The term “ugly duckling mole” has a specific meaning when it comes to melanoma, the deadliest skin cancer.

Here’s how to spot the ugly duckling mole.

If you’re new to examining your skin, and you notice that one mole doesn’t quite fit in with the other moles…this should be concerning.

This outcast mole is often referred to as the “ugly duckling.”

“The ‘ugly duckling sign’ refers to a mole that looks different from the others,says Dr. Bucay.

“It could be a lighter colored mole in someone whose normal moles are dark brown.”

It could also be a very dark mole among lots of light ones, or the only mole that has erratic borders, an oval shape or a “funny” appearance.

Look out for the mole that stands out.

Look out for the mole that stands out.

The “ugly duckling” could also be the only mole that’s the diameter of a pencil eraser, while all the others are a lot smaller.

Now keep in mind that not every ugly duckling mole turns out to be melanoma.

But you should have a dermatologist inspect it with a dermatoscope, and if there’s any uneasy feeling on the doctor’s part – OR YOURS ONLY – have the spot biopsied!

It May Be a Matter of Relativity

The so-called ugly duckling mole may, in the context of isolation, look like a textbook-perfect mole.

  • Perfectly symmetrical — no matter where it’s bisected, both halves look the same.
  • All one color
  • Smooth edges
  • Smooth surface

But in the context of the other moles on that same person — it really stands out in terms of size, shape, color and/or flat vs. elevated.

An Ugly Duckling Isn’t Always a Mole

What appears to be an out of place mole may actually be another type of skin lesion, most notably a seborrheic keratosis.

This harmless skin barnacle usually begins making its first appearance after age 40.

A dermatologist can usually diagnose these by viewing them with the naked eye, but for more reassurance, ask your doctor to use a dermatoscope.

Some Melanomas ARE Truly Ugly

Some melanomas, by the time they are diagnosed, are ominous in appearance — such as the ones below. It’s a spot on the skin that looks “scary” or creepy, prompting the patient to seek an evaluation.



CDC, Carl Washington, MD, Emory Univ. School of Medicine, Mona Saraiya, MD, MPH


CDC, Carl Washington, MD, Emory Univ. School of Medicine, Mona Saraiya, MD, MPH

“Something about it just doesn’t look right,” is what the patient might think. When in doubt, have a dermatologist check it out!

An ugly melanoma may have the following features:

  • An unruly border
  • Areas of tar-black or very dark bumps
  • A smear-like pigment extending out from it
  • A splotchy color pattern
  • Tiny satellite spots around the mole
  • Any other strange features that make it look “bad.”

Do Not Wait Till a Mole Starts Looking Ugly to Get It Checked Out

Once more, don’t let the term “ugly duckling” mislead you.

“Ugly means that it stands out from the others as opposed to ‘not pretty,'” says Dr. Bucay.

“I once biopsied a tiny purple ‘dot’ on the forearm of a woman, simply because it stood out from her moles and freckles, and she said it was new.

“It turned out to be a melanoma.”

Classic Signs of Suspicion

If you’ve been familiar with your moles for many years, and faithfully examine your skin once a month, it’ll be easy for you to detect a change in a long-time mole (that’s located in an easy-to-inspect area) that’s suspicious for a malignant transformation.

  • New colors or darkening
  • Getting larger
  • Border more jagged
  • Bumps appearing on it
  • Pigment appearing to “bleed” out from the border
  • Crusting, oozing or bleeding
  • Changing shape
In private practice since 1991, Dr. Bucay has been a keynote speaker across the globe on a wide scope of topics ranging from innovations in facial aesthetics to evidence-based skin care to cancer survival.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health. 



Top image: Shutterstock/Andrey_Popov