Skin cancer: How do I check my moles for signs of melanoma?
Social media influencer Molly-Mae Hague, 21, has been raising awareness about the importance of young people getting moles checked for potential skin cancer. Melanomas can occur relatively frequently among younger age groups, so what are the signs to look for?
"I never knew the word melanoma before," Darcy Shaw, 22, tells the BBC.
"I didn't know what the doctor meant when he said it.
"I went to the appointment by myself because I wasn't expecting to get news like that. It's not something that's on your radar as a young person."
Darcy, a teacher from Salford, was diagnosed with skin cancer in February.
It was her mum who encouraged her to go to the doctor, after spotting - during Darcy's visits home from university - that a mole on her collarbone was getting larger and darker.
"I think it's quite hard to see those changes in your body," says Darcy. "But my family could see it."
'Didn't know signs'
Darcy decided to mention it during a GP appointment about another issue, but said her doctor initially believed it was nothing to worry about.
However, upon comparing photos of herself, Darcy continued to feel the mole was changing and she returned to the GP a month later with her concerns.
She was then referred to hospital, where she underwent a procedure in February - removing it for tests to check if it was cancerous.
"I was called into the hospital and told that I had skin cancer," Darcy adds, as she recalls the "scary" experience.
"I had no idea about the signs of skin cancer. I didn't see it coming."
She has since undergone a second procedure - known as a wide local excision - to remove a wider area of healthy skin to check whether the cancer had spread.
This came back all clear, although Darcy was still left "nervous about whether the cancer would return".
She was also initially self-conscious about her scars, which are visible when wearing a V-neck top. "I work in a school and was worried that kids might point it out, but it's not happened," she says.
"Facing that has really helped," she adds, along with support from Teenage Cancer Trust events.
What is melanoma?
Melanoma, also known as malignant melanoma, is a type of skin cancer that can spread to other organs in the body.
Melanomas are less common than non-melanoma skin cancers, but they are one of the most dangerous forms of skin cancer, according to the British Skin Foundation.
They can develop from existing moles, but they more often appear as new marks on the skin, the charity says.
This can appear anywhere on the body, but the most commonly affected areas are the back in men and the legs in women.
According to Cancer Research statistics, the highest rates of melanoma skin cancer are among older people.
However, it also occurs relatively frequently at younger ages - in contrast to most cancer types.
Incidence rates increase steadily in men and women from around age 20 to 24 upwards, with a significantly higher average number of new cases in younger women.
This trend then reverses in older people, with higher rates among men.
ITV's Love Island star Molly-Mae Hague has recently had a mole removed from her calf over skin cancer fears.
She had the operation in September and later received results that "were not at all what I was expecting", according to a post on her Instagram stories earlier this month.
However, she has yet to reveal her diagnosis - ahead of further surgery this week.
She said she "never thought at 21 something like this would happen to me", but has stressed the importance of sharing her story to raise awareness of the situation.
Loti Jackson, 35 - who found out she had malignant melanoma seven years ago - says hearing such stories from prominent figures like Molly-Mae is key for encouraging young people to "not ignore" the signs.
Loti, from Haywards Heath near Brighton, was at work when she first became aware that a mole on her left cheek fitted many of the skin cancer warning signs, and needed to be checked.
She was working in PR for a self-tanning brand, which happened to run an annual campaign to raise awareness for skin cancer. Besides this campaign, she had no awareness of skin cancer.
Although the mole was deemed non-cancerous in August 2012, within three months it had changed - requiring a procedure to remove it. It was diagnosed as melanoma.
Loti, who gave birth to her first child four weeks ago, has since another mole removed from the left side of her upper chest, which was deemed non-cancerous.
"I'm lucky because it was caught early," says Loti. "Now I'm aware that if it's not caught early [it could] potentially become life-threatening."
"I don't know if I would be here if I hadn't taken it seriously and had it checked.
"It took five minutes to speak to a doctor. Anyone's life is worth that five minutes."
What to look for
It is recommended that people examine their skin on a monthly basis in a well-lit room with a full-length mirror - to detect unusual growths or changes early.
Dermatologist and British Skin Foundation spokeswoman Dr Anjali Mahto advises looking "closely at the entire body including the scalp, buttocks and genitalia, palms and soles including the spaces between the fingers and toes", with help from a trusted individual if needed.
This acronym can help establish if moles need to be checked
Asymmetry one half of mole is different to the other
Border irregular, scalloped or poorly defined edge
Colour uneven colour or variable colours within mole
Diameter mole bigger than 6mm (quarter of an inch) in size
Evolving mole changing in size, shape or colour
Other signs to look out for include any new moles, a mole that looks significantly different to the others or any skin lesion that bleeds or fails to heal.
Dr Mahto adds: "Any concerns should prompt a visit to a dermatologist who will perform a full skin examination and may go on to either excise a mole or take a sample or biopsy of any unusual growths or patches on the skin."
Darcy's surgeries took place before the coronavirus lockdown, but she later found a lump under her ear - prompting concerns that the cancer might have spread.
The pandemic meant that a scan to check the issue was delayed, but fortunately once it could go ahead the lump was not deemed to be cancerous.
Covid-19 restrictions also meant she struggled initially to tell her friends about the diagnosis. "It wasn't the kind of thing I wanted to tell them over the phone," she says.
"It meant that I didn't get the support from them that I might have got if lockdown didn't happen."
But Darcy says it is important to get skin concerns checked out as soon as possible "especially in times like these when you might feel that you can't go to the doctors or it's not as important".
And now that Darcy has spoken to her friends, she feels positive that a few have asked her how she noticed the changes in her mole.
She says she showed them pictures for comparison and pointed out how it had two different colours, irregular borders, was quite large, along with explaining the ABCDE signs.
"I hope they took that [on board] and know it's what to look for."