How to Do a Monthly Skin Self-Exam: A Step-by-Step Guide

The Bottom Line

A monthly skin self-exam takes about 15 minutes and can help you catch melanoma at an earlier, more treatable stage. People who regularly check their own skin detect melanomas at a median thickness of 0.6-1.0 mm—significantly thinner than the 1.5-2.5 mm average for clinically detected cancers. Thinner means better odds. This guide shows you exactly how to do it, what to look for, and when to call your dermatologist.

Why Monthly Skin Self-Exams Matter

You know your own skin better than anyone else. You see it every day, and you are often the first person to notice when something new appears or when an existing mole changes. Studies show that patients who perform regular skin self-examinations detect melanomas at significantly earlier stages than those who rely only on doctor visits for detection. Earlier detection translates directly to better survival:

  • Melanoma caught at Stage IA (thinnest) has a 10-year survival rate of over 95%
  • Melanoma caught at Stage IIC (thicker, more advanced) has a 10-year survival rate of about 40%
  • Regular self-examiners have been shown to have 15-25% better melanoma-specific survival compared to non-screened populations

Self-examination is not a replacement for seeing a dermatologist—about 30% of melanomas develop on areas you can't easily see yourself. But it is a powerful complement to professional screening.

How Often Should You Examine Your Skin?

  • Monthly: If you have a personal history of melanoma, a family history of melanoma, or 5 or more atypical moles
  • Every 3 months: If you have some risk factors (family history, fair skin, significant sun exposure history)
  • Annually: If you are at average risk

Set a recurring monthly reminder on your phone so the habit sticks. Many people tie it to the same date each month or a routine event (like the first day of the month, or after a specific household task).

What You Need

  • A brightly lit room (natural daylight is ideal, or a bright exam light)
  • A full-length mirror
  • A handheld mirror (for viewing hard-to-see areas)
  • A hair comb or part-comb for the scalp
  • Your smartphone for photos (optional but very helpful)

The ABCDE Warning Signs

Before walking through the exam steps, understand what you're looking for. Any mole or spot that shows one or more of these features warrants a dermatologist visit:

  • A – Asymmetry: If you drew a line through the center of the mole, the two halves would look noticeably different from each other.
  • B – Border: The edges are irregular, scalloped, notched, or blurry instead of smooth and well-defined.
  • C – Color: Multiple shades within the same spot—tan, brown, black, red, white, or blue all in one lesion—instead of a uniform single color.
  • D – Diameter: Larger than 6 mm (about the width of a pencil eraser). Note: Some melanomas are smaller, so size alone should not reassure you.
  • E – Evolution: Any change over recent weeks or months—growing larger, darker, lighter, changing shape, starting to bleed, itch, or crust. This is often the most important sign.

Also use the “ugly duckling” rule: if one mole looks noticeably different from all your others, it deserves attention regardless of whether it technically meets ABCDE criteria.

Step-by-Step Exam Guide

Step 1: Face, Scalp, and Neck

Stand in front of the full-length mirror in good light. Examine your face, including the skin around your eyes, nose, lips, and ears (front and back). Use the comb to part your hair in multiple sections to examine your entire scalp. Don't forget your neck—front, sides, and back.

Step 2: Arms and Hands

Examine the fronts and backs of both arms, your elbows, and your forearms. Look carefully at your hands—both the palms and the backs. Spread your fingers and look at the skin between them. Check under your fingernails (dark stripes under nails can rarely be nail melanoma).

Step 3: Chest and Abdomen

Examine your chest and abdomen. Women should lift their breasts to check the skin underneath. Also check your armpits, which many people forget.

Step 4: Back and Buttocks

Use the handheld mirror in front of the full-length mirror to see your upper and lower back. Examine your buttocks. This is the area most people miss and where many melanomas are discovered late—consider asking a trusted partner to help with the upper back.

Step 5: Legs and Feet

Sit down to examine your legs more easily. Check the fronts, backs, and sides of both thighs and lower legs. Look carefully at the soles of your feet, between your toes, and under your toenails. Acral lentiginous melanoma—a type that occurs on palms and soles—is often diagnosed late because these areas are easy to overlook.

Step 6: Genital Area

Melanoma can develop in the genital and perianal area. Use the handheld mirror to examine these areas. About 5-10% of melanomas occur in genital locations.

Documenting What You Find

Photography is one of the most useful tools for tracking change over time. Take photos of any moles you want to monitor and store them with the date. At each exam, compare current photos to previous ones—it is much easier to spot subtle changes this way than relying on memory alone.

  • Use consistent lighting and distance for each photo
  • Include a ruler or common object for scale when photographing a lesion
  • Simple written notes work too: “mole on right shoulder blade—5mm, brown, symmetric, stable borders”

What to Do If You Find Something Concerning

Do not panic. Most moles—even unusual-looking ones—turn out to be benign on professional evaluation. But do not ignore a concerning finding either. Call your dermatologist if you notice:

  • A new mole or spot that appeared since your last exam
  • Any existing spot that has changed in size, shape, or color
  • A spot that bleeds, itches, crusts, or oozes without injury
  • A lesion meeting 2 or more ABCDE criteria
  • Anything that simply doesn't look right to you—your instinct matters

Aim to be seen within a few weeks for a change you are concerned about. Truly rapidly changing lesions (doubling in size within weeks) should be seen as soon as possible.

The Limits of Self-Examination

It's important to be realistic about what self-exams can and cannot do:

  • About 30% of melanomas develop on areas that are very hard to see yourself—the back, scalp, and similar areas
  • Your own diagnostic accuracy (sensitivity ~40-60%) is lower than a dermatologist with dermoscopy (90-95%)
  • Self-examination may occasionally miss a lesion that looks subtle and benign to your eye

For these reasons, self-exams should always be paired with regular professional dermatology screenings. Think of self-exams as your ongoing watchfulness between doctor visits, not a replacement for them.

When to See a Dermatologist

  • You found something during self-exam that meets ABCDE criteria
  • A spot has changed in any way since your last exam
  • A lesion is bleeding, itching, or won't heal
  • You want a dermatologist to document your moles with photography for future comparison
  • You haven't had a professional full-body skin check in the past year (or past 3-6 months if high-risk)

Frequently Asked Questions

What if I have hundreds of moles? How do I keep track?

If you have many moles, consider asking your dermatologist for a mole mapping session—this involves photographing all significant moles at your visit for professional comparison at future appointments. At home, focus your attention on moles that you find unusual or that seem different from the others. You do not need to photograph every single mole; prioritize the ones that concern you or look atypical.

My mole has been there for years. Should I still watch it?

Yes. Melanomas can arise from existing moles that have been stable for a long time. The key warning sign is change—if a long-standing mole suddenly starts growing, darkening, or behaving differently, that change warrants evaluation. However, a mole that is truly stable year after year is more likely benign than one that evolves.

Can I use a smartphone app to analyze my moles?

Several apps can help you photograph and track moles over time, which is genuinely useful. However, no consumer app replaces professional dermoscopy or a dermatologist's evaluation. AI-based apps analyzing mole photos have variable accuracy and should not be used to reassure yourself that a concerning spot is fine. Use apps as a documentation tool, not a diagnostic one.

Is a self-exam enough if I'm high-risk?

No. If you have a personal or family history of melanoma, multiple atypical moles, or other high-risk features, monthly self-exams need to be paired with professional dermatology visits every 3-6 months. Your dermatologist has tools (dermoscopy, photographic documentation) that significantly improve detection accuracy beyond what you can achieve on your own.

References

  1. Friedman RJ, Rigel DS, Kopf AW. Early detection of malignant melanoma: the role of physician examination and self-examination. CA Cancer J Clin. 1985;35(3):130-151.
  2. Berwick M, Begg CB, Fine SW, et al. Prevalence of cutaneous melanoma risk factors in a general population. J Clin Oncol. 1992;10(7):1011-1016.
  3. Rigel DS, Friedman RJ, Kopf AW, et al. ABCDE rule for the identification of high-risk melanomas. Dermatol Surg. 2015;41(6):653-659.
  4. Argenziano G, Puig S, Zalaudek I, et al. Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet. J Am Acad Dermatol. 2003;48(5):679-693.
  5. Green A, Williams G, Logan V, et al. Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol. 2011;29(3):257-263.
  6. Swetter SM, Tsao H, Bichakjian CK, et al. Guidelines of care for the management of primary cutaneous melanoma. J Am Acad Dermatol. 2019;80(1):208-250.

Trusted Resources

Always consult a board-certified dermatologist for personalized guidance on screening frequency and evaluation of any suspicious skin changes.