Pink Mole or Skin Cancer? When a Pink Spot Needs Checking

Brown moles get their color from melanin. A mole looks pink when it has little melanin and you're seeing blood vessels through it instead. The AAD notes that ordinary moles can be tan, black, red, pink, blue, skin-toned or colorless ^[1], and that some change slowly over the years, possibly even disappearing ^[1]. A mole can also turn pink for a while when it's irritated or inflamed. Rarely, a pink spot is a melanoma that makes little or no pigment ^[2].

Color alone can't sort these out. How the spot feels, and what it does over the next month, tells you far more.

A Spitz nevus is a harmless mole seen most often in children; DermNet notes that 70% are diagnosed in the first 20 years of life ^[3]. It's typically a smooth, dome-shaped red or reddish-brown bump that grows quickly for a few months and then may stay the same size for years ^[3]. Because it can look like melanoma, even under the microscope, doctors often remove it as a precaution or follow it with dermoscopy photos ^[3].

Small pearly bumps with a dimple in the middle, often in clusters, are usually molluscum contagiosum, a common viral infection in children that clears up by itself.

A pink bump that is growing in a child should still be shown to a doctor. Most turn out to be one of these.

For a pink spot you're unsure about, our skin cancer checker describes what a photo shows and suggests a next step. It is paid and does not diagnose; a pink bump that grows or bleeds needs a doctor.

Dermal nevus. A soft, raised, pale or pink mole, often on the face or upper body, that has looked the same for years. Harmless, and only removed if it catches on things or bothers you.

Dermatofibroma. A firm pink-brown bump, often on the legs, that dimples inward when you pinch the skin on either side. Harmless.

Pyogenic granuloma. A red or pink fleshy bump that grows over a few weeks, often after a small injury or during pregnancy, and bleeds very easily ^[4]. It isn't cancer, but DermNet names amelanotic melanoma as its most important look-alike ^[4], so it should be looked at and is usually removed.

Basal cell carcinoma. A shiny pink bump, often on the face, that may bleed and crust. Our guide on clear and pearly bumps covers it in detail.

Amelanotic melanoma makes little or no pigment, so it can be pink, red or skin-colored ^[2]. DermNet estimates it at anywhere from 2% to 20% of melanomas ^[2]. It is often diagnosed later than pigmented melanoma, partly because neither patients nor doctors expect a pink spot to be melanoma ^[2].

The ABCDE rule was built for brown and black moles and can miss it. For raised spots, doctors also use EFG: elevated, firm to the touch, and growing ^[5]. A pink bump that stands up from the skin, feels solid rather than soft, and gets bigger month by month needs a doctor, whatever its color.

1. How long has it looked like this? Years without change points toward a harmless mole. New in the last few months is a reason to get it checked.

2. Is it soft or firm? A soft, squashy mole is reassuring. A small, hard bump is not.

3. Has it bled or crusted without being knocked? Bleeding with no injury is a warning sign at any color.

4. Is it growing? Put a ruler next to it today and again in four weeks. Take a photo with the ruler in it each time, so you are not relying on memory. Steady growth is the G in EFG. Australian melanoma guidelines say a spot that keeps changing or growing over more than a month should be removed or seen promptly by a specialist ^[6].

5. Is it different from your other moles? One pink bump among brown moles stands out for a reason.

Book within 2 weeks: a pink bump, at any age, that is firm and growing over weeks; a pink spot that bleeds or crusts without an injury; or any new pink spot if you've had melanoma before.

Book in the next few weeks: a new pink spot in an adult that is soft and doesn't seem to be growing, or a pink mole that has changed shape.

Mention it at your next check-up: a soft pink mole you've had for years that hasn't changed.

At the appointment, ask directly whether it could be an amelanotic melanoma. A dermatoscope shows blood-vessel patterns and traces of pigment that the eye can't see, and if there is any doubt the doctor will take a small biopsy.