How do moles change over time. What causes moles to darken. When should you be concerned about a changing mole. What are the ABCDE signs of melanoma. How are suspicious moles removed and examined.

Understanding Mole Types and Their Characteristics

Moles, also known as nevi, are common skin growths that come in various shapes, sizes, and colors. They can be flat or raised, and their appearance is largely determined by genetics. However, external factors like sun exposure and tanning bed use can influence mole formation and pigmentation.

There are three main categories of moles:

• Congenital moles: Present at birth, classified by size (small, medium, large)
• Acquired moles: Develop after birth, typically smaller than a pencil eraser
• Atypical moles (dysplastic nevi): Irregular in shape and color

Are all moles created equal? Not quite. Large congenital moles (over 20mm) and multiple atypical moles can increase the risk of skin cancer. It’s crucial to monitor these types closely and consult a dermatologist for regular check-ups.

Factors Influencing Mole Changes and Development

While genetics play a significant role in mole formation, several external factors can contribute to changes in existing moles or the development of new ones:

• Sun exposure
• Tanning bed use
• Hormonal changes during puberty
• Pregnancy

Can environmental factors really affect mole appearance? Absolutely. Prolonged sun exposure, in particular, can cause moles to darken or lead to the formation of new moles. This is why sun protection is crucial for maintaining healthy skin and reducing the risk of potentially dangerous mole changes.

The ABCDE Rule: A Guide to Identifying Suspicious Moles

When examining your moles, it’s essential to remember the ABCDE rule of melanoma. This acronym helps identify potentially cancerous moles:

1. A – Asymmetry: One half of the mole doesn’t match the other
2. B – Border: Irregular, jagged, or scalloped edges
3. C – Color: Multiple shades of black, brown, white, red, or blue
4. D – Diameter: Larger than 6mm (about the size of a pencil eraser)
5. E – Evolving: Changes in size, shape, or color over time

Is the ABCDE rule foolproof? While it’s an excellent guideline, it’s important to note that not all melanomas will exhibit all these characteristics. Some may only show one or two signs, which is why regular self-examinations and professional skin checks are crucial.

When to Consult a Dermatologist About Your Moles

Regular self-examinations are vital for early detection of problematic moles. However, certain situations warrant a visit to your dermatologist:

• A mole exhibiting any of the ABCDE characteristics
• New moles appearing after age 30
• Moles that bleed, itch, or cause pain
• A family history of atypical moles or skin cancer
• Having numerous moles

Should you panic if you notice a change in a mole? While it’s important to take changes seriously, not all changing moles are cancerous. However, early detection is key in treating skin cancer effectively, so it’s always better to err on the side of caution and consult a professional.

The Process of Mole Removal and Examination

If a dermatologist identifies a suspicious mole or if you wish to have a mole removed, the process is typically straightforward:

1. The area around the mole is numbed with local anesthesia
2. The mole is shaved or cut off
3. Stitches may be required in some cases
4. The removed tissue is sent to a laboratory for examination

Is mole removal painful? Thanks to local anesthesia, the procedure is generally painless. You may experience some discomfort during the healing process, but this is usually minimal and short-lived.

Preventing Mole Changes and Reducing Skin Cancer Risk

While you can’t control your genetic predisposition to moles, there are steps you can take to minimize the risk of dangerous mole changes and skin cancer:

• Use broad-spectrum sunscreen with at least SPF 30 daily
• Avoid tanning beds and excessive sun exposure
• Wear protective clothing, including wide-brimmed hats and sunglasses
• Seek shade during peak sun hours (10 am to 4 pm)
• Perform regular self-examinations
• Schedule annual skin checks with a dermatologist

Can lifestyle changes really make a difference in skin cancer prevention? Absolutely. While some risk factors are beyond our control, adopting sun-safe habits and maintaining vigilance through regular check-ups can significantly reduce your risk of developing skin cancer.

Understanding the Link Between Moles and Melanoma

While most moles are harmless, it’s crucial to understand the potential link between moles and melanoma, the most dangerous form of skin cancer. Melanoma can develop in existing moles or appear as new, unusual growths on the skin.

Factors that increase the risk of melanoma include:

• Having a large number of moles (more than 50)
• Having atypical moles
• A personal or family history of melanoma
• Fair skin that burns easily
• History of severe sunburns, especially in childhood

Does having moles automatically mean you’ll develop melanoma? Not at all. While moles can increase your risk, many people with numerous moles never develop skin cancer. The key is to be aware of your risk factors and maintain vigilant monitoring of your skin.

The Importance of Early Detection

Early detection of melanoma significantly improves treatment outcomes. When caught in its early stages, melanoma has a five-year survival rate of 99%. However, this rate drops dramatically if the cancer has spread to distant parts of the body.

This stark difference in survival rates underscores the importance of regular skin checks and prompt attention to any suspicious changes in moles. Remember, it’s always better to have a dermatologist examine a mole that turns out to be benign than to ignore a potentially dangerous change.

Technological Advancements in Mole Monitoring and Skin Cancer Detection

As our understanding of skin cancer grows, so does the technology available to detect and monitor suspicious moles. Some recent advancements include:

• Total body photography: Creates a map of existing moles to track changes over time
• Dermoscopy: Uses a special magnifying lens to examine mole structures not visible to the naked eye
• Confocal microscopy: Provides detailed images of skin cells without the need for a biopsy
• Artificial intelligence: Assists in analyzing images of skin lesions to identify potential cancers

Can these technologies replace dermatologist examinations? While these tools are incredibly useful, they’re meant to supplement, not replace, professional examinations. The expertise of a trained dermatologist remains crucial in interpreting results and making treatment decisions.

The Role of Genetic Testing

For individuals with a strong family history of melanoma or multiple atypical moles, genetic testing may be recommended. Certain genetic mutations, such as those in the CDKN2A gene, are associated with an increased risk of melanoma.

Genetic testing can help identify individuals who may benefit from more frequent skin checks or additional preventive measures. However, it’s important to note that not all cases of melanoma are linked to known genetic mutations, and a negative test result doesn’t eliminate the need for sun protection and regular skin examinations.

Living with Atypical Moles: Management and Lifestyle Adjustments

If you’ve been diagnosed with atypical moles or have a high risk of developing skin cancer, you may need to make some lifestyle adjustments:

1. Increase the frequency of skin self-examinations to monthly
2. Schedule more frequent dermatologist visits, potentially every 3-6 months
3. Be extra vigilant about sun protection, including daily sunscreen use and protective clothing
4. Consider vitamin D supplementation if reducing sun exposure
5. Educate family members about the importance of skin checks, as they may also be at increased risk

Is it possible to live a normal life with atypical moles? Absolutely. While managing atypical moles requires extra care and attention, it shouldn’t significantly impact your quality of life. Many people with atypical moles lead active, outdoor lifestyles while taking appropriate precautions.

Emotional Impact and Support

Living with atypical moles or a high risk of skin cancer can be emotionally challenging. Some individuals may experience anxiety about their appearance or fear of developing cancer. It’s important to address these concerns and seek support if needed.

Support options may include:

• Counseling or therapy
• Support groups for individuals with atypical moles or skin cancer risk
• Educational resources to better understand your condition and risk factors
• Open communication with your healthcare provider about your concerns

Remember, knowledge is power. Understanding your risk factors and taking proactive steps to manage them can help alleviate anxiety and empower you to take control of your skin health.

The Future of Mole Monitoring and Skin Cancer Prevention

As research in dermatology and oncology continues to advance, we can expect to see new developments in mole monitoring and skin cancer prevention. Some areas of ongoing research include:

• More sophisticated AI algorithms for analyzing skin lesions
• Development of non-invasive diagnostic tools
• Personalized risk assessment based on genetic and environmental factors
• Novel sun protection technologies
• Targeted therapies for treating and preventing skin cancer

Will these advancements eliminate the need for vigilance in skin care? While future technologies may improve our ability to detect and prevent skin cancer, they’re unlikely to replace the need for sun protection and regular skin examinations. These fundamental practices will likely remain crucial components of skin cancer prevention.

The Importance of Ongoing Research

Continued research into mole biology and skin cancer is vital for improving our understanding of these conditions and developing more effective prevention and treatment strategies. Participation in clinical trials and research studies can contribute to these advancements and potentially benefit future generations.

If you’re interested in contributing to skin cancer research, speak with your dermatologist about potential opportunities to participate in studies or clinical trials. Your involvement could play a role in shaping the future of skin cancer prevention and treatment.

What to Look For and When to Worry

Keywords

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.