Mole checks & head to toe skin check

What is the difference between a mole check and mole mapping?

Mole mapping usually refers to a photography-based screening service. Photographs are taken of the whole body, with close-up images of selected moles or skin marks that appear unusual. The person taking the photographs is usually a trained imaging technician or healthcare professional, but is not usually a Consultant Dermatologist and may not be the clinician who reviews the images. The images may then be assessed electronically by artificial intelligence, a dermatologist, or another skin specialist, often remotely.

Mole mapping can be helpful, especially when good-quality photographs are available for comparison over time. However, it is important to understand that photography-based mole mapping is not the same as a full in-person skin examination with a Consultant Dermatologist.

What can a face-to-face mole check assess that mole mapping may miss

• Difficult-to-photograph areas: Some areas of the body are difficult to photograph properly, including the scalp, tops and backs of the ears, groin, soles of the feet, between the toes, and under the nails. These areas can be examined properly during an in-person mole check.
• Incidental skin cancers. Photography-based services usually assess the images submitted to them by the operator. If a lesion has not been photographed clearly, or has not been selected for close-up imaging, it may not be assessed in detail. During a face-to-face consultation, the dermatologist examines the skin directly and can identify unrelated or unexpected lesions elsewhere on the body.
• Contextual assessment of all your moles and skin. An experienced Consultant Dermatologist does not assess each mole in isolation. They compare each lesion against the pattern of all your other moles and your skin in general. A mole that looks different from your own usual pattern — known as the “ugly duckling” sign — can be an important warning sign and is best assessed during a face-to-face whole-body examination.
• Inclusion of pink, red or skin-coloured lesions. Photography-based mole mapping is mainly designed to assess pigmented moles. However, not all skin cancers are brown or black. Some melanomas are pink, red, skin-coloured, or only lightly pigmented. These are known as amelanotic melanomas. Non-melanoma skin cancers, such as basal cell carcinoma and squamous cell carcinoma, may also be pink, red, scaly, crusted, or non-pigmented. In-person dermoscopy allows the dermatologist to assess blood vessel patterns and other structures, even when pigment is absent.
• Assessment of symptoms, not just appearance. Symptoms such as itching, bleeding, tenderness, crusting, or a new sensation in a mole can be clinically important, even if the lesion does not look especially worrying in a photograph.
• Precancerous skin lesions. A Consultant Dermatologist can also identify and assess precancerous skin changes, such as actinic keratoses, during the examination. These may not always be the main focus of a mole mapping service.
• Immediate decision making and same-day action if treatment is needed. If a lesion looks suspicious during a Consultant Dermatologist appointment, a biopsy or removal can often be planned without needing a separate assessment first. Some precancerous lesions may also be treated at the appointment with liquid nitrogen therapy or managed with prescription treatments.

Is mole mapping still useful?

Yes. Total body photography and mole mapping can be very useful, especially for monitoring changes in the skin over time. It can be particularly helpful for patients with many moles, atypical moles, or a history of melanoma. Mole mapping is best thought of as a supplement to, rather than a replacement for, a Consultant Dermatologist mole check. If you have previous mole mapping photographs, please bring them to your appointment. They can help show whether any lesions have changed over time.