Sunspot, mole or something to check?

Living on this stretch of coast, most of us have plenty of sun-exposed skin with freckles, sunspots and moles on it. The goal is not to worry about every mark. It is to know which ones deserve a closer look.

What a sunspot is

Sunspots, or solar keratoses, are flat, scaly patches that feel rough, a bit like sandpaper, and are often easier to feel than to see. They can be skin coloured, pink or red, and they turn up on the face, ears, scalp, forearms and backs of the hands, mostly from about the age of 40.

They are a sign of sun damage rather than a cancer, but they matter for two reasons. A small number can develop into a squamous cell carcinoma if left alone, and having them tells your GP your skin has had enough sun to raise the chance of skin cancer elsewhere.

Signs a spot is worth checking

For moles and pigmented spots, the ABCDE guide is a good place to start:

• Asymmetry: the two halves do not match.
• Border: the edge is irregular, blurred or notched.
• Colour: more than one colour, such as brown, black, red, pink or blue.
• Diameter: larger than about 6mm, though early melanomas can be smaller.
• Evolving: changing in size, shape, colour or height.

Some skin cancers do not follow that pattern at all. Also book for:

• A sore or scab that has not healed after three or four weeks.
• A pearly or shiny lump, sometimes with fine blood vessels on the surface.
• A thickened, red, scaly spot that is growing or tender.
• A firm lump that is raised and growing over weeks, even if it is not dark.
• A spot that looks different from all the others on your body.

What happens at the appointment

Your GP examines the spot with a dermatoscope, a magnifier with a polarised light that shows structure under the surface of the skin. Many things can be settled there and then. Sunspots are often treated with liquid nitrogen in a few seconds, or with a prescription cream where there are many across one area. A spot that needs a closer look can be sampled or removed under local anaesthetic, and it is sent to pathology. We contact you with the result either way.