What to Look For and When to Worry

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Kevin Dahle, MD






May 19, 2017

Moles are mostly determined by genetics, though sun exposure and tanning bed use can cause you to form new moles or make your existing moles darker. Moles may also change during puberty and pregnancy, as well.

Moles are generally small, pigmented spots on the skin. Moles come in many shapes, sizes and colors. Moles can be raised off the skin or flat. There is a huge variety in the types of moles that a person can have. Moles are classified generally into the following categories:

• Congenital moles. Moles that are present at birth are called congenital moles. Congenital moles are categorized by their size: small, medium and large. Only large congenital moles (greater than 20mm in size) have a significantly increased risk of turning into a skin cancer.
• Acquired moles. Most moles are acquired, meaning they develop after birth. They are typically smaller than a pencil eraser and have even pigmentation and a symmetrical border. Most acquired moles will not develop into a skin cancer.
• Atypical moles. Atypical moles (also called dysplastic nevi) have asymmetrical, irregular borders and often have multiple colors. The pigmentation is often uneven and they can have focal darker areas. Multiple atypical moles can run in families. The more atypical moles that you have, the higher your risk of skin cancer.

When to See Your Doctor About Your Mole

It is important to consult your doctor about any suspicious moles, as these lesions may represent malignant melanoma, a life-threatening type of skin cancer 

Examine your skin every month or two to look for any new or changing moles. If you have a family history of atypical moles or skin cancer or you have numerous moles, you may benefit from seeing a dermatologist for regular skin checks.

When you examine your moles, remember the ABCDEs of melanoma. If you notice any of the following, consult your doctor or dermatologist:

A for asymmetry: A mole in which one half of the mole does not look like the other half

B for irregular border: A mole with a poorly defined or scalloped border

C for varied color: A mole with multiple shades of black, brown, white, red and/or blue

D for large diameter: A mole that is larger than a pencil eraser in size

E for evolving: A mole that is changing in size, shape or color

New moles: A new mole that develops, especially if it appears after your 30s

Bothersome moles: A mole that bleeds, itches or is painful

Removing a Mole

Most moles are harmless. However, if your dermatologist is concerned about one of your moles or you want a mole removed, this can usually be done easily in the clinic.

To remove a mole, your dermatologist will numb the area around the mole and shave or cut it off. Sometimes a few stitches are required. The tissue will be sent to a laboratory to confirm it is not cancerous.

Keep an eye on your moles. The earlier a skin cancer is detected, the easier it is to be treated. 

LiVe Well



Dermatology,


Intermountain Healthcare,


Skin Cancer

Last Updated:
4/20/2020

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Copyright ©2023, Intermountain Health, All rights reserved.

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New moles: A new mole that develops, especially if it appears after your 30s

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Bothersome moles: A mole that bleeds, itches or is painful

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Removing a Mole

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Most moles are harmless. However, if your dermatologist is concerned about one of your moles or you want a mole removed, this can usually be done easily in the clinic.

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To remove a mole, your dermatologist will numb the area around the mole and shave or cut it off. Sometimes a few stitches are required. The tissue will be sent to a laboratory to confirm it is not cancerous.

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Keep an eye on your moles. The earlier a skin cancer is detected, the easier it is to be treated. 

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Moles: When Should I Worry?

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by Dr. Curtis Chastain

I was recently diagnosed with a “pre-melanoma” on my leg.

It all started when I noticed a mole on my left leg had changed. My colleague removed a part of the mole and sent it off for tests. The results indicated that my mole was “melanoma in situ,” which means the malignant tumor was still confined to the upper layers of the skin and had not spread. A second excision was performed to remove the mole entirely, and there’s no reason to believe that I won’t be fine.

Had I not noticed the change in the mole, it may have become a malignant melanoma, and my situation could have been dramatically different.

Malignant melanoma, which starts out as a mole, is the most dangerous form of skin cancer, killing almost 10,000 people each year. The majority of melanomas are black or brown, but they can be almost any color; skin-colored, pink, red, purple, blue or white. Melanomas are caused mainly by intense UV exposure.

If malignant melanoma is recognized and treated early, like in my case, it is almost always curable. However, if it has time to spread to other parts of the body, it becomes very difficult to treat and can lead to death.

Identifying Malignant Melanoma

The ABCDE Criteria can help you identify moles that could be malignant melanoma. Being aware of these criteria may very well save your life.

A = Asymmetrical
If you look at a benign, or harmless, mole, it is usually symmetrical. On the other hand, a worrisome mole is asymmetrical, meaning if you cut in half, the two sides do not look the same.

B = Border
Benign moles typically have a regular, round border. Cancerous moles tend to have irregular borders. If the border isn’t smooth, you should get your mole checked out.

C = Color
Benign moles are usually one uniform color throughout. They can be brown, or black or pink, as long as they are one single color. Cancerous or pre-cancerous moles are multicolored. If the mole has more than one color, get it looked at.

D = Diameter
Imagine a pencil eraser. Moles smaller than the diameter of a pencil eraser are less likely to be cancer. If a mole is bigger than a pencil eraser, it is not necessarily cancerous, but it should be evaluated.

E = Evolving
The ABCD above is very important. However, if any mole on your skin shows signs of change, that can indicate a problem. A change in size or color for example might be the only sign that it is cancerous.

Please take the time during your next check up to have a total body skin exam. If your primary care physician does not feel comfortable evaluating your skin, request a referral to a dermatologist who can check your skin for abnormal moles.

About Dr. Chastain

Curtis C. Chastain, MD, FACP, is an internal medicine physician focused on the primary care of men. He is a thought leader and frequently requested expert on men’s health, bringing his personal insights and 25 years of practice experience to this topic. Dr. Chastain is the founder and medical director of the Men’s Health Center at Our Lady of the Lake Regional Medical Center. To learn more about becoming a member of the Men’s Health Center, call 225-765-4400.

Moles: is it worth it to be afraid?

Almost everyone has some number of moles, which usually appear in childhood and adolescence.

Almost everyone has some number of moles that usually appear during childhood and adolescence. The medical name is nevus (naevus maternus), a malformation of the skin, in which certain parts of it differ in color and / or a special warty appearance of the surface.

Many skin and subcutaneous neoplasms are quite common, and a careful examination by an oncologist is sufficient for a preliminary diagnosis. Most skin tumors are benign, but malignant tumors are also not uncommon, so early and accurate diagnosis is extremely important.

To provoke a mole to rebirth, of course, a push, an irritant is needed. The strongest irritant of all possible is excessive exposure to the sun.
Ultraviolet irradiation in high doses causes irreversible changes in skin cells, greatly increasing the risk of their degeneration. For each person, the critical amount of insolation is purely individual. It is not easy to determine this line, so it is better to just remember that prolonged exposure to the sun is harmful to the body. The skin is forced to protect itself from ultraviolet radiation. Excessive tanning is inevitable burns that “hit” the skin’s immunity.

The second common cause of tumor development is trauma to the mole. Therefore, if you touched it with your fingernail, inadvertently damaged it with a washcloth, with some sharp object, especially if these injuries are permanent (for example, from underwear), be sure to see a doctor. Teach your children from childhood to take care of small marks on the skin.
Because birthmarks are very common and melanomas are rare, prophylactic mole removal is not warranted. Look at the mole at an angle, take a magnifying glass: a uniform color, a smooth edge, a transition of the “skin pattern” from an area with a normal color to a pigmented area, the presence of hair is a good sign.

However, if the mole suddenly increases in size (especially if there are uneven edges), darkens, becomes inflamed, becomes mottled, starts to bleed, ulcerates, itches or hurts, the “lacquer” surface of the mole, the special pattern of the edge – alarm!
Having found possible signs of degeneration of a mole, be sure to consult an oncologist.

It is important to remember that all removed moles are subject to mandatory morphological (histological) examination, because the final diagnosis for the morphologist. Only he, through a microscope, knows the danger in person.

Signs of malignant transformation of pigmented neoplasms according to the “BLOW” scheme:

• Growth acceleration
• Diameter over 6 mm
• Asymmetry, irregular shape
• Multicolour, change in color of one of the sections

More than a hundred oncological diseases are known to science, but melanoma among them is the recognized “insidious and evil queen”. The insidiousness and aggressiveness of this type of skin cancer is unparalleled. Once having arisen, the disease can imperceptibly develop in the superficial layers of the skin for 5–50 (!) years. Then, having chosen the weakest place on the skin – a mole or a pigment spot, single cells of a ripening tumor begin to grow in depth.

In order not to start the problem, you just need to be a little more attentive to yourself and not miss the first alarming symptoms. About how serious your concerns are, you need to consult with an oncologist. Self-treatment of age spots and moles is dangerous, but self-examination is welcome!
In case of any even slight suspicions, it is necessary to visit an oncologist. In such situations, correspondence consultations and consultations of cosmetologists are unacceptable!

What are moles?

Lentigo (marginal) is a flat, evenly pigmented brownish-brown to black patch resulting from an increase in the number of melanocytes at the border of the epidermis and dermis (skin layers). Compared to freckles, lentigines are darker and less common; moreover, their color does not increase and the number does not increase under the influence of solar radiation.
Epidermal-dermal nevi – usually flat, but sometimes slightly raised above the level of the skin. Coloring from light brown to almost black, sizes – from 1 to 10 mm. Birthmarks on the palms, soles, and genital area are usually epidermal-dermal.
Complex nevi – more often have a dark color due to the accumulation of melanocytes and to some extent rise above the level of the skin.
Intradermal nevi elevated above skin level; their color varies from flesh to black, and the surface may be smooth, hairy, or warty.
Sutton’s nevi are pigmented birthmarks (usually complex and intradermal nevi) surrounded by a ring of depigmented (unstained) skin. Sutton’s nevi disappear spontaneously, and only in rare cases give rise to malignant melanomas.
Dysplastic nevi are pigmented spots of irregular shape and indistinct borders, slightly elevated above the level of the skin, their color varies from reddish-brown to dark brown on a pink background. Dysplastic nevi first attracted attention with their unusual appearance and increased frequency in some families (inherited).
Blue nevi – rising above the skin, sometimes hemispherical formation, dense, usually with a smooth surface, blue, blue, occasionally brown, with a clear border, ranging in size from 0.5 to 2.0 cm, without hairline. The preferred localization is the face, limbs, buttocks.
Giant pigmented nevus – is most often congenital and increases as the child grows. These nevi have a flat surface and can occupy significant areas of the skin of the trunk, limbs, and face. The predominant color is brown, grayish, black.

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9 birthmark myths

The term “mole” is unscientific, colloquial. Speaking of moles, people mean both benign and malignant skin tumors. Moles are also called hemangiomas (vascular tumors), and seborrheic keratomas, and pigmented melanocytic nevi, which only occasionally become precursors of melanoma.

In about 80% of cases, melanoma occurs de novo – as a new formation on the skin – and only in one in five cases is its appearance associated with a mole.

1. If a person has many moles, then he will definitely have melanoma

This is a myth. A large number of moles is indeed associated with the risk of developing skin melanoma during life, but such an event is not at all necessary.

The presence of a large number of moles on the body indicates that there are mutations in skin melanocytes that cause the formation of benign formations, the so-called melanocytic nevi. This is a favorable background for the development of melanoma, however, additional mutations that will provoke the appearance of malignant tumors may not occur.

2. The darker the mole, the more likely it is to turn into cancer

This is a myth. The degree of pigmentation of the nevus is not related to whether cancer arises from this mole or not. In most cases, melanoma occurs as an independent formation, not associated with moles.

A new skin lesion may indeed be more pigmented than the rest and may differ in appearance from other lesion.

The difference between the neoplasm and the existing ones is the “ugly duckling” symptom. Its detection may indicate early melanoma and should be the reason for additional examinations.

This can be, for example, dermatoscopy, as well as histological examination of a surgically removed mole.

Benign melanocytic nevi can be of different colors – this is completely normal, and there is no proven connection between the dark color of the mole and its degeneration into cancer.

It should also be borne in mind that melanoma is not necessarily black.

There is a so-called non-pigmented melanoma, which can visually look like a pink or flesh-colored mass, but by no means black.

3. Only moles that change color or size are dangerous

Not exactly a myth. Indeed, if the mole began to change, then both the patient and the specialist should pay attention to the dynamics of changes.

In the event that the mole changes color and shape, if its borders change, if there are unpleasant sensations in the area of ​​the mole (itching, burning, pain) and if it is obvious that something is happening to it, you should contact a specialist. Sometimes melanoma occurs at the site of benign melanocytic nevi.

In addition, at the initial stages of melanoma development, sometimes even a specialist cannot identify whether this neoplasm is malignant or benign. Changes in size, color and shape can be an additional clue that will indicate the malignancy of the formation.

Well, in general, a complex of ABCDE symptoms is used for skin melanoma:

A – asymmetry – asymmetry,

B – border – uneven borders,

C – color – heterogeneous color0003

D – diameter – diameter of 5 mm or more,

E – evolution – dynamic changes in these characteristics.

4. When exposed to the sun, large moles should be covered with plaster

This is a myth. There is no need to cover moles – regardless of their size – with a band-aid. It will not protect against melanoma in any way.

Since the vast majority of melanoma cases occur de novo, it is important to remember to protect the skin from UV in general. To do this, you can and should wear sun-protective clothing – it can be both beach and casual. It is necessary to apply sunscreens to exposed areas of the body, which are now produced by different brands and have different degrees of protection.

The most important thing is to change your behavior.

A tan that is of no benefit to the body should not become a fetish and should not be the goal.

5. It is better not to touch moles – any damage to them is dangerous

This is a myth. You can often hear stories about the fact that “a person removed a mole and soon died”, from which it is often concluded that it is better not to touch, remove or injure moles.

The thing is that patients quite often turn to doctors at stage II, III, IV of skin melanoma, when the tumor begins to metastasize, or the patient already has regional or distant metastases.

They come with complaints about an unusual mole and the doctor removes it surgically for further histological examination, without which it is impossible to determine the nature of the formation and, if necessary, prescribe treatment. But, since they turned already quite late, melanoma is still progressing. Without proper treatment, this can be fatal.

Most of the inhabitants associate the patient’s death not with the development of the disease, but with the removal of a mole. In fact, the mole was removed already at a late stage of the disease and it was not the removal that caused death, but the fact that it was performed too late.

Another popular belief is that damage to a mole will inevitably lead to its degeneration into melanoma. Both a benign mole and melanoma can really be injured – after damage, it bleeds, which worries patients and becomes a reason to see a doctor.