29/08/2025
Monitoring pigmented spots is like the art of playing the “Spot the Change” game 🕵️♀️ - and it can save lives. Those are lesions monitored over time - the latest date is when a decision was made for excision due to monitored dermoscopic change… and pathology confirmed melanoma in situ in all of them.
If your skin doctor says, “we will Monitor a spot” !! So what does monitoring a mole actually mean (and there are rules to follow here) ?
Sometimes when we check the skin, we find a spot that isn’t 100% typically normal—but it doesn’t look dangerous or have enough clues to remove right away(no melanoma clues) . Instead of leaving it and hoping for the best (never a good idea!) we monitor it closely.
How?
✅ We take high-quality dermoscopic photos (under a special skin microscope) with tools to be able to save lesion images over time!
✅ We compare the spot over time—usually every 3 months (sometimes 6 months) over certain period of time or compare with a baseline image from a previous checks
✅ If the spot shows any change in size, colour, or pattern → it goes through thorough assessment which may lead to a decision to remove it immediately.
💡Why do we do this?
Because:
✔ Some benign spots look a little unusual but never change.
✔ Cutting every “atypical ” mole means lots of unnecessary scars. Imagine patients who have many atypical moles.. 🤦♀️
✔ Melanoma changes over time - so catching that change early saves lives.
But most importantly: if your doctor says he/she needs to monitor a lesion- you must understand how critical it is to turn up for the follow-up appointment. I see it as a commitment between the skin doctor and the patient—because early detection only works if we both keep our part of the plan .
