Dermoscopy - what is it and when is it worth examining a mole?

Content author: physician. Katarzyna Przekazińska-Boager · Editorial work: Editorial team of Wyspa Medycyny Przyjaznej · Medical review: lek. Katarzyna Przekazińska-Boager · Date of creation: 07.08.2026 · Date of review: 07.08.2026 · Updated: 07.08.2026

The article is educational and does not replace a medical examination. Dermatoscopy is an assessment tool, not a conclusive examination - a certain diagnosis can only be made by histopathological examination of the excised lesion. A lesion that grows rapidly, bleeds, ulcerates, does not heal or significantly changes its appearance requires urgent consultation, regardless of the date of the planned inspection.

The most important information at a glance

• Dermatoscopy is the examination of skin lesions under magnification, with lighting allowing the assessment of structures beneath the surface of the epidermis.
• Allows you to see the arrangement of the dye and vessels, which cannot be assessed with the naked eye or from a photo.
• It is non-invasive, painless, takes a few minutes and does not require preparation.
• Does not provide a final diagnosis - histopathological examination of the excised lesion is decisive.
• Helps you make one specific decision: observe or cut.
• Reduces the number of unnecessary treatments because it allows you to recognize benign changes that look disturbing.
• It is worth examining a lesion that is new, changing, looks different from the others, or any lesion that worries the patient.
• People with fair skin, numerous or atypical moles and a history of melanoma require regular check-ups.
• In the case of numerous moles, it is helpful to digitally document changes and compare them over time.
• Applications assessing moles from photos do not replace dermatoscopy or medical examination.

Find out more about the specialist

Doctor. Katarzyna Przekazińska-Boager works at the Island of Friendly Medicine in Gdańsk. He assesses and treats skin lesions, including examining moles. The goal of dermatoscopy is not to remove as many lesions as possible, but to distinguish those that require excision from those that simply need to be observed.

Meet the doctor. Katarzyna Przekazińska-Boager

What is dermatoscopy and why is the eye not enough

A dermatoscope is a small device that combines a magnifying lens with a light source. The latter is key. Ordinary light reflects from the surface of the epidermis, so with the naked eye we only see what is on the surface: the color, shape and size of the lesion.

The dermatoscope uses polarized light or contact with an immersion fluid. Both solutions eliminate reflection from the stratum corneum and allow you to see deeper - into the epidermis and the upper layer of the dermis. This changes the image completely: instead of a spot, you can see its internal structure.

The doctor then assesses, among other things, the arrangement of the pigment network, the symmetry of the pigment distribution, the presence of characteristic structures and the pattern of blood vessels. It is these features - and not the appearance alone - that help distinguish benign lesions from suspicious ones.

The practical consequence is twofold. Firstly, dermatoscopy helps detect early changes that look innocent to the naked eye. Secondly - and this is sometimes equally important - it allows avoid unnecessary treatments, because many changes that look dangerous turn out to be completely benign under magnification.

What dermatoscopy can and cannot do

The last line needs to be underlined. If the clinical picture is disturbing - the lesion grows, bleeds, does not heal - then a correct dermatoscopy result does not close the case. In such situations, the whole image is decisive, and in case of doubt, excision is performed with histopathological examination.

When is it worth examining a birthmark?

The simplest answer is: when something changes or when change worries you. Below are situations in which testing is particularly justified.

• Change evolves — grows, changes color, shape or borders. This is the strongest signal, more important than static features.
• A new birthmark in an adult, especially after the age of forty.
• The change looks different from the others — different in color, shape or size than the rest of the moles.
• Itching, burning, bleeding or ulceration within the lesion.
• A change in a place that is difficult to observe — on the back, neck, scalp.
• Birthmarks exposed to irritation — through the belt, strap, collar, glasses frame.
• Numerous birthmarksthat the patient is unable to control on his own.
• Atypical moles recognized earlier.
• Melanoma or other skin cancer in your own or family interview.
• Fair complexion, tendency to sunburn, numerous burns in the past, use of solarium.
• Reduced immunity or immunosuppressive treatment, including after organ transplantation.
• Nail changes — a dark stripe on the nail plate requires assessment.

It is worth emphasizing one thing: a change that causes concern for the patient is sufficient reason for examination. You don't have to meet any criteria or wait for "something to happen." An examination lasting several minutes usually ends with information that the change is benign - and this is also a valuable result.

What does the examination look like step by step?

The test is completely non-invasive. The dermatoscope is placed on the skin - sometimes with a small amount of gel - and it does not cause any pain or discomfort. Assessment of a single lesion takes a moment, while an examination of the entire skin takes a correspondingly longer time.

How to prepare: you do not need to fast or stop taking medications. However, it is worth removing makeup if the examination covers the face, and removing nail polish if the nail plate is to be assessed. On the day of the examination, it is better not to apply lotions and oils to the skin. If you have photos of changes from months ago, it's worth taking them - comparison over time can be very helpful.

Single change or inspection of the entire skin?

It is worth asking this question when making an appointment, because the scope of the examination really varies.

Assessment of a single lesion makes sense when the patient comes in with a specific concern: something has changed, appeared or has started bleeding. The examination is short and answers one question.

Whole skin inspection includes a systematic assessment of all areas, including those that the patient cannot see. This is important because a significant part of the changes are detected accidentally, while assessing something completely different. The patient comes in with a mole on his arm, and a lesion on his back draws attention.

In the case of numerous or atypical moles, additional digital documentation is used: photos of selected lesions are archived and compared during subsequent visits. This allows you to detect a change that does not look suspicious in itself, but is different from the image from a year ago. When there are a large number of moles, this approach may be more effective than a single assessment.

How often should I get tested?

There is no one size fits all - the frequency is determined by your doctor after assessing your risk factors. However, a general rule can be indicated: the more risk factors, the shorter the intervals.

• No risk factors - periodic skin inspection and ad hoc examination when something changes.
• Multiple or atypical moles - regular inspections, at intervals determined individually.
• History of melanoma or other skin cancer - more frequent check-ups, according to a plan established by the attending physician.
• Family history of melanoma - regular follow-up, usually more common than in the general population.
• Immunosuppressive treatment - regular inspections of the entire skin.

Regardless of the deadlines, one overarching rule applies: a change that causes concern does not wait for a scheduled inspection. If something starts to grow, bleed or change, it is worth reporting it earlier.

It is also worth examining the skin yourself from time to time, in good light, using a mirror or the help of another person on the back and scalp. Self-observation does not replace examination, but it is what most often brings the patient to the office.

What happens when a lesion is suspected

The result of dermatoscopy leads to one of two decisions: observation with a scheduled follow-up date or excision of the entire lesion with histopathological examination.

There is no third option but to wait for the lesion to grow. If the image is ambiguous, excision is safer than observation - and an unnecessarily removed mole costs incomparably less than an early missed lesion.

Pigmented lesions cannot be removed by laser, electrocoagulation or freezing. These methods destroy the tissue, leaving no material for histopathological examination. If the lesion removed in this way was an early form of cancer, the diagnosis is irreversibly lost.

The procedure is performed under local anesthesia on an outpatient basis, and the results of the histopathological examination are discussed during a follow-up visit. It is the final diagnosis.

The most common myths

• "The application on your phone will assess the birthmark." No. The applications analyze the photo of the surface and do not see the structures visible in the dermatoscope.
• "Dermatoscopy gives a certain diagnosis." No. It is an assessment tool; histopathological examination decides.
• "The examination is painful." No. It is completely non-invasive and involves placing the device on the skin.
• "This test is only for people with numerous birthmarks." No. A single change of concern is reason enough.
• "You have to prepare for it." No. It is enough to remove makeup and nail polish if the examination covers these areas.
• "Since the dermatoscopy was good, I can forget about the skin." No. Changes may appear and evolve, so observation is needed.
• "It's better to remove all moles at once." No. Most melanomas arise on previously unaffected skin, and preventive removal does not reduce the risk.
• "The birthmark can be removed with a laser." Not in the case of pigmented lesions - no material is left for testing.

Do you have a mole that worries you or you haven't had your skin checked for a long time?

Dermatoscopy takes a few minutes, is painless and does not require preparation. Most often, it ends with information that the lesion is benign - and if not, early detection is crucial.

Examination of moles at the Island of Friendly Medicine in Gdańsk

At the Island of Friendly Medicine doctor. Katarzyna Przekazińska-Boager performs dermatoscopic assessment of moles and other skin lesions. The visit includes an interview, assessment of risk factors, dermatoscopic examination and determination of further proceedings: observation with a follow-up date or qualification for removal of the lesion.

Pigmented lesions requiring removal are surgically removed and histopathologically examined. The scope of the examination - assessment of a single lesion or examination of the entire skin - should be determined when making an appointment. The current scope of services, availability of dates and prices must be confirmed during registration.

Find out more about the medicine. Katarzyna Przekazińska-Boager Dermatoscopy

What to ask the doctor?

• Does this change raise doubts in dermatoscopy?
• Surveillance or removal - and why?
• If observation, for how much and what should I pay attention to?
• Do I have atypical moles?
• Do you see changes that I haven't noticed myself?
• Is it worth digitally documenting my birthmarks?
• How often should I get tested?
• Do I have risk factors that require more frequent monitoring?
• Which areas should I pay special attention to?
• How to properly examine your skin at home?
• Which filter should I use and how often should I apply it?
• What should I worry about between visits?

FAQ - dermatoscopy

What is dermatoscopy?

This is an examination of skin lesions under magnification, with lighting that eliminates reflection from the surface of the epidermis. It allows you to assess the structure of the lesion - the pigment and vascular system - invisible to the naked eye.

Are dermatoscopy and dermoscopy the same thing?

Yes, both terms refer to the same study. In the literature it is also called epiluminescence microscopy.

Does the examination hurt?

NO. It is completely non-invasive and involves applying the device to the skin, sometimes with a small amount of gel. It does not require puncturing or collecting material.

How to prepare for the test?

There is no need to fast or stop taking medications. It is worth removing makeup if the examination covers the face, removing nail polish when assessing the nail plate and not using balms on the day of the examination.

How long does the test take?

Assessment of a single lesion takes several minutes. An examination of the entire skin, including a systematic assessment of all areas, takes correspondingly longer.

Does dermatoscopy provide a reliable diagnosis?

No. It is an assessment tool that helps decide whether to observe or excise the lesion. A certain diagnosis can only be made by histopathological examination of the excised lesion.

When should I have my moles checked?

When the lesion grows, changes color or shape, itches, bleeds, has recently appeared in an adult, looks different from others, or simply causes concern.

How often should the test be repeated?

The frequency is determined by your doctor based on your risk factors. People with numerous or atypical moles, a history of or family history of melanoma, and immunosuppressed patients require more frequent monitoring.

Can a phone application replace dermatoscopy?

No. The applications analyze a photo of the skin surface and do not see the structures visible in the dermatoscope. They can help you archive your photos, but they are not the basis for your decisions.

What is digital documentation of moles?

This is for archiving photos of selected changes and comparing them during subsequent visits. It allows you to detect a change that does not look suspicious in itself, but is different from the image from months ago.

Can children be examined with a dermatoscope?

Yes, the test is non-invasive and painless, so there are no age contraindications. However, the assessment of moles in children is governed by its own rules and requires taking into account the patient's age.

Who performs the examination at WMP?

On the WMP website, MD. Katarzyna Przekazińska-Boager sees patients with skin lesions requiring assessment and treatment. The scope of the study and the availability of dates are confirmed by registration.

Sources

• Island of Friendly Medicine, MD. Katarzyna Przekazińska-Boager: https://www.wyspamedycynyPrzyjaznej.pl/pl/katarzyna-przekazinska-boager
• DermNet, Dermatoscopy: https://dermnetnz.org/topics/dermatoscopy
• DermNet, Melanocytic naevus: https://dermnetnz.org/topics/melanocytic-naevus
• DermNet, Atypical naevus: https://dermnetnz.org/topics/atypical-naevus
• DermNet, Melanoma: https://dermnetnz.org/topics/melanoma
• NHS, Moles: https://www.nhs.uk/conditions/moles/
• NHS, Melanoma skin cancer: https://www.nhs.uk/conditions/melanoma-skin-cancer/
• NHS, Sunscreen and sun safety: https://www.nhs.uk/live-well/seasonal-health/sunscreen-and-sun-safety/
• NICE, Melanoma: assessment and management (NG14): https://www.nice.org.uk/guidance/ng14
• NICE, Suspected cancer: recognition and referral (NG12): https://www.nice.org.uk/guidance/ng12
• British Association of Dermatologists, information for patients: https://www.bad.org.uk/patient-information-leaflets/