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Moles are common. Almost everyone has a few, and some people develop hundreds. Individuals with light skin tend to have more moles, with the average ranging from 10 to 40.
Probably the most important thing to know about moles is that melanoma, the deadliest type of skin cancer, can develop in or near a mole. Some moles increase the risk of developing skin cancer as the following section describes.
TYPES OF MOLES
Research has shown that certain moles have a higher-than-average risk of becoming cancerous.
• CONGENITAL MOLE
When a person is born with a mole, the mole is called a congenital nevus. About one in 100 people is born with one or more moles. These moles vary in size from small to large/giant. The large/giant congenital mole (greater than 20 centimeters) has been shown to carry a higher risk of developing a melanoma.
• ATYPICAL MOLE
Also called dysplastic nevi, these moles are generally larger than average (bigger than a pencil eraser) and irregular in shape. They tend to have uneven color with mixtures of tan, brown, red, and pink. Atypical moles often run in families, but anyone may develop these moles. People with atypical moles have a greater chance of developing melanoma.
• ACQUIRED MOLE
Moles that appear after birth are called acquired moles and generally not cause for concern. People who have more than 50 to100 acquired moles, however, have a greater risk for developing melanoma than those who have fewer moles.
Anyone who has a mole that has a higher-than-average risk for developing melanoma should see a dermatologist regularly, perform skin self-exams, and practice sun protection.
CHECKING MOLES: SKIN SELF-EXAMS
Performing regular skin self-exams helps people recognize the early warning signs of melanoma. Dermatologists recommend that everyone perform regular skin self-exams. When examining your moles, look for the ABCDEs of Melanoma Detection:
A stands for ASYMMETRY; one half unlike the other half.
B stands for BORDER; irregular, scalloped, or poorly defined border.
C stands for COLOR; varied from one area to another; shades of tan, brown, and black; sometimes white, red, or blue.
D stands for DIAMETER; melanomas are usually greater than 6mm (the size of a pencil eraser) when diagnosed, but they can be smaller.
E stands for EVOLVING; a mole or skin lesion that looks different from the rest or is changing in size, shape, or color.
As you examine your skin, it is important to know that not all moles look alike. Even in the same individual, moles can differ in size, shape, or color. Moles can be flat or raised. The most common colors range from tan to brown, but moles can be pink, black, blue, or even skin-toned. Moles can have hair. Some moles will change slowly over time, possibly even disappearing.
Be sure to examine your entire body. Moles can appear anywhere on the skin. Moles develop on the scalp, between the fingers and toes, on the soles and palms, and even under the nails.
A dermatologist should examine any mole that stands out from the rest. This includes any spot that changes in size, shape, or color, and any lesion that bleeds, itches, or becomes painful.
WHEN TO SEE A DERMATOLOGIST
If a mole seems worrisome, displays one or more of the ABCDEs, or is new and looks unusual, promptly make an appointment to see a dermatologist.
Most moles are not melanoma, but a dermatologist can assure you that the mole is harmless, or perform a biopsy to check the mole. A biopsy, which involves removing the mole or other suspicious lesion and examining it under a microscope, is the only way to confirm that a lesion is skin cancer.
TREATMENT FOR MOLES
Dermatologists remove a mole when it becomes a nuisance, a patient finds the mole unattractive, or skin cancer is suspected. How a dermatologist removes the mole depends on the size of the mole, where it appears on the body, and other factors.
One commonly used method for removing a mole is called surgical excision. This involves cutting out the entire mole and stitching the skin closed. Another option for removing a mole is to use a surgical blade to shave away the mole. Never try to shave off a mole at home. If skin cancer is present, much of the cancer can remain and possibly spread. Shaving it yourself also can cause disfiguring results and can cause an infection.
In a dermatologist's office, removing a mole is a simple and safe procedure, which can be performed using local anesthesia.
Sometimes another appointment is necessary. If the biopsy confirms that the mole is cancerous, the dermatologist may need to perform additional treatment or may want to talk about additional treatment for the cancer.
Another appointment is essential if a mole grows back after being removed. If this happens, make an appointment immediately.
EARLY DETECTION AND PREVENTION ARE ESSENTIAL
Routinely examining the skin for change helps to detect skin cancer early when it is most treatable. If a mole begins to change or a new mole appears, see a dermatologist. It also is wise to have an annual skin examination by a dermatologist. This is especially important for adults who have risk factors for skin cancer, such as a family history of skin cancer or for those who have had lots of sun exposure.
Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. As unprotected sun exposure is thought to increase the number of moles, reducing sun exposure is an easy way to reduce your risk for skin cancer. Here's how to Be Sun SmartSM:
• Generously apply a broad-spectrum water-resistant sunscreen with a Sun Protection Factor (SPF) of 30 or more to all exposed skin. Broad-spectrum provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Reapply approximately every two hours, even on cloudy days, and after swimming or sweating.
• Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, where possible.
• Seek shade when appropriate, remembering that the sun's rays are strongest between 10 a.m. and 4 p.m. If your shadow is shorter than you are, seek shade.
• Protect children from sun exposure by playing in the shade, using protective clothing, and applying sunscreen.
• Use extra caution near water, snow, and sand because they reflect the damaging rays of the sun, which can increase your chance of sunburn.
• Get vitamin D safely through a healthy diet that may include vitamin supplements. Don't seek the sun.
• Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you've been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
• Check your birthday suit on your birthday. If you notice anything changing, growing, or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.
We apologize for not showing any photos here for ethical reasons. You may refer to the following website for before and after photos: www.aad.org
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