Learn to look at your skin
Checking yourself in the mirror once a month, protecting yourself from the sun properly and keeping the skin barrier healthy: the basis of skin health is laid at home. In this guide I explain what to look for, what to do and when to see a doctor.
AuthorDr. Aygun MustafayevaAesthetic dermatologist, dermatovenereologist and trichologist
A monthly self-check
In good light, with a large mirror and a hand mirror, look at all of your skin, including your back, soles and scalp. The aim is to catch new and changing moles.
- ABCDE: asymmetry, border, colour, diameter, evolution
- Pay special attention to a mole unlike the others
- Photograph a mole that worries you and compare after a month
- Ask someone close to check places you cannot see, like your back
Smart sun protection
Regular sunscreen use has reduced both skin ageing and the risk of melanoma in clinical trials. The best sunscreen is the one you apply every day.
- SPF 30 or higher, broad spectrum
- Apply enough before going outside
- Reapply every 2 hours outdoors and after swimming
- Shade around midday, a hat and sunglasses
Protect the skin barrier
For dry and eczema-prone skin, moisturiser is part of the treatment. Regular moisturising reduces eczema flares and can reduce the need for medication.
- Moisturise after a shower, while the skin is still slightly damp
- Short, lukewarm rather than hot showers
- A gentle cleanser instead of soap and harsh detergents
- Do not stop skin care in quiet periods
Add actives gradually
Retinol, acids and hyaluronic acid can be useful, but starting them all at once irritates the skin. One product, a low concentration and patience.
- Start retinol on 2-3 evenings a week
- If you use retinol, sunscreen in the morning is a must
- During pregnancy or when planning one, agree on retinoids with a doctor
- If redness and peeling get worse, take a break and ask for advice
Gentle care for children’s skin
Molluscum, warts and eczema are common in children. They are usually not dangerous, but squeezing, picking and using adult creams make things worse.
- Do not squeeze or pop spots
- Keep nails short and reduce scratching
- Personal towels and bath items
- Show a fast-growing lesion in a baby without delay
Numbers worth remembering
These figures are based on scientific sources and clinical guidance. They make checking yourself easier but do not replace an examination by a doctor.
- a month: check all of your skin in front of a mirror
- Once
- five signs to look for in a mole
- ABCDE
- on the 7-point checklist means see a doctor promptly
- 3 points
- daily, broad-spectrum protection
- SPF 30+
The odd one out
A person’s moles usually look alike. A mole that stands out from the others in size, colour or shape deserves separate attention, even without ABCDE signs.
Check your mole in 7 questions
This check is based on the weighted 7-point checklist that doctors use to pick out a suspicious mole. Think of one mole that worries you and answer each question looking at it.
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Question 1 of 7
You chose no warning signs
Based on your answers, this mole has none of the signs on the 7-point checklist. Keep checking your skin in the mirror once a month, and come for an examination if the mole changes or a new one appears.
Have the mole checked with dermoscopy
You chose one major or one or two minor signs. This does not mean cancer, but it is worth looking at the mole with a dermatoscope and following any change. Book a routine visit and take a photo of the mole now so we can compare later.
See a dermatologist without delay
Your score is 3 or more. In UK clinical guidance (NICE), this threshold means the mole should be checked by a dermatologist promptly. This is not a diagnosis: most such moles turn out to be benign after an examination, but it is important not to lose time.
7-point checklist scale
- 0 points
- 1-2 points
- 3 points or more
This check is for one mole. A mole that looks different from all your other moles also deserves attention. A “Not sure” answer is counted as “Yes” to be on the safe side.
Source: Walter, F. M., Prevost, A. T., Vasconcelos, J., et al. (2013). Using the 7-point checklist as a diagnostic aid for pigmented skin lesions in general practice: a diagnostic validation study. British Journal of General Practice, 63(610), e345-e353. [PMID: 23643233] | [DOI: 10.3399/bjgp13X667213]
The test does not make a diagnosis and does not replace an examination by a doctor. If a mole changes quickly, bleeds or forms a sore, come for an examination whatever the result.
Self-check and doctor’s check
Regular checks at home and dermoscopy when needed complement each other.
At home, once a month
- Prepare a well-lit room, a large mirror and a hand mirror
- Look at your face, neck, behind your ears and your scalp
- Check your torso, back, arms, palms and nails
- Do not forget your legs, soles and between your toes
At the clinic
- We examine changing or odd moles with a dermatoscope
- We set how often to check based on your risk factors
- We keep photos of moles that need monitoring
- A suspicious lesion is removed and sent for histology
Scientific sources
The information in this article is based on the peer-reviewed papers, systematic reviews and clinical guidance below.
- Abbasi, N. R., Shaw, H. M., Rigel, D. S., et al. (2004). Early diagnosis of cutaneous melanoma: revisiting the ABCD criteria. JAMA, 292(22), 2771-2776. [PMID: 15585738] | [DOI: 10.1001/jama.292.22.2771]
- Grob, J. J., & Bonerandi, J. J. (1998). The 'ugly duckling' sign: identification of the common characteristics of nevi in an individual as a basis for melanoma screening. Archives of Dermatology, 134(1), 103-104. [PMID: 9449921] | [DOI: 10.1001/archderm.134.1.103-a]
- Walter, F. M., Prevost, A. T., Vasconcelos, J., et al. (2013). Using the 7-point checklist as a diagnostic aid for pigmented skin lesions in general practice: a diagnostic validation study. British Journal of General Practice, 63(610), e345-e353. [PMID: 23643233] | [DOI: 10.3399/bjgp13X667213]
- Dinnes, J., Deeks, J. J., Chuchu, N., et al. (2018). Dermoscopy, with and without visual inspection, for diagnosing melanoma in adults. Cochrane Database of Systematic Reviews, 2018(12), CD011902. [PMID: 30521682] | [DOI: 10.1002/14651858.CD011902.pub2]
- Green, A. C., Williams, G. M., Logan, V., & Strutton, G. M. (2011). Reduced melanoma after regular sunscreen use: randomized trial follow-up. Journal of Clinical Oncology, 29(3), 257-263. [PMID: 21135266] | [DOI: 10.1200/JCO.2010.28.7078]
- Hughes, M. C., Williams, G. M., Baker, P., & Green, A. C. (2013). Sunscreen and prevention of skin aging: a randomized trial. Annals of Internal Medicine, 158(11), 781-790. [PMID: 23732711] | [DOI: 10.7326/0003-4819-158-11-201306040-00002]
- Young, A. R., Claveau, J., & Rossi, A. B. (2017). Ultraviolet radiation and the skin: Photobiology and sunscreen photoprotection. Journal of the American Academy of Dermatology, 76(3S1), S100-S109. [PMID: 28038885] | [DOI: 10.1016/j.jaad.2016.09.038]
- van Zuuren, E. J., Fedorowicz, Z., Christensen, R., et al. (2017). Emollients and moisturisers for eczema. Cochrane Database of Systematic Reviews, 2017(2), CD012119. [PMID: 28166390] | [DOI: 10.1002/14651858.CD012119.pub2]
- Kafi, R., Kwak, H. S., Schumacher, W. E., et al. (2007). Improvement of naturally aged skin with vitamin A (retinol). Archives of Dermatology, 143(5), 606-612. [PMID: 17515510] | [DOI: 10.1001/archderm.143.5.606]
- van der Wouden, J. C., van der Sande, R., Kruithof, E. J., et al. (2017). Interventions for cutaneous molluscum contagiosum. Cochrane Database of Systematic Reviews, 2017(5), CD004767. [PMID: 28513067] | [DOI: 10.1002/14651858.CD004767.pub4]
