Skin cancer screening: methods to record mole changes in size and color

I didn’t set out to become “the person who photographs their own moles,” but one summer I realized my memory kept playing tricks on me. Was that spot on my shoulder always that shade of brown? Had the edge always looked a little smudged? I decided to keep calm and get systematic. I wrote down what I could trust, made a plan for what I couldn’t, and promised myself I would treat this like a small, recurring project rather than a crisis. What follows is the method I’ve been using to record mole changes in size and color—practical enough for real life, but grounded in what dermatology groups actually recommend. For a bigger-picture view of screening policy, I also bookmarked the USPSTF statement and the National Cancer Institute’s PDQ page so I could check details in plain English when needed.

The tiny shift that made it all click

My turning point was realizing that consistency beats perfection. The perfect camera doesn’t matter if I never use it; an ordinary phone used the same way, month after month, will show patterns my memory can’t. That one idea—be consistent—became my anchor. I also wanted a short checklist to judge whether something looked worrisome. The ABCDE guide for melanoma (Asymmetry, Border, Color, Diameter, Evolving) is still the simplest place to start, and the “ugly duckling” concept (the mole that looks different from all your other moles) helps me spot outliers fast. For the policy context I keep in mind that national screening recommendations focus on evidence for benefit and harm; they don’t take away personal vigilance or a dermatologist’s clinical judgment. If you’re curious, you can skim the USPSTF overview here and the American Academy of Dermatology’s ABCDE guide here.

• High-value takeaway: pick a repeatable setup (same light, same distance, same angles) and stick to it more than you chase perfect images.
• Use one map of your body (front, back, left, right, limbs) and mark landmark moles so you can relocate spots easily.
• Remember that personal risk varies. Family history, past skin cancers, and lots of atypical moles may change how often a pro should check you.

A home photo routine that pulls real weight

I tried fancy and I tried simple; simple won. My home kit is a phone, a small tape measure or credit-card-sized ruler, a sticky note, and a door to tape things on. If someone can help, great; if not, I use the timer. Lighting is the big variable, so I made rules: blinds closed, overhead light on, same room every time. I also avoid flash because it can wash out colors and cast hard shadows. The payoff isn’t artsy pictures—it’s that the second and third sessions look like the first, so changes stand out.

• Distance and angle: I stand the same number of floor tiles from the door, or I use a piece of painter’s tape on the floor as a marker. I keep the camera roughly perpendicular to the skin surface to avoid distortion.
• Scale object: I place a small ruler or a flat coin next to the mole (not covering it) so every photo has a built-in size reference.
• Background and labels: For each region (e.g., “right forearm inner”), I take a wide shot for context, then a close-up with the ruler. I say the location out loud as I shoot (the phone saves the audio name) or I hand-write it on a small card in the frame.
• File hygiene: I make an album called “Skin log,” then sub-albums by date. I turn off filters and “auto enhance.” Keep it boring; boring is reliable.
• For a printable body map to mark locations, the AAD offers a simple template—handy for appointments and for your own notes; their ABCDE page links to it.

Measuring size without fuss

“Diameter” is the most quoted metric, but I learned to record two dimensions because moles aren’t perfect circles. I pick a long axis and a short axis, measure in millimeters, and add a note like “6×4 mm, oval, smooth border.” If I don’t have a good ruler, I place a coin or a standard adhesive bandage in the frame and later measure on-screen against that known object. I repeat measurements only when I think I see a change; otherwise, I leave it to the photo timeline to do the heavy lifting. Anything that seems to be increasing over weeks to a few months or looks different from its neighbors earns a spot on my “ask the derm” list.

• Tip: if glare hides edges, dab a tiny bit of lotion around the mole (not on it) to even out shine, then re-shoot.
• Keep orientation steady: if the mole sits on a curved area (shoulder, calf), I try to keep the limb in the same position each time; otherwise, perspective can fake a “size change.”
• Note growth with words: I write short captions like “border fuzzier than last month” or “new darker fleck at 2 o’clock.” Phrases beat memory.

Color is trickier than size but still doable

Color shifts can be subtle. Screens lie, daylight varies, and phone cameras compensate in ways we don’t see. I make three moves to tame the chaos. First, I shoot in the same indoor light every time. Second, I place a small white card in the corner of the frame for a rough white balance reference. Third, I avoid any edits (no contrast, no filters). If a mole has multiple colors—tan with a darker speck, or a new grayish veil—I write that down, because a note about pattern is more robust than relying on exact shades in photos.

• White balance helper: a cheap “gray card” is optional; a plain, matte white index card is good enough for relative comparisons.
• Texture matters: color plus change in surface (becoming scaly, crusting, or bleeding) matters more than color alone.
• Document patterns: “lighter halo,” “darker knot in center,” “peppery dots at edge”—these phrases help your future self and your clinician see what you saw.

When my notes say go faster, not slower

I keep a short list of signs that push me to stop tracking and start asking. It’s not about panic; it’s about not waiting too long. The ABCDE framework is the backbone, and the ugly duckling “odd one out” sign is a sanity check across your own skin. The AAD’s public education page is a helpful refresher if you want to see examples of each letter.

• Asymmetry or border change: one side no longer mirrors the other; edges turn blurred, notched, or scalloped.
• Color change: new shades of black, blue-gray, red, or multiple colors where it used to be uniform.
• Diameter or Evolving: notably enlarging over weeks to months, or any clear “something is different” compared with old photos.
• New lesion in adulthood: especially if it looks different from your other moles.
• Symptoms: itching that persists, bleeding without obvious trauma, or a sore that doesn’t heal.

Any one of these—especially in combination—moves me to book an appointment rather than keep collecting images. The ABCDE overview and body-mapping tools from the AAD are here if you need a refresher What to look for.

The pro tools I learned about and when they matter

At dermatology visits I asked about technology beyond phone photos. Two ideas came up frequently. One is dermoscopy, a magnified, polarized view that lets clinicians see structures beneath the surface that aren’t visible to the naked eye. The other is total-body photography (TBP)—a standardized set of images covering the whole skin surface. When combined with repeat dermoscopic images of selected moles (sometimes called sequential digital dermoscopy imaging), these tools can help monitor people with many nevi or with prior melanoma. There’s ongoing research on 2D and 3D TBP systems; the headline for me is that these are clinician-guided tools, not DIY replacements, and they’re most useful when your risk is higher or your skin is “busy” with lots of look-alikes.

• For background reading, the National Cancer Institute’s PDQ pages explain what screening means and why evidence for population screening is complex; skim the patient version here.
• Studies suggest that combining total-body photography with digital dermoscopy can reduce unnecessary biopsies and help detect change in patients with multiple moles over time (a clinic-based workflow).
• As for direct-to-consumer phone apps that promise to “rate” a spot, reviews have found variable accuracy; I treat them as not diagnostic and avoid using them to make stay-or-go decisions.

One more nuance I had to unlearn: a national “I statement” (insufficient evidence to recommend for or against routine visual screening in people without symptoms) doesn’t mean “don’t look at your skin” or “don’t see a professional.” It means policy groups didn’t find strong enough proof that mass screening of people without symptoms improves outcomes compared with usual care. Personal risk and shared decision-making with a clinician still matter—and they always will.

My step-by-step loop for tracking change

Here’s the loop I’ve settled into. It’s not flashy; it’s repeatable, which is the whole point.

• Step 1 Set the scene: same room, same lighting, phone timer on. Ruler and white card ready.
• Step 2 Shoot wide then near: capture context, then a close-up with the ruler in frame.
• Step 3 Note size and color: write two dimensions in mm and 1–2 words on color/pattern.
• Step 4 File smartly: add to the “Skin log” album with a short caption (“R calf outer, 6×4 mm”).
• Step 5 Compare, don’t obsess: once a month or every other month, compare to prior. If something stands out, I re-shoot in a week to confirm.
• Step 6 Escalate appropriately: ABCDE or ugly-duckling concerns → I book an appointment and bring my photos or the AAD body map printout.

Small frictions I solved so I keep going

I almost quit when photos piled up with random filenames. Two tweaks fixed it: a dedicated album and a naming convention (“2025-05-R-calf”). I also store a copy in a cloud service and keep the album hidden on my phone for privacy. On days when I don’t have help, I use a cheap phone stand and a mirror for the back shots. And if I miss a month, I start again without guilt—tracking works because of repetition over time, not because I never skipped a date.

• Security: if privacy is a concern, use a passcode-locked album and avoid auto-sync to shared devices.
• Reminders: I set a low-key recurring calendar reminder titled “Five-minute skin check.” If I’m busy, I snooze it to the weekend.
• Bring evidence: for visits, I jot two or three concrete questions and bring a couple of comparison photos—clinicians appreciate clarity more than a photo dump.

What I’m keeping and what I’m letting go

I’m keeping three principles on a sticky note inside my bathroom cabinet: be consistent, describe not judge, escalate when uncertain. Describing (“darker fleck at edge”) keeps me curious and honest. Consistency makes the comparisons meaningful. And escalating when I’m unsure respects the limits of home tracking; it turns a worry into a plan.

For deeper dives, I return to a handful of trusted pages rather than chasing every headline. The AAD’s ABCDE guide keeps my eyes calibrated. The NCI’s PDQ pages explain the reasoning behind screening and prevention. And the USPSTF statement reminds me that policy is about populations; my care still gets personalized in the room with a clinician.

FAQ

1) How often should I photograph my moles?
Answer: There isn’t a one-size-fits-all schedule. I aim for monthly or every other month so I can see trends without turning it into a daily project. If you’re high-risk (personal/family history of melanoma, many atypical moles), a dermatologist may suggest a different cadence.

2) What’s the best way to measure diameter accurately?
Answer: Include a small ruler in the photo and record two measurements (long and short axis) in millimeters. Avoid measuring on stretched skin; keep limbs in the same position each time.

3) Can I trust a skin-cancer app to tell me if a mole is risky?
Answer: Treat apps as not diagnostic. Reviews have found variable accuracy. If an app flags something, that’s a reason to ask a professional; if it reassures you but your eyes say “this looks different,” trust your concern and get it checked.

4) What if the color looks different in every photo?
Answer: Standardize lighting and add a white card in the frame. Then focus on pattern descriptions (new darker fleck, gray veil, lighter halo) rather than exact shades. Color variation over time matters more than a single snapshot.

5) Do national guidelines say not to get skin checks?
Answer: Policy statements may say there’s not enough evidence to recommend routine visual screening for everyone without symptoms. That doesn’t mean “don’t look” or “don’t go.” Personal risk, new or changing lesions, and your preferences still guide decisions with your clinician.

Sources & References

• USPSTF Skin Cancer Screening (2023)
• NCI PDQ Skin Cancer Screening Patient Version (2025)
• AAD ABCDEs of Melanoma
• BMJ Systematic Review of Skin-Cancer Apps (2020)
• Digital Monitoring with Photography and Dermoscopy (2022)

This blog is a personal journal and for general information only. It is not a substitute for professional medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always seek the advice of a licensed clinician for questions about your health. If you may be experiencing an emergency, call your local emergency number immediately (e.g., 911 [US], 119).