For a mole that is changing, a dermatologist is usually the better choice for the evaluation. Dermatologists train specifically in skin, hair and nails, and checking moles is a routine part of their work. Your primary care doctor is still a reasonable first stop, especially if you can be seen sooner or your insurance requires a referral. What matters most is that a changing mole gets checked soon.
The short answer: a dermatologist for evaluation, a PCP if that's faster
Think of it as a team, not a contest. Your primary care doctor (PCP) knows your overall health, your medicines and your history. A dermatologist brings focused training in skin conditions, including skin cancer.
If you can see a dermatologist in a reasonable time, start there. If your PCP can see you much sooner, or your plan needs a referral, see your PCP first. A PCP who isn't sure about a mole will typically refer you to a dermatologist.
A note on screening guidance: the U.S. Preventive Services Task Force has said there isn't enough evidence to recommend for or against routine skin cancer screening by a clinician for people with no symptoms. A changing mole is a different situation. Change is a symptom, and it's a reason to get checked.
How they compare
- Training: PCPs train across all of medicine, including common skin problems. Dermatologists complete several years of residency training focused on skin, hair and nails, including skin cancer.
- Close-up tools: Many dermatologists use a dermatoscope, a handheld magnifier with a light that shows patterns inside a mole the naked eye can't see. Some PCPs use one too, but it is less routine in primary care. A 2018 Cochrane review found that dermoscopy, used by trained clinicians, identifies melanoma more accurately than looking with the eye alone.
- The whole picture: A dermatologist will often look at your other moles too, because a mole that looks different from the rest stands out. A PCP visit may focus on the one spot, often during a visit for something else.
- Biopsy: Some PCPs do skin biopsies, and many refer to a dermatologist instead. Dermatologists commonly take skin biopsies in the office.
- Referral: You don't need a referral to see your PCP. Some insurance plans, often HMO plans, require a PCP referral before you see a dermatologist. Others let you book directly, so check your plan.
- Timing: Depending on your plan and your area, one may have an opening sooner than the other. A prompt visit with either is better than a long wait.
What a primary care doctor typically does with a changing mole
Your PCP will usually ask when you noticed the change and what changed: size, shape, color, or new symptoms like itching or bleeding. Then they'll look at the mole and the skin around it.
From there, a PCP will often:
- Reassure you and suggest watching the mole, if it looks typical and harmless
- Refer you to a dermatologist if anything looks unusual or they aren't sure
- Take a biopsy themselves, if they are trained and set up to do it
If your PCP refers you to Bay Ridge Dermatology, their office can fax the referral to (347) 497-4980 or call (347) 497-4984. Our referral page has more information for referring offices.
What a dermatologist does
A dermatologist starts with the same questions: what changed, and when. Then they look closely at the mole, often with magnification, and compare it with the rest of your skin. That comparison matters, because a mole that doesn't match your other moles can be worth a closer look even if it is small. Your dermatologist may also suggest a full-body skin exam, at the same visit or a later one.
After the exam, there are usually three paths:
- Reassurance: the mole looks harmless, and you'll learn what changes to watch for.
- Monitoring: the dermatologist notes how the mole looks and checks it again later to see whether it changes.
- Biopsy: the dermatologist removes the mole or part of it so a lab can examine the cells under a microscope.
At Bay Ridge Dermatology, moles and skin cancer concerns are part of medical dermatology. When a spot needs a closer look, a shave biopsy can be done right in the office. A shave biopsy removes the top layers of the spot with a thin blade, and the sample goes to a lab. You can read more about in-office procedures and about Dr. Evangeline Perez, a board-certified dermatologist with more than 20 years of experience.
If it turns out to be melanoma
Many moles that are biopsied turn out to be harmless. A biopsy is how you find out for sure.
If a biopsy does show melanoma, the next step is planning treatment. At Bay Ridge Dermatology, melanoma is diagnosed in the office, and patients are referred to cancer centers in New York City for treatment. According to the American Academy of Dermatology, melanoma is highly treatable when found early. That's the main reason a changing mole is worth checking promptly. Your PCP stays part of your care, too, for your overall health along the way.
Signs that mean you shouldn't wait
The American Academy of Dermatology suggests using the ABCDEs to spot moles that need a look:
- Asymmetry: one half doesn't match the other.
- Border: the edge is uneven, ragged or blurry.
- Color: more than one color, or shades of tan, brown or black, sometimes with red, white or blue.
- Diameter: larger than about 6 millimeters (the size of a pencil eraser), though melanomas can be smaller.
- Evolving: the mole is changing in size, shape, color or height.
Book promptly, with whichever doctor can see you first, if a mole:
- Has changed over weeks or a few months
- Bleeds, oozes or crusts without an injury
- Itches or hurts
- Is new and looks different from your other moles
If you start with your PCP and they aren't sure, ask for a dermatology referral. Bay Ridge Dermatology offers same-day appointments, though availability varies, so it's worth calling to ask.
Getting a changing mole checked in Bay Ridge
Bay Ridge Dermatology is at 515 84th Street, 1st Floor, in Bay Ridge, Brooklyn (11209). If a mole has you wondering, you can book online or call (347) 497-4984, and we'll help you find a time.
This article is general information, not medical advice. For advice about your own skin, see a dermatologist.