A new or changing mole and when to arrange a skin assessment
A mole that is changing in size, shape or colour is worth having checked. Most moles are harmless, but changes can sometimes be a sign of skin cancer. Arrange an assessment rather than trying to decide from a photograph or waiting for the spot to become painful.
A new or unusual growth, repeated bleeding, persistent itching or a sore that does not heal also deserves attention. You do not need to match every feature on a checklist before seeking advice. The Cancer Association of South Africa (CANSA) advises seeking medical advice promptly for a concerning spot rather than waiting for the next routine check.
A useful way to notice changes
The ABCDE guide is a reminder of features to mention when you book an appointment:
- Asymmetry: one half looks different from the other
- Border: the edge looks irregular, uneven or difficult to define
- Colour: there are different shades or a change in colour
- Diameter: the spot is growing or is larger than about 6 mm, although melanoma can be smaller
- Evolving: its appearance is changing, or it looks different from your other moles
CANSA’s guidance on melanoma warning signs explains these changes. Its 2026 melanoma fact sheet also notes that some melanomas are smaller than 6 mm. These warning signs are prompts for assessment, not a test you can use to rule cancer in or out. A small, evenly coloured spot can still need attention if it is new, changing or concerning you.
When you call, describe the change and when you first noticed it. If the spot is growing rapidly or repeatedly bleeding, make that clear so the practice can advise how promptly it should be seen.
Check more than your face and arms
Skin cancer can occur on areas that receive little sun as well as frequently exposed skin. Look at your back, scalp, the spaces between your toes, the soles of your feet, palms and nails. A mirror or someone you trust can help you see awkward areas.
All skin tones can develop skin cancer. In darker skin, a new or changing patch on a palm or sole, an unusual growth or a changing dark mark around or under a nail should not be overlooked. CANSA’s 2026 fact sheet describes melanoma on palms, soles and beneath nails, including in people with darker skin.
There are also skin cancers that do not resemble a typical dark mole. A persistent rough patch, shiny bump or sore that heals and returns can need assessment. CANSA’s basal-cell carcinoma information describes these warning signs. These signs have other possible causes; examination is how a clinician starts to distinguish them.
Prepare a clear history
Before the appointment, write down where the spot is, when you first noticed it and what has changed. Note itching, tenderness, crusting or bleeding. If you have a dated photograph showing how it looked previously, bring it along. Taking a photograph can help record a change, but should not delay booking a concerning lesion.
Tell the clinician about any personal or family history of skin cancer, previous biopsies or removals, and relevant medicines or health conditions. Bring earlier results if you have them. Mention all the spots that concern you rather than assuming the most visible one is the only one that matters.
Ask reception how to prepare, particularly if the area is under a nail, on the scalp or difficult to examine. You can ask about privacy, a chaperone or other support that would help you feel comfortable during the examination.
What an assessment may involve
The clinician will review your history and examine the area. A dermatologist may use a dermatoscope, a device that provides a closer view of features in the skin. CANSA describes dermoscopic screening in its SunSmart information; confirm which assessment is appropriate and available at your appointment. Depending on the findings, the next step could be advice, follow-up, a specialist referral or a biopsy.
A biopsy involves removing tissue so a laboratory can examine it. CANSA’s patient education on diagnostic tests explains the role of examining the skin and testing a biopsy in a laboratory. Being referred or having a biopsy does not by itself establish a cancer diagnosis.
Ask what the clinician is checking, whether a procedure is recommended, and what the benefits, risks and costs are. If a sample is taken, confirm who will contact you with the result and when to follow up if you have heard nothing. Do not assume that silence means the result is normal.
Protect your skin while staying alert to change
Sun protection helps reduce exposure to ultraviolet radiation. For outdoor days in Johannesburg, combine shade, protective clothing, a broad-brimmed hat and UV-protective sunglasses. Use a broad-spectrum sunscreen with SPF 30 or higher on exposed skin, and reapply at least every two hours and after swimming or sweating, following the product instructions.
The WHO’s sun-protection guidance recommends using these measures together and avoiding sunbeds. Sunscreen does not provide complete protection or make a changing mole safe to ignore. CANSA encourages monthly self-checks, including areas you cannot easily see. Ask your clinician how often you should also have professional checks based on your own risk.
Arrange a skin assessment in Fourways
Mediwell’s service directory lists dermatology and skin-health screening at Dainfern Square. Contact Mediwell on 011 300 2900, describe the concern and ask about the appropriate appointment and current practitioner availability. If you cannot access dermatology promptly, ask about a GP assessment and referral rather than leaving a changing lesion unchecked. If you use public healthcare, ask your clinic for assessment and the appropriate referral route; do not wait for an occasional screening campaign to investigate a worrying change.
This article is general information. A skin examination and, where necessary, laboratory testing are needed to establish a diagnosis and guide treatment.
