Is That Mole Changing? What Melanoma Actually Looks Like

Every 30 minutes, an Australian is diagnosed with melanoma. And by the age of 85, around 1 in 17 Australians will have heard the words, “You have melanoma.”

For a cancer that often begins as just a mole that looks a bit “off”, that’s a staggering statistic.

If you’ve ever stood in front of a mirror wondering, “Has that mole always looked like that?” you’re definitely not alone. With our strong sun, outdoor lifestyle and mostly fair-skinned population, Australia has some of the highest melanoma rates in the world.

The good news? When melanoma is found early, surgery can cure about 90% of cases. The challenge is recognising the skin cancer signs before they cause trouble.

In this post, we’ll walk through:

• What melanoma actually is (in plain English)
• The key melanoma symptoms to look out for
• The ABCDE rule of skin – your practical mole check guide
• What to do about a changing mole and when to worry
• What happens if your doctor is concerned
• How a telehealth service like NextClinic can help with referrals, prescriptions and medical certificates along the way

We’ll focus on the Australian context, use evidence from trusted sources like Cancer Council, Cancer Australia and Melanoma Institute Australia, and keep the tone straightforward, conversational and – we hope – empowering.

This is general information for Australian readers, not personalised medical advice. If you’re worried about a specific spot right now, please arrange to see a doctor promptly, call Healthdirect on 1800 022 222, or dial 000 in an emergency.

Looking for online prescriptions?

Starting from $24.90

Request Now

Looking for online prescriptions?

Starting from $24.90

Request Now

Why melanoma deserves your attention in Australia

Australia and New Zealand consistently rank at or near the top for melanoma incidence worldwide. Melanoma is:

• The third most common cancer overall in Australia
• The most common cancer in Australians aged 20–39
• Responsible for an estimated 18,964 new cases in 2024 alone

At the same time, five‑year survival for melanoma is now around 94%, largely thanks to earlier detection and better treatments.

So we’re looking at a cancer that is:

• Common in Australia
• Potentially deadly if missed
• Often curable when caught early – sometimes with a relatively small operation

That’s why learning to recognise skin cancer signs – especially what melanoma really looks like – is so valuable.

What is melanoma, really?

Your skin is made up of different cell types. The pigment‑producing cells are called melanocytes – they give your skin, hair and moles their colour.

Melanoma happens when these melanocytes turn cancerous and start to grow in an uncontrolled way. Over time, melanoma cells can invade deeper layers of the skin and, if not treated, spread (metastasise) to lymph nodes and organs like the lungs, liver or brain.

Melanoma is less common than other skin cancers like basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), but it is usually more dangerous, because it’s more likely to spread if not caught early.

Melanoma can:

• Develop in an existing mole
• Appear as a brand‑new spot
• Show up in places that rarely see the sun – under nails, on the soles of the feet, or even in the genital area or inside the mouth

That’s one reason a quick glance at your shoulders in summer isn’t enough.

Melanoma symptoms: skin cancer signs you shouldn’t ignore

There isn’t just “one look” for melanoma, but there are patterns doctors and dermatologists see again and again.

Common melanoma symptoms include:

• A new spot on the skin that looks different to your other moles or freckles
• A changing mole – in size, shape, colour or thickness
• A spot with irregular edges (not smooth or round)
• A mole that is more than one colour – for example, various shades of brown, black, tan, red, white or blue
• A mole or spot that itches, bleeds, oozes or becomes crusty
• A sore that doesn’t heal after several weeks
• Dark areas under a finger- or toenail, especially if there’s no clear injury
• Dark or unusual spots on mucosal surfaces – for example, inside the mouth, on the genitals, or around the anus

The tricky part is that many of these can be caused by non-cancerous conditions as well. So the goal isn’t to turn yourself into a dermatologist overnight, but to develop a basic radar for “that doesn’t look right – time to get it checked”.

That’s where the ABCDE rule comes in.

Your mole check guide: the ABCDE rule for skin

The ABCDE rule skin checklist is one of the simplest, most widely used tools for spotting potential melanomas.

Think of it as a quick scan you can do when you notice a mole that makes you pause.

A – Asymmetry

Look at the mole and imagine drawing a line through the middle.

• Symmetrical moles are usually harmless: both halves look similar.
• Asymmetrical spots (one half doesn’t match the other) are more concerning.

If the mole would make a very dodgy butterfly if you folded it in half, that’s a flag.

B – Border

Check the edges of the spot.

• Benign moles usually have smooth, even borders.
• Suspicious spots may have irregular, jagged, scalloped or blurred edges, or colour “spilling” into the nearby skin.

An uneven, smudgy outline is worth a closer look.

C – Colour

Healthy moles are often one consistent colour (typically a uniform light to medium brown).

Potential melanomas may:

• Contain multiple colours – different shades of brown, black, red, white, grey or blue
• Look patchy or blotchy
• Include areas of loss of colour within a darker mole

Remember that some melanomas can be relatively pale or even skin‑coloured, so colour alone doesn’t rule anything in or out.

D – Diameter

Size matters, but it’s not everything.

• Many melanomas are larger than about 6 mm across (roughly the size of a pencil eraser or the blunt end of a chopstick).
• Some melanomas are smaller than this, especially early on.

More important than the exact measurement is a mole that is getting bigger over time.

E – Evolving

This is often the most important sign.

Ask yourself:

• Has this mole changed in the last few weeks or months?
• Is it growing, darkening, becoming lumpier, starting to itch or bleed?
• Does it just feel “not like it used to be”?

Any mole or spot that is evolving – changing in size, shape, colour, surface, or symptoms – deserves a medical review.

"If a mole scores a “yes” for several ABCDE points, it doesn’t mean you definitely have melanoma – but it strongly means “don’t ignore this”."

When the ABCDE rule misses things: nodular & “ugly duckling” melanomas

The ABCDE checklist is useful, but not perfect. Some dangerous melanomas don’t follow the classic pattern.

Two important concepts to know are nodular melanoma and the “ugly duckling” sign.

Nodular melanoma and the EFG rule

Nodular melanoma is an aggressive type that tends to grow downwards into the skin rather than spreading outwards. It can grow quickly over weeks.

These spots often do not tick all the ABCDE boxes. Instead, doctors sometimes use the EFG rule:

• E – Elevated: the spot is obviously raised
• F – Firm: it feels firm or hard to touch
• G – Growing: it’s getting bigger, often quickly

Nodular melanomas are often:

• Smooth and dome‑shaped
• Red, pink, brown, black or skin-coloured
• Prone to bleeding or crusting

If you notice a new, firm, growing lump, especially one that bleeds easily, don’t wait for it to “settle down”.

The “ugly duckling” sign

If you have lots of moles, it can be overwhelming to check every one in detail. A simpler strategy is to look for the one that doesn’t match the others – the “ugly duckling”.

• If most of your moles are small, round and light brown, a larger, darker, oddly shaped mole stands out.
• If you have darker skin with few moles, a single new dark spot may be the one to watch.

In other words: pay special attention to any spot that makes you think, “That one just looks different.”

Changing mole? When to worry and call a doctor

Everyone gets the odd new freckle or mole, especially in childhood and adolescence. But in adults, new or changing moles should never be ignored.

Here’s a practical guide for “changing mole – when to worry”:

You should see a doctor promptly (within days to a couple of weeks) if you notice:

• A new mole or spot that:
  • Appears in adulthood, especially after about age 25–30
  • Looks different to your other spots
• An existing mole that:
  • Grows noticeably over a few weeks or months
  • Changes shape (becomes more uneven or lopsided)
  • Develops new colours or becomes much darker
  • Becomes raised or develops a lump in one area
• A spot that itches, tingles, feels sore or bleeds without obvious injury
• A mole or patch of skin that crusts, oozes or doesn’t heal
• A dark streak under a finger- or toenail that:
  • Isn’t clearly linked to trauma
  • Seems to be spreading
  • Is accompanied by pigment in the nearby skin around the nail
• Any patch in the genital area, between the buttocks, on the soles of the feet, or inside the mouth that’s new, dark or changing

You should seek urgent medical review (same day or within 24–48 hours) if:

• A mole or lump suddenly becomes very painful, inflamed or rapidly enlarges
• You have a concerning spot plus you feel generally unwell (fever, weight loss, unexplained fatigue) – this is less common but should be taken seriously

If in doubt, err on the side of getting it checked. Doctors would much rather reassure you about a harmless mole than see a melanoma months later.

How to do a simple at‑home skin check (Australia-friendly version)

Regular self‑checks can make a big difference. Cancer Council recommends getting to know your skin so you can spot changes early.

Aim to do a head‑to‑toe check every few months (more often if you’re high risk). Here’s how:

1. Set yourself up
   • Choose a well‑lit room with a full‑length mirror if possible.
   • Use a handheld mirror for harder‑to‑see areas.
   • Completely undress – skin cancers can show up where the sun “doesn’t shine” too.
2. Go from top to toe
   • Face & scalp: Check your face, ears and neck. Use a comb or hairdryer to part your hair and look through your scalp – or ask a partner or friend to help.
   • Torso: Look at your chest, breasts and stomach. Lift breasts and skin folds to check underneath.
   • Back: Use a handheld mirror to see your upper and lower back, then buttocks.
   • Arms & hands: Check fronts and backs of your arms, elbows, wrists, palms and the spaces between your fingers.
   • Legs & feet: Look at the fronts, backs and sides of your legs, behind your knees, inner thighs, ankles, tops and soles of your feet, between your toes, and under your toenails.
   • Genital area: With another mirror if needed, check the groin, genitals and around the anus. Melanoma can appear here too, and doctors are very used to examining these areas when necessary.
3. Look for
   • New spots that stand out
   • Existing moles that have changed (using the ABCDE rule)
   • Any sore that isn’t healing, or spot that looks and feels different from the rest
4. Take photos
   • Use your phone to take clear photos of any moles you’re watching.
   • Take new photos every few months from the same angle and distance to spot subtle changes over time.

If you’re not sure whether a change is meaningful, that in itself is a good reason to chat with a GP or skin cancer doctor.

Who is most at risk of melanoma in Australia?

Melanoma can affect anyone, but some groups are at higher risk, especially in a high‑UV country like Australia.

Risk factors include:

• Skin type & appearance
  • Fair skin that burns easily, freckles, or doesn’t tan well
  • Light‑coloured eyes (blue or green) and blonde or red hair
  • Large numbers of moles (especially more than 50)
  • Atypical‑looking moles (irregular or “dysplastic” moles)
• Sun exposure & environment
  • History of intense, intermittent sun exposure, particularly blistering sunburns in childhood or teenage years
  • Working or spending lots of time outdoors (tradies, farmers, surf lifesavers, outdoor athletes)
  • Living in high‑UV regions (e.g. much of Queensland and the NT)
• Personal & family history
  • Previous melanoma or other skin cancer
  • Strong family history of melanoma (especially in close relatives)
  • Certain inherited genetic syndromes
• Immune system factors
  • Conditions or medications that suppress your immune system (e.g. organ transplant recipients, certain autoimmune treatments)

What about darker skin?

People with brown or Black skin have a lower overall risk of melanoma, but it’s not zero. Melanoma in darker skin can be more likely to appear:

• On palms, soles and under nails
• In mucosal areas (e.g. mouth, genitals)
• At a more advanced stage, because it’s often not suspected early

So no matter your skin tone, any new, changing, persistent or unusual spot should be taken seriously.

What happens if your doctor is concerned?

If you see a GP, skin cancer clinic or dermatologist about a suspicious mole, here’s what typically happens.

1. Clinical skin examination

The doctor will:

• Ask about your history – when you first noticed the spot, how it has changed, family history of skin cancer, sun exposure, etc.
• Examine the spot and your surrounding skin.
• Often use a dermoscope – a special handheld magnifying device that helps them see structures beneath the surface.

Sometimes they’ll also examine the rest of your skin, especially if you’re high‑risk.

2. Decision: monitor vs biopsy

Depending on what they see, they might:

• Reassure you that it looks benign, but still remind you to monitor for changes
• Ask you to return for a review in a few months
• Recommend a biopsy – usually an excisional biopsy, where they remove the whole spot with a small margin of normal skin

A biopsy is the only way to definitively diagnose melanoma. The sample goes to a pathology lab, and a specialist looks at it under a microscope.

3. If it is melanoma

If the biopsy shows melanoma, the report will include details like:

• Thickness (Breslow depth)
• Whether it has ulceration
• How fast the cells are dividing
• Whether the edges (margins) are clear

These factors help stage the melanoma and guide treatment.

For early melanomas, the main treatment is usually:

• A second operation to remove a wider margin of normal skin around where the melanoma was

For more advanced cases, your team might discuss:

• Sentinel lymph node biopsy
• Further scans (e.g. ultrasound, CT, PET)
• Immunotherapy or targeted therapy, usually under the care of a specialist melanoma team

Overall, melanoma in Australia now has an excellent average outcome when caught early, with a five‑year survival of around 94%.

Where telehealth fits: how we can help at NextClinic

A crucial point first: telehealth can’t replace a hands‑on skin examination or a biopsy. No online doctor can “diagnose” melanoma from a photo alone with complete certainty.

But telehealth can play an important role in your skin cancer journey, especially in a big, sun‑soaked country where access to in‑person care isn’t always simple.

Here’s how we at NextClinic can help:

1. First step when you’ve noticed something worrying

If you’ve spotted a mole or lesion that concerns you:

• You can request a telehealth consultation with one of our Australian‑registered doctors from anywhere in Australia, often within an hour.
• We’ll take a detailed history – when you first noticed the spot, how it has changed, your risk factors and any symptoms (itching, bleeding, pain).
• Where appropriate, the doctor may ask you to describe the mole carefully and, if our platform allows, review clear, well‑lit photos.

From there, we can advise whether this looks like something that:

• Needs an urgent in‑person skin check or biopsy, or
• Could reasonably be reviewed in a standard GP or skin clinic appointment soon

If we believe you need prompt face‑to‑face care, we’ll say so clearly – your safety comes first.

2. Getting a dermatologist or skin clinic referral faster

If a specialist opinion is needed – for example, a dermatologist, plastic surgeon or dedicated skin cancer clinic – we can help with that too.

Our doctors can:

• Provide you with a specialist referral letter via telehealth when clinically appropriate, so you don’t have to wait weeks for a traditional appointment just to get the paperwork.
• In our guide on how to fast‑track your specialist referral, we explain step‑by‑step how online referrals work and what information a specialist needs.

Having that referral organised early can sometimes help you get into the right clinic sooner, especially if you live regionally or have limited local GP access.

3. Medical certificates if you need time off

Skin biopsies and melanoma surgery can be physically and emotionally draining. You might need time off for:

• The biopsy or excision appointment
• Post‑op recovery (especially if the lesion is on a weight‑bearing area or a place like the back, shoulder or leg)
• Follow‑up appointments, scans or specialist reviews

We can provide legitimate online medical certificates for work or study where appropriate, so you don’t have to drag yourself into a clinic just for paperwork:

• Our article on online medical certificates explains how this works in Australia and when telehealth certificates are suitable.
• If you’re working from home, you may also find our post on medical certificates for remote workers helpful.

4. Prescriptions and other support

While the main treatment for melanoma is surgery and, in advanced cases, specialist therapies, there are times you might need related prescriptions – for example:

• Pain relief and wound‑care supplies after surgery
• Short‑term medications for anxiety, poor sleep or nausea (if clinically appropriate and not better handled by your specialist or regular GP)

Our doctors can assess you via phone and, where appropriate, issue eScripts sent directly to your mobile. If you’re curious about how online prescribing works in Australia, our post “Can you get a script without a video call?” breaks down the rules and safety standards in detail.

Again, we won’t replace your regular specialist or melanoma team – but we can often help with practical, day‑to‑day aspects of your care, especially if getting to a clinic is difficult.

Common myths about moles and melanoma

Let’s quickly bust a few myths that often delay people from seeking help.

“If it doesn’t hurt, it can’t be cancer.” Most melanomas don’t hurt at all in the early stages. Pain is not a reliable sign.

“I’m under 40, so I don’t need to worry.” Melanoma is actually the most common cancer in young Australians aged 15–29. While age increases risk, young adults are far from immune.

“I have dark skin, so I can’t get melanoma.” Melanoma is less common in darker skin, but it still happens – often in places you might not expect, like palms, soles and nails.

“It’s been there for years; if it were cancer, I’d be dead by now.” Some melanomas grow slowly, and others sit in an early in‑situ phase for a while. Any new change in an old mole should be taken seriously, regardless of how long it’s been there.

“If I don’t sunbake anymore, I’m safe.” Damage from past sunburns – especially in childhood – can still lead to melanoma decades later. But there’s good news: being sun smart from now on can still reduce your future risk.

Sun safety and prevention: looking after the skin you’re in

While this article focuses on recognising melanoma symptoms, prevention is always better than cure.

Australian authorities consistently recommend that whenever the UV Index is 3 or above, you:

• Slip on sun‑protective clothing
• Slop on broad‑spectrum SPF 50+ sunscreen – and reapply every two hours or after swimming/sweating
• Slap on a broad‑brimmed hat
• Seek shade, especially in the middle of the day
• Slide on wrap‑around sunglasses

You can check live UV index levels for your location via ARPANSA or weather apps designed for Australia.

Even if you’ve had a history of sun damage, every day you protect your skin now is a day you lower your risk of future skin cancers.

Bringing it all together

Let’s recap the key points:

• Melanoma is common in Australia, but often curable when picked up early.
• The main melanoma symptoms to watch for are new or changing spots, especially ones that look different from your other moles.
• The ABCDE rule of skin – Asymmetry, Border, Colour, Diameter, Evolving – is a powerful, simple mole check guide, but it doesn’t catch every case.
• Also watch for firm, raised, rapidly growing lumps (the EFG rule), and for “ugly duckling” moles that don’t fit your usual pattern.
• A changing mole is worth worrying about enough to get it checked – not to panic, but to act.
• Regular self‑checks and sun‑smart behaviour are two of the best tools you have.
• If you’re concerned, seeing a doctor in person is essential for proper assessment and biopsy – but telehealth services like NextClinic can help you:
  • Get timely medical advice on what to do next
  • Arrange specialist referrals without extra delays
  • Obtain medical certificates and eScripts that support you through diagnosis and treatment

Your challenge for this week

Pick one of these actions and actually do it in the next 7 days:

1. Do a 5–10 minute full‑body skin check using the ABCDE rule and “ugly duckling” idea – and take photos of any moles you want to monitor.
2. Book a skin check with your GP or a skin cancer clinic, especially if you’ve never had one or you’re overdue.
3. If you already have a spot that’s been bothering you, organise care today – that could mean booking a local appointment or starting a telehealth consultation with us at NextClinic so we can help you plan the next step.

When you’ve done it, we’d love to hear from you:

• Which strategy did you choose?
• Did you notice anything new about your skin, or did you finally get that nagging mole assessed?

Taking even a small step now could make a very big difference to your future self – and to the skin you’re in.

References

• Melanoma Facts | Melanoma Institute Australia
• Cancer incidence | National Cancer Control Indicators
• Melanoma of the skin statistics | Cancer Australia
• Check for signs of skin cancer | Cancer Council
• What are the symptoms of melanoma? | Cancer Australia
• Melanoma | Cancer Council SA
• Signs of melanoma | Cancer Council NSW
• Melanoma | Causes, Symptoms & Treatments | Cancer Council
• Online Doctors: Telehealth Consultations at NextClinic
• Incidence and mortality | National Cancer Prevention Policy Skin Cancer Statistics and Issues | Cancer Council
• Risk factors/epidemiology | National Cancer Prevention Policy Skin Cancer Statistics and Issues | Cancer Council
• Trends in Melanoma Incidence and Mortality | ARPANSA

FAQs