Is It Cancerous? A Derm Explains How to Decode Your Skin Marks
If I had to give myself a lifetime grade for sun protection, it would probably be a B-minus. I've never stepped foot in a tanning bed; I've never been so hell-bent on bronzed skin to cover myself in oil and lay out for hours on end. But I've also never been particularly stringent about lathering on SPF on a daily basis. (I'm just going to the office, I tell myself.) Or, I'll go for a hike with a layer of sunscreen on my face and shoulders but completely neglect my arms and legs. (It's just an hour, I tell myself.) Or, I'll shrug off the resulting bad burn. (It happens, I tell myself.)
When I moved to L.A. last year, my own negligence became a lot more difficult to justify—it's a lot harder to ignore the sun when it shines for nearly 365 days a year, unpunctuated by overcast skies and harsh winters. And even though I think I've greatly improved my habits over the past several months as a result (you'll always find a tube of La Roche-Posay's Anthelios in my bag), this summer, I've still noticed a handful of phantom marks appear on my skin. There's a chance that some of them have lived there for some time, and I'm only seeing them now as a result of my newly invigorated routine. But how can I know for sure? What's the difference between an innocuous sunspot and a precancerous mole, anyway?
It only made sense to defer to a dermatologist—in fact, I spoke with two to clear things up. And while both strongly advise checking in with your own skin doc for regular scans—especially if you notice anything new or worrisome—you can sidestep some immediate panic by looking out for certain signs at home. Below, we decode it all.
Sunspots: "Sunspots—or as we call them in dermatology, solar lentigos—are a result of sun damage or sun exposure and tend to be larger than freckles," says Dr. Rachel Nazarian, NYC-based dermatologist. "They can fade and get darker based on exposure to sunlight but don't ever fully disappear." "A sunspot has a well-defined border and is symmetrical," adds Dr. Debra Jaliman, NYC-based dermatologist and founder of Sea Radiance. They often appear on the back of the neck, hands, and chest, and we'll often see more of them appear as we get older. Like moles, sunspots have the potential to be cancerous, and should be checked out by a derm if you notice any abnormalities.
Freckles: On the flip side, freckles are inherited, smaller, and tend to decrease with age—not to mention they usually make more of an appearance in the summer and fade as sun exposure decreases in the winter.
Moles: "Moles, which come in different colors and types, are benign collections of cells called melanocytes, which produce pigment," says Nazarian. "They are permanent findings on skin, and although they may darken with exposure to sun or during pregnancy, they never fully disappear. Moles can either be acquired later in life or can even be seen at birth." Jaliman adds that moles can be either flat or raised, and both note that like sunspots, they should be monitored very closely for any changes or irregularities.
When Should I Be Concerned?
"Signs of concern with sunspots and moles include uneven borders, uneven colouring, change in size or shape, or irritation and bleeding," says Nazarian. To help you remember, consider learning the Skin Cancer Foundation's ABCDEs of warning signs:
A: Asymmetry. If you were to draw a line through your skin mark, do both sides match in color and shape? If not, it could be a sign of melanoma.
B: Border. Benign marks tend to have smooth, defined borders, while malignant moles might be uneven or scalloped.
C: Colour. If your mark looks dappled or has multiple colors, it could be a sign of melanoma. Benign moles and sunspots tend to be solid and brown.
D: Diameter. Malignant marks tend to be bigger in size, but the best rule of thumb is to monitor your mole or sunspot and see if it grows. If so, it's time to get it checked out by a doc.
E: Evolving. Again, while they might darken and fade with sun exposure, most benign marks stay the same over time. If you notice any changes in a sunspot or mole, you should get it checked to be sure.
How Can I Check Myself?
Your dermatologist will give you the most thorough exam, but it's definitely worth knowing how to give yourself the once-over at home so you can always have an eye out for warning signs. "Take a mirror once a month and examine your entire body including your back and the back of your legs," says Nazarian. "This helps you make a mental map of the spots you have, and you'll be more likely to notice if something is new or changing."
The Bottom Line
When in doubt, see a doctor—in fact, see a doctor regardless. "It can be difficult for people to tell the difference between sunspots, freckles, and moles at home," says Nazarian. "Everybody should get an annual total body skin check, where they visit with their dermatologist and are examined from head to toe for all their moles and sunspots."
And most importantly, don't doubt yourself! "Trust your gut instinct," says Nazarian. "If you have a bad feeling about a mole or spot but can't articulate exactly why, trust your instincts and show it to a dermatologist. Many patients can tell when something is wrong with their body, including with their skin."
Being smart about your skin starts with picking a great SPF. Here is everything you need to know about sunscreen.