How can I see for myself if it is dangerous?

It is not always easy to tell whether a mole is benign or malignant. For dermatologists, it is often necessary to assess the course of the mole over a certain period of time in order to detect malignant changes. The appearance of the mole cannot always be clearly judged, so in many cases moles are removed as a precaution even if the diagnosis is unclear.

But how can you now see for yourself whether a bleeding mole is dangerous or not? Suspicious are frequent bleedings that occur even with the slightest mechanical irritation of the mole. For example, simply putting on clothes, scrubbing sweaters, taking a shower in the morning or a light scratching can be enough to cause a bleeding.

Furthermore, itching or pain in the mole is more often suspected to be a malignant cause. The ABCDE rules are a good scheme for evaluating liver spots. With the help of these rules, one can assess whether a mole could be malignant.

Below is a brief guide to self-assessing a mole according to the ABCDE rules:

A= Asymmetry (e.g. irregular, not oval/not round mole)
B= Boundary (e.g. blurred liver spot with runners/extractions)
C= Colour (e.g. different pigmentation / several colors in one spot / unusual color, e.g. grey)
D= diameter (over 5mm)
E= Elevation or development (strongly elevated above the skin level with irregular surface/ changes in a short time

Itching as accompanying symptom

Moles can also itch slightly every now and then and thus provide an incentive to scratch them open. In the course of this, light, superficial bleeding may occur. At first this need not be a cause for concern.

The itching does not necessarily have to be connected with a malignant disease of the skin, as is often claimed. However, it can also be a symptom of skin cancer. It is therefore recommended as a prophylactic measure to show itchy and bleeding moles to a dermatologist once, so that he can make an assessment.

Often the mole is then observed at regular intervals to assess its progress. In other cases, if the status of a mole is unclear or a malignant disease is suspected, it is removed and examined under a microscope. Additional suspicious changes in the appearance of the mole (see ABCDE rules) substantiate the suspicion.

A visit to the doctor should not be delayed. Skin cancer is very well treatable in its early stages, whereas at an advanced stage and spread of the cancer there are often no good treatment options left. An objective scheme for the assessment of liver spots is the ABCD rule.

It is used both for the initial assessment and in the course of preventive examinations. Even as a layman, one can roughly follow it if there are any uncertainties. Nevertheless, a doctor should always be consulted in case of suspicious bleeding.

The more criteria are met, the more suspicious the mole is. A – Asymmetry: Inconspicuous liver spots are usually regularly round or oval and symmetrical. Asymmetries are suspicious.

B – Boundary: The border of the mole should be smooth and sharply defined, frayed edges or runners are an indication of degeneration.C – Color: The color is sometimes the most important criterion, because it is the one where changes in the mole are most noticeable over time. Black to bluish, gray or reddish spots or several color shades next to each other are suspicious. A mole should also not become paler.

D – Diameter: Every spot with a diameter of more than 5mm should be observed, also spreading liver spots. In the meantime, an E for sublimity or development has been added. Elevation, i.e. whether the spot is palpable, is also a criterion.

As already mentioned, the development of the mole with any changes is also very important. The liver spot is examined by the dermatologist with the so-called dermatoscope, a magnifying glass with a light source. This allows the criteria to be assessed particularly well.

If the spot is now found to be conspicuous according to the ABCD rule, it is cut out in its entirety and examined microscopically. Malignant changes are thus detected at the cellular level and confirm the diagnosis. Particularly in old age, other benign changes, such as seborrheic warts, which at first glance may resemble black skin cancer, also occur.