Mole checks in the UK: what happens and what to expect

Most people book because a mole has changed, a new one has appeared, something itches or bleeds, or they have a family history or lots of moles. Others want reassurance after a sunburn-heavy summer. Any new or changing pigmented lesion in adulthood deserves attention, because early melanoma is highly treatable, and most changing moles turn out to be harmless.

The clinician takes a brief history: how long the lesion has been there, whether it has changed, your skin type, sun exposure, previous skin cancers and family history. They examine the lesion in good light, usually with a dermatoscope, and may photograph it. If you ask for a full skin check, they will examine the whole surface, including the scalp, back, soles, between toes and nails, with your consent. You can ask for a chaperone.

• Reassurance that the lesion is benign, with advice on what changes to watch for.

• Monitoring: photographs and a review after a few weeks or months to look for change.

• Removal of the lesion with the sample sent for laboratory examination.

• Urgent referral to a skin cancer service if melanoma or another skin cancer is suspected.

• Treatment of non-cancerous conditions, such as a wart, seborrhoeic keratosis or dermatofibroma.

On the NHS, a GP assesses a lesion that concerns you or them and refers on the urgent suspected cancer pathway when criteria are met. The pathway aims for fast specialist assessment, though waits vary. Private mole checks offer faster access and often longer appointments, and some include digital photography. Quality varies with the clinician's training. Ask who will examine you, what training they have and what happens if something suspicious is found.

No test is perfect. Dermoscopy improves accuracy in trained hands, but some melanomas look benign and some benign moles look worrying. That is why clinicians combine appearance with change over time, and why a biopsy is sometimes needed. A normal check today does not exclude a new problem later, so keep checking your own skin.

Remove nail varnish and makeup if relevant, wear clothes that are easy to remove, and note moles that worry you. Bring photographs from previous months if you have them, because change is the most useful sign. Tell the clinician about previous skin cancers, sunbed use, immunosuppression and family history.

Ask whether the clinician uses a dermatoscope, how they will record findings, what the plan is for lesions that need review and how results of any removed lesion will be communicated. If a lesion is removed, ask to see the histology report and who will explain it.