The ABCDE Rule for Melanoma
Warning Signs of Melanoma Can Save Your Life
The ABCDE criteria are the internationally recognized warning signs of melanoma — the most dangerous form of skin cancer. Dr. Sierro uses these criteria alongside dermoscopic findings to systematically evaluate every mole at the Santa Monica Skin Cancer Center. If you have noticed any of these changes in an existing mole or a new lesion, schedule a mole check immediately.
A Asymmetry One half of the mole does not mirror the other — normal moles are symmetric in shape
B Border Irregular, ragged, notched, or blurred borders — normal moles have smooth, well-defined edges
C Color Multiple colors within a single lesion — shades of brown, black, red, white, or blue
D Diameter Larger than 6mm — approximately the size of a pencil eraser — though melanomas can be smaller
E Evolving Any change in size, shape, color, or new symptoms such as bleeding, itching, or crusting
If you have noticed any ABCDE warning signs in a mole, do not wait for your annual screening. Schedule an urgent mole evaluation with Dr. Sierro at the Santa Monica Skin Cancer Center at Kare Plastic Surgery. Early melanoma — caught at Stage I has a 5-year survival rate exceeding 98%. Stage IV melanoma has a 5-year survival rate below 30%. The urgency of mole evaluation cannot be overstated. Call (310) 998-5533 today.
Who Should Get a Mole Check in Los Angeles
High Sun Exposure History
Patients with a history of significant sun exposure — including outdoor work, beach lifestyle, or years of living in Southern California without consistent sunscreen use — are at elevated melanoma risk and should have annual full-body mole checks with dermoscopy by Dr. Sierro at the Santa Monica Skin Cancer Center.
Prior Tanning Bed Use
Tanning bed use before age 35 increases melanoma risk by 59% according to published dermatology literature. Patients with any history of indoor tanning should undergo annual skin cancer screening regardless of current age. Dr. Sierro specifically evaluates tanning bed history as a risk stratification factor at every new patient consultation.
Family History of Melanoma
A first-degree relative with melanoma increases personal melanoma risk approximately two-fold. Patients with a family history of melanoma — particularly multiple family members or early-onset melanoma — should be screened every 6 months and may benefit from total body photography and mole mapping to track lesion changes over time.
Large Number of Moles
Patients with more than 50 moles have a significantly elevated melanoma risk. The presence of dysplastic (atypical) nevi — moles with irregular features that are not yet melanoma but represent intermediate-risk lesions — further increases that risk. Dr. Sierro evaluates dysplastic nevi with dermoscopy and recommends excision of those with highest-risk features to prevent progression.
Fair Skin, Light Eyes, Red Hair
Patients with Fitzpatrick skin types I and II — fair skin that burns easily, light-colored eyes, and red or blonde hair — have reduced melanin photoprotection and are at higher baseline risk for all forms of skin cancer including melanoma. Annual full-body screening and daily broad-spectrum SPF 50+ sunscreen are the standard of care for these patients.
Prior Skin Cancer History
A prior diagnosis of melanoma, basal cell carcinoma, squamous cell carcinoma, or actinic keratosis significantly increases the risk of future skin cancers. Dr. Sierro performs surveillance skin cancer screenings for patients with a prior skin cancer diagnosis, monitoring for recurrence and new primary lesions at the Santa Monica Skin Cancer Center.
Dr. Sierro's Approach to Melanoma Diagnosis at Kare Plastic Surgery
Full-Body Dermoscopy Screening
Every mole check at the Santa Monica Skin Cancer Center includes comprehensive full-body dermoscopic evaluation — not a visual scan from across the room. Dr. Sierro examines each lesion individually under dermoscopy, applying evidence-based pattern analysis criteria including the seven-point checklist, Menzies method, and ABCDE criteria to identify features of concern with the greatest possible diagnostic sensitivity. Dermoscopy improves melanoma detection accuracy by up to 35% compared to unaided visual inspection.
In-Office Skin Biopsy
When dermoscopic examination identifies features concerning for melanoma, dysplastic nevi, basal cell carcinoma, or squamous cell carcinoma, Dr. Sierro performs an in-office biopsy under local anesthesia — shave, punch, or excisional — during the same visit in most cases. Same-day biopsy eliminates the anxiety and delay of a separate follow-up appointment and ensures that concerning lesions are sampled and submitted for pathology without unnecessary waiting.
Minimally Scarring Mole Removal
Benign and atypical moles requiring removal are excised by Dr. Sierro using minimally scarring technique — fine-blade shave removal, punch excision, or elliptical excision with layered closure using the finest available suture material. For moles on the face and other cosmetically sensitive areas, Dr. Sierro coordinates with the plastic surgery team at Kare Plastic Surgery when indicated to optimize closure and minimize visible scarring at the excision site.
Melanoma Management Coordination
When biopsy confirms melanoma, Dr. Sierro coordinates a comprehensive multi-specialty management plan. Wide local excision with oncologically appropriate surgical margins is performed by the plastic surgery team at Kare Plastic Surgery. Sentinel lymph node biopsy is coordinated with a surgical oncologist when indicated by Breslow thickness and other staging parameters. Medical oncology referral is arranged for patients requiring immunotherapy, targeted therapy, or radiation based on staging. Patients at the Santa Monica Skin Cancer Center never face a melanoma diagnosis alone.
"Dermoscopy is not optional in a thorough mole check — it is the standard of care. A mole that looks unremarkable to the naked eye can show regression structures, atypical vascular patterns, or a blue-white veil under dermatoscopy that changes the entire clinical picture. That is what we are looking for every single time."
— Dr. Tiffany Sierro, MD · Board-Certified Dermatologist · Santa Monica Skin Cancer Center at Kare Plastic Surgery
Related Resources at Kare Plastic Surgery
Frequently Asked Questions
Where can I get a mole check or skin cancer screening in Los Angeles?
Dr. Tiffany Sierro, board-certified dermatologist at the Santa Monica Skin Cancer Center at Kare Plastic Surgery, performs comprehensive full-body mole checks and skin cancer screenings with dermoscopy at 804 7th Street, Santa Monica, CA 90403. Serving Los Angeles, Santa Monica, Beverly Hills, Pacific Palisades, Brentwood, and Malibu. Call (310) 998-5533 to schedule.
What is dermoscopy and why is it important for mole checks?
Dermoscopy uses a polarized light magnification device to examine the subsurface structure of moles and pigmented lesions at 10x–40x magnification, revealing features invisible to the naked eye — atypical pigment networks, vascular patterns, and regression structures that are critical diagnostic criteria for melanoma. Studies show dermoscopy improves melanoma detection sensitivity by up to 35% compared to visual examination alone. Dr. Sierro uses dermoscopy on every mole evaluated at the Santa Monica Skin Cancer Center. Call (310) 998-5533.
How often should I get a mole check in Los Angeles?
Annual full-body skin cancer screenings are recommended for all adults. Patients with a history of melanoma, atypical moles, significant sun exposure, tanning bed use, or fair skin should be screened every 6 months. Southern California's year-round UV exposure makes regular screening especially important for Los Angeles residents. Dr. Sierro recommends an individualized screening interval based on each patient's risk profile at the Santa Monica Skin Cancer Center. Call (310) 998-5533.
What happens if Dr. Sierro finds a suspicious mole or melanoma?
If dermoscopic examination identifies a concerning lesion, Dr. Sierro performs an in-office biopsy under local anesthesia the same day in most cases. Confirmed melanoma triggers a coordinated management plan including wide local excision by the plastic surgery team at Kare Plastic Surgery, sentinel lymph node evaluation when indicated, and oncology referral for staging. Melanoma caught at Stage I has a 5-year survival rate exceeding 98%. Call (310) 998-5533 immediately if you have a concerning mole.
Related Resources at Kare Plastic Surgery