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Abnormal Moles

The concept of abnormal moles is confusing to many patients. Most people have heard that everyone should check his or her skin each month for symptoms of skin cancers. When an individual has many moles on the face and body, a board-certified dermatologist, such as Dr. Kathleen J. Smith, at Dermatology Specialists of Atlanta is needed to determine whether any of them are actually abnormal or atypical. However, certain warning signs can help patients know when it’s best to report suspicious-looking moles or growths to the dermatologist.

Fortunately, there’s a simple acronym to help patients remember what to look for when examining their moles. Think “ABC’s” – asymmetry, border, and color — or continue with “ABCD’s” – asymmetry, border, color, and diameter — or even “ABCDE’s” — asymmetry, border, color, diameter and elevation — to take notes about any potentially abnormal moles. Then, contact Dr. Kathleen J. Smith about any abnormal or atypical mole concerns as soon as possible.

  • Assymmetry. Benign common moles or pigmented freckles are usually quite balanced or symmetrical. Imaging drawing a line from the center of one of these skin spots—there are two practically identical, symmetrical parts of the whole. In abnormal or atypical moles, the halves aren’t equal and look uneven.
  • Border. Unlike the smooth edges of a common benign mole, potentially cancerous moles have uneven, ragged, feathery, or even blurred borders.
  • Color. Common, benign moles are just one color. They’re suspicious, or abnormal, when they’re multi-colored (or show more than a single shade of a primary color palette). The mole can look much lighter, even white, or darker, even black, than its usual healthy color.
  • Diameter. Think about the size of a number two pencil eraser, about one-fourth an inch or six millimeters. Wider moles, even those without the other elements –A, B, or C—are automatically suspicious.
  • Elevation. Some people also say “E” is for “evolution” of the mole when it’s apparently changing in any way described above. However, the elevation, whether raised or depressed, of the mole or surrounding skin can indicate abnormal or atypical moles or the presence of cancer.


Dermatology Specialists of Atlanta evaluates the patient’s potential abnormal or atypical moles through the following steps:

  1. Determines whether mole is atypical, i.e. with poorly-defined borders, coloration-variegation, or if mole has recently changed in any way.
  2. If no: Patient should continue self-checks and make an annual skin check-up appointment with Dr. Kathleen J. Smith.
  3. If it’s difficult to ascertain yes or no, the dermatologist considers biopsy (especially if the mole is in a hard-to-see spot, e.g. scalp or genitalia.)
  4. Dermatology Specialists of Atlanta evaluates the patient’s level of genetic risk: Does/Did a first-degree relation have/had melanoma, or has patient previously had melanoma? Does patient have many atypical moles or “atypical mole syndrome”?
  5. If no, dermatologist checks for any stand-out atypical moles according to ABCDE’s criteria — includes visual scan for any moles that stand out from the rest.
  6. If yes, perform excise or punch biopsy.
  7. Secondary consideration: if any moles have changed according to ABCDE’s criteria, discuss patient risk factors. Include photography/dermal monitoring. Patient follow-up in six to twelve months.


Patients with suspicious abnormal or atypical moles shouldn’t panic! Concerns about skin cancer require scheduling an office visit. It’s best to call Dermatology Specialists of Atlanta to arrange an appointment because only a board-certified dermatologist can determine what’s normal — and what isn’t. Because not all atypical or abnormal moles are the result of cancer — they may be genetic or the result of sunlight, hormones, or pregnancy — patients in and around North Decatur, GA, Druid Hills, GA, Panthersville, GA, Tucker, GA, Sandy Springs, GA, or throughout Greater Atlanta Metro can take advantage of an experienced, triple board-certified dermatologist by calling Dr. Kathleen Smith at 678-904-4932 now.

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