Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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The single most important sign that a mole could be turning into melanoma is change — in size, shape, colour, or sensation — over weeks to months. The quickest way to judge a mole is the ABCDE rule (Asymmetry, Border, Colour, Diameter, Evolving), backed up by the ugly-duckling sign: the mole that simply looks different from all your others. A mole that changes, looks out of place, itches, bleeds, or will not heal should be examined by a clinician promptly. Most flagged moles turn out to be harmless — but melanoma caught early is highly treatable, and the cost of checking is far lower than the cost of waiting. This guide shows you exactly what to look for and when to act.
Why Change Is the Key Signal
A mole you have had, unchanged, since childhood is very rarely a concern. What matters is a mole that is doing something new: growing, darkening, developing an irregular edge, or starting to itch or bleed. Melanoma is fundamentally a story of evolution over weeks and months — which is why noticing change, not memorising a single snapshot, is the skill worth having. If you struggle to remember how a mole looked before, that is exactly the problem mole mapping solves, by recording a precise baseline to compare against.
The ABCDE Rule — What Each Letter Really Means
The ABCDE rule, used by the British Association of Dermatologists and the NHS, is the most practical self-check framework. The detail behind each letter matters:
- A — Asymmetry
- If you drew a line through the middle, the two halves would not match. Benign moles are usually symmetrical.
- B — Border
- Edges that are ragged, notched, blurred or scalloped, rather than smooth and well-defined.
- C — Colour
- More than one colour, or uneven distribution — shades of brown, black, and sometimes red, white or blue within one mole.
- D — Diameter
- Larger than about 6 mm (a pencil-end). Useful, but not absolute — melanomas can be smaller, so never dismiss a small mole that is changing.
- E — Evolving
- Any change over time in size, shape, colour, elevation, or new symptoms such as bleeding or itching. This is the most important letter of the five.
A useful companion is the tracking of evolving moles with photographs over time.
The Ugly-Duckling Sign
Most of a person’s moles tend to resemble one another — a recognisable “family”. The ugly-duckling sign is the mole that stands out from that family: darker, larger, differently shaped, or simply off compared with its neighbours. Research shows this instinctive “this one is different” judgement is a powerful detector — sometimes more so than rule-based checks — because melanomas often do not look like the patient’s other moles. If one mole keeps catching your eye, take that seriously.
What Early Melanoma Can Look Like
Early melanoma does not always look dramatic. It may be a flat or barely raised patch with slightly uneven colour and an irregular edge — easy to dismiss. It can arise within an existing mole or, more often, as a new lesion on otherwise normal skin. A minority are amelanotic (lacking dark pigment), appearing pink, red or skin-coloured, which is why they are so often missed. Be especially alert to:
- A new mole appearing in adulthood, particularly after age 30;
- A flat patch developing a raised area, or new unevenness in colour;
- A pink or red spot that will not settle and does not heal.
Not every changing brown spot is melanoma — many are harmless age spots or seborrhoeic keratoses. Telling them apart is covered in age spots vs skin cancer and how doctors tell benign from malignant.
Signs That Need Urgent Attention
Arrange prompt assessment — do not wait for a routine slot — if a mole or skin spot:
- Bleeds, weeps, or crusts without an obvious injury;
- Itches or is painful persistently;
- Is growing or changing noticeably over weeks;
- Will not heal within a few weeks;
- Has several ABCDE features together.
London Skin Clinic offers focused urgent suspicious-mole assessments. Call 0203 916 6200 or request an appointment online. If a mole needs removing, it is excised and sent for laboratory analysis — see the mole removal guide.
How and How Often to Check Yourself
A monthly self-examination in good light, using a mirror for hard-to-see areas, is enough for most people. Work methodically head to toe — including the scalp, behind the ears, the back, between the toes, the soles, and the nails, where melanomas are easily overlooked. Photographing any mole you are watching helps you judge real change objectively. Our step-by-step monthly skin self-exam makes this routine.
When to Get a Professional Check
Self-checks find changes; a clinician confirms what they mean. See a professional if a mole meets any urgent criterion above, if you cannot tell whether a mole has changed, or if you are simply unsure. People at higher risk — many moles, fair skin, a personal or family history of melanoma, or significant past sun exposure — benefit from structured annual screening and FotoFinder mole mapping, which compares your moles year on year.
“Such knowledgeable people and truly amazing results. The whole experience was reassuring from start to finish — great service and very friendly too.”
Questions Patients Often Ask
- How can I tell if a mole is dangerous?
- Use the ABCDE rule — Asymmetry, irregular Border, uneven Colour, Diameter over about 6 mm, and Evolving change — together with the ugly-duckling sign, the mole that looks different from your others. Change over time is the most important warning sign. Any mole that meets these features, itches, bleeds or will not heal should be examined by a clinician.
- How quickly does melanoma develop?
- It varies. Some melanomas (superficial spreading type) change over months; others (nodular type) can grow within weeks. This is why any mole that is changing noticeably over a short period should be assessed promptly rather than watched indefinitely.
- Can a normal mole itch?
- Occasional brief itching from a mole — for example from dry skin or friction — is usually harmless. Persistent itching, especially with any change in appearance, bleeding or crusting, should be checked, as it can be an early symptom of melanoma.
- If a mole does not hurt, is it safe?
- Not necessarily. Many early melanomas are painless. The absence of pain is reassuring on its own but does not rule anything out — appearance and change matter far more than whether a mole hurts.
- Where do melanomas most often appear?
- In men, most commonly on the back; in women, on the legs. But melanoma can occur anywhere, including areas with little sun exposure such as the soles, palms and under the nails — so a thorough head-to-toe check is important.
- How often should I have a professional skin check?
- Average-risk adults do not need routine professional checks if monthly self-examination is normal, but should see a clinician about any changing mole. Higher-risk individuals are generally advised to have an annual professional screening, often with mole mapping to track change accurately.
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