Skin & Complexion — 22 Harley Street
Skin Assessment & Lesion Review

Moles & Lesions

Assess · Monitor · Act

Clinical Rigour Timely Referral Excellence on Harley Street

22 Harley Street· CQC Regulated· All Skin Tones· Dermoscopy Assessment· Same-Week Referral

Most moles and skin lesions are entirely benign. But the ones that are not can be life-threatening when missed, and straightforwardly treatable when caught early. A clinical assessment is always the right place to start.

Skin lesions encompass a wide spectrum — from common, harmless seborrhoeic keratoses and benign moles to pre-malignant lesions and early skin cancers. What distinguishes a lesion that requires monitoring from one that requires urgent action is rarely apparent to the untrained eye, and often not apparent without dermoscopy — a technique that allows examination of subsurface skin structures invisible to the naked eye.

At PHP Aesthetic-Wellness, Dr Philippe Hamida-Pisal and Dr Jihyun Byun conduct thorough lesion assessments using clinical examination and dermoscopy. Where a lesion raises any concern, we do not delay: same-week referral to a consultant dermatologist or plastic surgeon is arranged, with a clear clinical summary accompanying every patient we refer. For lesions confirmed as benign, we offer monitoring, documentation, and patient education to support confident, informed self-examination in between appointments.

If you are concerned about a mole or skin lesion, do not wait. Early detection is the single most important factor in skin cancer outcomes. Contact us to arrange an assessment — we prioritise appointments for patients with new or changing lesions and aim to see urgent referrals within the same week.

Types of Moles & Skin Lesions

Understanding the range of lesions we assess — from entirely benign to requiring urgent referral — helps patients know what to look for and when to seek a clinical opinion.

Common Moles
Melanocytic naevi
Benign clusters of melanocytes, typically round or oval, evenly pigmented, and with a well-defined border. Most adults have between 10 and 40 moles; they are entirely normal and rarely require intervention. Changes in size, shape, colour, or surface warrant clinical review.
Seborrhoeic Keratoses
Extremely common benign growths that appear with age — waxy, stuck-on in appearance, and varying in colour from pale yellow to dark brown. Often mistaken for moles or warts. No malignant potential, but assessment confirms the diagnosis and rules out mimics.
Dermatofibromas
Firm, benign nodules most commonly found on the lower legs, often following minor skin trauma. Typically skin-coloured to brown, dimple inward when pinched, and are entirely benign. Reassurance and documentation is usually all that is required.
Actinic Keratoses
Pre-malignant
Rough, scaly patches on sun-damaged skin — the face, scalp, hands, and forearms — representing abnormal keratinocyte proliferation driven by UV exposure. A proportion of untreated actinic keratoses progress to squamous cell carcinoma. Treatment and monitoring are always advised.
Basal Cell Carcinoma
Most common skin cancer
The most frequently occurring skin cancer in the UK. Typically presents as a pearly, translucent papule or nodule, often with visible surface vessels, most commonly on sun-exposed areas of the head and neck. Rarely metastasises but is locally destructive if untreated. Prompt referral and excision is curative in the vast majority of cases.
Squamous Cell Carcinoma
Requires urgent referral
A malignant tumour of keratinocytes, typically presenting as a firm, crusted, or ulcerated lesion on sun-damaged skin. Carries a low but meaningful risk of metastasis, particularly in immunocompromised patients or where the lesion is large or on the lip or ear. Urgent referral is always arranged.
Melanoma
Urgent referral
The most serious form of skin cancer, arising from melanocytes. Early melanoma is highly treatable; advanced disease carries a significantly worse prognosis. Any lesion with features of irregularity — asymmetry, irregular border, multiple colours, diameter over 6mm, or evolution — is treated as an urgent referral until proven otherwise.
Vascular Lesions
Including cherry angiomas (Campbell de Morgan spots), spider naevi, and pyogenic granulomas. Most are entirely benign and require only reassurance. Pyogenic granulomas, which can bleed significantly and grow rapidly, warrant clinical assessment and referral for removal.
“The lesions that concern us most are often the ones patients have been watching and waiting on for months. If something has changed — in size, colour, shape, or feel — that is the moment to have it seen, not the moment to continue watching.” PHP Aesthetic-Wellness, 22 Harley Street

The ABCDE Rule

The ABCDE criteria are the internationally recognised framework for identifying features of a mole or pigmented lesion that require clinical assessment. Any one of these features in a lesion you have not had assessed warrants a prompt appointment.

ABCDE — When to Seek Assessment
A
Asymmetry
One half of the mole does not match the other. Benign moles tend to be symmetrical; irregular or mismatched halves are a concern.
B
Border
Edges that are irregular, ragged, notched, or blurred rather than smooth and well-defined require closer examination.
C
Colour
Multiple shades of brown, black, red, white, or blue within a single lesion. Benign moles are typically a consistent single shade.
D
Diameter
A lesion larger than 6mm — approximately the size of a pencil eraser — warrants assessment, although melanomas can present at smaller sizes.
E
Evolution
Any change in a mole or lesion — in size, shape, colour, elevation, or any new symptom such as bleeding, itching, or crusting — is the single most important signal that clinical assessment is needed.

Our Assessment & Referral Process

Our role in mole and lesion assessment is to provide expert clinical evaluation, clear communication, and timely action. We do not remove lesions in this setting; our focus is accurate diagnosis and ensuring every patient reaches the right specialist without delay.

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Dermoscopy Assessment

A handheld dermoscope illuminates subsurface skin structures invisible to the naked eye, significantly improving the accuracy of lesion assessment. Each lesion of concern is examined dermoscopically and the findings documented alongside clinical photographs for monitoring or referral.

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Total Body Skin Check

A systematic examination of the entire skin surface, mapping and documenting all significant lesions. Recommended for patients with a personal or family history of skin cancer, a large number of moles, previous significant sun exposure, or immunosuppression.

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Monitoring & Documentation

For benign lesions, clinical photographs and dermoscopy images are recorded at each visit to allow accurate comparison over time. This provides reliable evidence of stability — or early detection of change — far more accurately than patient recall alone.

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Same-Week Referral

Where a lesion raises clinical concern, we do not ask patients to wait. A detailed referral letter and clinical images are sent to a consultant dermatologist or plastic surgeon, and we aim to secure an appointment within the same week for any lesion requiring urgent assessment.

A note on lesion removal: We do not remove moles or lesions at PHP Aesthetic-Wellness. Excision requires histopathological analysis of the removed tissue to confirm the diagnosis — this is performed by a consultant dermatologist or plastic surgeon in an appropriate surgical setting. Our role is to identify, assess, document, and refer with the clinical information that allows the right surgical decision to be made promptly.

Related Services

Mole and lesion assessment sits within a broader set of skin health services at PHP Aesthetic-Wellness:

Skin Cancer Screening

A dedicated full-body skin cancer screening appointment for patients at elevated risk — those with a personal or family history of melanoma or non-melanoma skin cancer, a history of significant UV exposure, multiple atypical moles, or immunosuppression.

Screening includes a systematic total body skin examination, dermoscopy of all significant lesions, clinical photography, and a written summary of findings. Where lesions require referral, this is arranged on the same day. Annual screening is recommended for higher-risk patients; two-yearly for those at standard elevated risk.

Skin cancer is not exclusively a concern for fair skin. Melanoma in patients with darker skin tones is frequently diagnosed at a later stage precisely because the index of suspicion — in patients and clinicians alike — is lower. Our screening service is available to and designed for all skin tones.

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Ethnic Skin Clinic

Darker skin tones present unique diagnostic and management challenges that are frequently underserved by mainstream aesthetic and dermatology practice. Conditions including post-inflammatory hyperpigmentation, keloid scarring, pseudofolliculitis barbae, melasma, and dermatosis papulosa nigra behave differently — and require different clinical approaches — in Fitzpatrick skin types IV–VI.

Our ethnic skin clinic offers specialist assessment and management for the full range of pigmentation, scarring, hair, and inflammatory skin conditions as they present in medium-to-deep skin tones. Treatment protocols are adapted specifically to the physiology and reactivity of darker skin — not repurposed from protocols designed for lighter complexions.

Skin cancer screening is an equally important part of this service. Acral lentiginous melanoma — the subtype most common in patients with darker skin, affecting the palms, soles, and nail beds — is specifically included in our screening examination.

Your Skin Health Journey

Whether you have a single lesion of concern or require an ongoing monitoring programme, we provide the clinical rigour and continuity that skin health demands.

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Initial Assessment

Clinical and dermoscopic examination of lesions of concern, with full documentation. Any lesion requiring urgent review is referred on the same day.

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Diagnosis & Decision

A clear clinical summary: benign and suitable for monitoring, requires referral for further investigation, or requires urgent specialist assessment. No ambiguity, no delay.

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Referral if Needed

Where referral is indicated, we write a detailed clinical letter and images to a named consultant and confirm the appointment with the patient before they leave.

Ongoing Monitoring

For patients with multiple moles or elevated risk, a regular monitoring programme is established with standardised photography at each visit to allow accurate longitudinal comparison.

Do Not Wait

Book a Mole & Lesion Assessment

PHP Aesthetic-Wellness

22 Harley Street, Suite 8, London W1G 9PL

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contact@phpaesthetic.com  ·  +44 (0)7917 785 695  ·  WhatsApp available
PHP Aesthetic-Wellness — 22 Harley Street, Suite 8, London W1G 9PL · phpaesthetic.com