Nearly everyone has at least a few moles, or beauty marks, as they’re sometimes called. They are especially common in people with lighter skin. Melanin, the skin’s natural pigment, is made by cells called melanocytes. When melanocytes grow in a cluster, they create moles.
Although most moles are harmless, there are several factors that represent an increased risk for melanoma, a type of skin cancer. The presence of 50 or more moles can indicate a higher risk for melanoma. If a mole has an odd shape, contains more than one color or is larger than an eraser at the end of a pencil, it is considered atypical. Having four or more atypical moles can present a greater risk for melanoma. People who have a personal or family history of melanoma are also in danger of developing skin cancer.
While most moles will not become melanoma, it is important to monitor your moles for any changes. Early detection is very important. Melanoma can be cured if it’s caught early, but it can be serious if it’s not detected and treated in a timely manner.
If a mole itches, bleeds, or changes in shape or appearance, you should have one of our dermatologists examine it. A mole that appears different from the rest of your moles in shape, color, and size is referred to as an “ugly duckling.” Any ugly duckling moles should also be looked at by a dermatologist.
Wellness & Prevention
Though many people are born with moles, sun exposure can increase the number of moles an individual has. Minimizing your sun exposure helps to protect your skin from damage. Wearing a high SPF sunscreen and avoiding tanning are protective measures that can help to prevent melanoma. Even on overcast days, the sun’s rays affect the skin. It’s important to always practice good sun protection.
It’s also important to perform regular self-exams of your skin by keeping a “mole map.” You can create a mole map by taking clear photographs of your moles every year. This is particularly useful for places on your body that are harder to observe, such as your back. Compare these photos side by side to detect any changes in your moles. Looking at mole features can be remembered with your ABCDE’s:
- Borders that are irregular
- Color changes or multiple colors
- Diameter that is greater than the size of a pencil eraser
- Evolving or changing moles
The American Academy of Dermatology has an excellent tool for mapping your moles. It addresses how to perform a self-examination, what changes you should watch for and good skin protection tips. It also has a diagram and chart to help you document your moles.
There are several types of moles that that can develop:
- Congenital Mole: Congenital moles are a type of birthmark that are present from birth, and vary in size, shape, color and hairiness. As you grow, these moles will grow with you.
- Acquired Mole: Also known as a common mole, this appears after birth, and can remain through adolescence and into the fourth decade of life. Most light-skinned people have between 10 and 40 common moles.
- Atypical or Dysplastic Mole: These typically have an unusual, asymmetrical shape and are not round. They are often larger than the end of an eraser and may have multiple colors. Having an atypical or dysplastic mole is not necessarily a cause for concern. However, four or more atypical moles may increase your chance of having a melanoma. When four or more of these type of moles are present, careful self-monitoring is required and yearly full body skin examinations by a board-certified dermatologist are necessary.
- Spitz Nevus: These are often raised and dome-shaped moles. They range in color from skin-colored to pink to dark, and can sometimes ooze or bleed. Most spitz nevi will appear within the first 20 years of life but can develop in adulthood. It is usually recommended that these moles are removed, because although they are harmless, they look like melanoma.
Most moles are harmless and don’t need further medical treatment. However, moles can be removed for a number of reasons. Some people feel self-conscious or experience discomfort depending on location and appearance of moles, even those that are harmless. These moles can be removed by a dermatologist. Moles that are concerning for cancer are also removed.
Mole removal is minor surgery that is performed by your dermatologist. Moles can be safely removed during one or two office visits. For surgery, the mole and surrounding skin are numbed with an injection of a local anesthetic. There are two options for removing the tissue. In a surgical shave, the dermatologist shaves off the mole with a blade. In a surgical excision, the mole is cut out and the skin is stitched closed. In some cases, only a portion of the mole is removed.
If cancer is suspected, the removed tissue is sent to a lab for a biopsy. During a biopsy, a pathologist examines the tissue under a microscope to look for signs of disease. Based on the results of the biopsy, your dermatologist will tell you if any additional treatment is necessary.
Never try to remove a mole yourself. Doing so can increase the risk that cancer goes undetected and will continue to spread. It can also increase risk of an unsightly scar and of an infection.
Once a mole is removed, the skin will heal. You can help the healing process by applying healing ointment or Vaseline® to the surgical site and avoiding sun exposure. After an excision, it is important to closely monitor the site. If the mole grows back, it could be a sign of melanoma, which requires immediate follow up with your dermatologist.