Mole-Check Apps and Online Skin Visits: What They Can't Rule Out

Spot-check apps promise to rate a mole’s risk from a phone photo, and online dermatology services let you send pictures for a clinician’s opinion, often for a flat fee or subscription. For a spot that’s been nagging at you, that speed is appealing. Here is what the research found about the apps, and how to use either option without letting a reassuring answer delay a needed exam.

What a review of skin cancer apps found

A 2020 review in the BMJ looked at nine studies of six smartphone apps that use an algorithm to judge skin cancer risk. The studies didn’t recruit people representative of the general population, and accuracy varied widely from study to study. The researchers concluded the apps can’t be relied on to detect every case of skin cancer.¹

A “low risk” result isn’t a clearance. If a spot worries you, see a clinician.

Know the warning signs yourself

The American Academy of Dermatology (AAD)² uses the ABCDEs to describe signs of melanoma:²

• A, Asymmetry: one half of the spot is unlike the other.
• B, Border: irregular, scalloped or poorly defined edges.
• C, Color: varying colors, such as shades of tan, brown or black, or areas of white, red or blue.
• D, Diameter: melanomas are usually bigger than a pencil eraser, about 6 millimeters, when diagnosed, but they can be smaller.
• E, Evolving: the spot looks different from the rest, or is changing in size, shape or color.

The AAD advises seeing a board-certified dermatologist for any new spot, a spot that looks different from your others, or one that itches or bleeds.²

How to use photos well

• Photos can help you track change. The AAD’s body mole map is a free way to note spots and changes over time.³ Take photos in the same light and distance each month, with a ruler or coin beside the spot.
• Online visits can be a starting point. If you use one, ask what happens next if the clinician sees something concerning, and whether they can arrange an in-person exam and biopsy near you.
• Don’t let a photo stand in for an exam of a spot that’s new, changing, itching or bleeding.²

Lower-cost ways to get checked

The AAD has run free skin cancer checks since 1985. You can search for an upcoming free check on its website.⁴ You can also ask your primary care clinician to look at a spot and refer you if needed.

Try: “This spot on my arm is new in the last few months and seems to be getting darker. Can you look at it, and does it need a biopsy?”

Skin, Head to Toe includes a 12-week SkinLog. Use it to keep dated photos and notes on any spot you’re watching, and bring them to your appointment. See the book.