Mole mapping

What is mole mapping?

With mole mapping, a specialist photographs and keeps track of the moles across your skin, comparing the images at each visit to check for anything new or changed. It's one of the main ways doctors watch for early signs of skin cancer.

Why might I need mole mapping?

Anyone can book mole mapping, whether that's for peace of mind or because something has caught your eye. It tends to matter more, though, if certain things apply to you.

You might be a good candidate for mole mapping if:

• you have lots of moles, or any that look out of the ordinary
• skin cancer runs in your family, or you've had it yourself before
• your skin is fair, or prone to burning and freckling outdoors
• you've had bad sunburn in the past, or spent long periods in hot climates
• you've used sunbeds 
• your immune system is weakened, whether from medication or a health condition.

The main thing mole mapping looks for is melanoma, a form of skin cancer that starts in pigment cells and can spread elsewhere in the body if it's missed early on.

Sun exposure and sunbed use are its main triggers, and while it can appear anywhere, it shows up most often on parts of the body that see the sun, such as your face, arms, hands and chest.

A useful way to remember what to look out for is the ABCDE check:

• Asymmetry: The two halves of a mole don't match
• Border: An edge that's become irregular
• Colour: Uneven or changing shades
• Diameter: Getting larger, especially past 6mm
• Evolving: Any new mole, or an old one that's changing.

A mole that bleeds, itches, or turns crusty is also worth getting looked at, even if it doesn't fit this pattern.

What are the benefits of mole mapping?

Catching a change early is what mole mapping is really about. When melanoma is caught at its earliest stage, it's usually curable with a fairly minor procedure, so the whole point of regular mapping is to give your specialist the best possible chance of spotting something while it's still easy to treat.

There's a reassurance side to it too. Photographing your whole body means nothing gets missed, even moles in spots you can't easily see yourself, like your back or scalp. For anyone worried about their skin, having a professional keeping watch can take a lot of the anxiety out of waiting and wondering.

Are there different types of mole check?

There are broadly two options:

• A full mole map: This covers your entire body, building a complete photographic record of every mole so that nothing gets missed and future changes are easy to spot
• A single mole check: This focuses on one spot you're worried about, giving it a detailed once-over without mapping the rest of your skin.

Either way, any mole that catches a specialist's attention gets a closer look through a dermatoscope, a lit magnifying tool that reveals detail beneath the surface of the skin that the naked eye can't pick up.

Do I need a referral for mole mapping?

You can typically book mole mapping yourself without going through your GP first, although a referral from your GP or a dermatologist works just as well if you'd rather go that route.

Private medical insurance sometimes covers this test, but policies vary and often only start paying once a problem has actually been found, so it's worth checking with your insurer beforehand.

How do I prepare for mole mapping?

There isn't much to do beforehand, and your consultant will walk you through what to expect at your appointment. A few small things on the day can still make the photographs clearer:

• ensure you aren't wearing make-up, fake tan, or lotion on the areas being photographed
• leave off nail varnish and jewellery
• tie long hair back so your neck and hairline are clear
• if you have body hair over any moles you'd like checked, trimming it first helps
• mention any moles in places that are hard to see or photograph, such as your scalp, beforehand.

You'll also fill out a short form when you arrive, covering your moles and why you've booked in, so it helps to arrive a little early.

What happens during mole mapping?

A typical appointment lasts about 30 minutes, combining a consultation with the imaging itself.

1. You'll talk through your health background with your consultant, covering any skin cancer in the family, your history in the sun, and any moles that concern you
2. Your skin is examined, and any moles that need a closer look are flagged for magnified photography
3. A series of standardised photographs, often around 16 to 18, are taken to cover every mole on your body – some clinics use a whole-body imaging system that captures everything in one go rather than through separate shots
4. Moles flagged as worth a second look are photographed again at higher magnification using a dermatoscope
5. Before you leave, your consultant will discuss what's been found and what, if anything, should happen next.

What happens after mole mapping?

It depends on what's found:

• If nothing of concern shows up, you'll likely be advised to keep checking your own skin and come back for another map in around a year
• If your risk is judged to be somewhere in the middle, an annual check alongside your consultant's review is often suggested
• A mole with some features of concern may mean closer monitoring every 3 to 6 months, rather than removal straight away
• A mole that looks more clearly abnormal is usually removed, sometimes on the same day, and sent off for testing to confirm what it is.

Your full written report may take a little while to reach you after your visit, and it will set out when your next appointment should be.

What are the risks of mole mapping?

Taking photographs of your skin carries no physical risk. There's no pain involved and no radiation, so it's considered one of the gentler ways to keep tabs on your skin health.

It's worth bearing in mind that mole mapping isn't foolproof. Occasionally a mole can change faster than your check-up schedule allows for, so don't wait for your next appointment if you spot something new or different in the meantime – get it looked at straight away.