessment. It cannot diagnose melanoma, but it is a useful guide during self-examination. A lesion that is changing, looks different from your other moles or causes concern should be assessed by a clinician.

One minute with an oncologist

ABCDE in video format

In this Ukrainian-language video I briefly explain the five self-check prompts. It does not replace dermoscopy or an in-person assessment of a suspicious lesion.

ABCDE rule for checking suspicious moles
ABCDE is a self-examination guide, not a diagnostic test.

A — Asymmetry

One half of the lesion does not match the other. This is one feature worth noticing during a skin self-check.

Asymmetry of a pigmented lesion in the ABCDE rule

B — Border

The edge may be irregular, scalloped, blurred or poorly defined.

Irregular or poorly defined border of a pigmented lesion

C — Colour

Colour may be uneven, or several shades may be present within the same lesion.

Uneven colour in a pigmented lesion

D — Diameter

Six millimetres is a classic reference point, not a diagnostic threshold. Melanoma can be smaller than 6 mm, so a small diameter does not by itself make a lesion safe.

Diameter of a pigmented lesion and the 6 mm ABCDE reference

E — Evolving

Changes in size, shape or colour matter. New symptoms such as bleeding or itching also deserve assessment.

A pigmented lesion changing over time
E = Evolution

Why change over time matters

In this Ukrainian-language video I explain why serial comparison and photography can be more useful than trying to remember how a lesion looked previously.

The “ugly duckling” sign

A lesion that clearly looks different from a person’s other moles deserves attention even when it does not show every ABCDE feature.

Ugly duckling sign: one mole looks different from the others

Clinical images from the author's archive, published with patient consent.

When to seek assessment

Self-examination does not replace a specialist consultation. A clinician makes the final assessment; when indicated, the diagnosis is clarified with a biopsy and histological examination.

Related resources

Traumatised a mole: what should you do?Skin lesion biopsyBreslow thicknessAfter a melanoma diagnosisPatient videos

Consultation

Noticed a change? Do not delay assessment.

Consultation information