How do moles normally develop and change over time. What are the key signs that indicate a mole may be problematic. When should you consult a doctor about changes in your moles. What are the ABCDEs of melanoma and how can they help you monitor your moles.

Understanding Mole Development and Types

Moles are common skin growths that can appear in various shapes, sizes, and colors. Their development is largely influenced by genetics, but environmental factors like sun exposure and tanning bed use can also play a role in their formation and appearance. Let’s explore the different types of moles and how they typically develop.

Congenital Moles

Congenital moles are present at birth and are categorized based on their size:

• Small: Less than 1.5 cm in diameter
• Medium: 1.5 to 20 cm in diameter
• Large: Greater than 20 cm in diameter

It’s important to note that large congenital moles have a significantly higher risk of developing into skin cancer compared to their smaller counterparts.

Acquired Moles

Most moles are acquired, meaning they develop after birth. These moles typically have the following characteristics:

• Smaller than a pencil eraser
• Even pigmentation
• Symmetrical border

Acquired moles generally have a low risk of developing into skin cancer.

Atypical Moles (Dysplastic Nevi)

Atypical moles, also known as dysplastic nevi, have distinct features that set them apart from regular moles:

• Asymmetrical shape
• Irregular borders
• Multiple colors
• Uneven pigmentation
• Focal darker areas

These moles can run in families, and individuals with multiple atypical moles have a higher risk of developing skin cancer.

Factors Influencing Mole Changes

While moles are generally stable, various factors can cause them to change over time. Understanding these factors can help you differentiate between normal changes and potentially concerning ones.

Hormonal Changes

Hormonal fluctuations during puberty and pregnancy can cause moles to change in appearance. These changes are often temporary and not typically a cause for concern.

Sun Exposure

Prolonged sun exposure can lead to the formation of new moles and darken existing ones. This is why it’s crucial to protect your skin from harmful UV rays, especially if you have a history of atypical moles or skin cancer.

Aging

As we age, it’s normal for moles to change slightly. They may become raised, lighter in color, or develop hairs. However, significant changes in size, shape, or color should be evaluated by a healthcare professional.

The ABCDEs of Melanoma: A Crucial Self-Examination Tool

The ABCDE rule is an essential guide for monitoring your moles and identifying potential signs of melanoma, a dangerous form of skin cancer. Let’s break down each component:

A – Asymmetry

Does one half of the mole match the other half? Asymmetry can be a red flag for melanoma.

B – Border

Are the edges of the mole irregular, ragged, or blurred? Benign moles typically have smooth, even borders.

C – Color

Does the mole have a variety of colors or shades? Healthy moles usually have a uniform color throughout.

D – Diameter

Is the mole larger than 6mm (about the size of a pencil eraser)? Larger moles have a higher risk of being cancerous.

E – Evolving

Has the mole changed in size, shape, or color over time? Any evolution in a mole’s appearance should be evaluated by a dermatologist.

When to Consult a Healthcare Professional

While not all mole changes are cause for alarm, certain signs warrant immediate medical attention. Here are some key indicators that you should consult a doctor:

• A mole that matches any of the ABCDE criteria
• A new mole appearing after age 30
• A mole that bleeds, itches, or becomes painful
• Rapid changes in a mole’s appearance
• A mole that looks significantly different from your other moles

If you have a family history of atypical moles or skin cancer, or if you have numerous moles, regular check-ups with a dermatologist are recommended.

The Importance of Regular Self-Examinations

Regular self-examinations are crucial for early detection of problematic moles. How often should you perform these checks? Experts recommend examining your skin every one to two months.

Tips for Effective Self-Examinations

• Use a full-length mirror and a hand mirror to check hard-to-see areas
• Examine your skin in good lighting
• Check all areas of your body, including between toes and fingers, and under nails
• Take photos of your moles to track changes over time
• Consider using a body map to record the location and appearance of your moles

Remember, early detection is key in successfully treating skin cancer. If you’re unsure about a mole, it’s always better to err on the side of caution and consult a healthcare professional.

Mole Removal: Process and Considerations

If a mole is deemed suspicious or if you wish to have it removed for cosmetic reasons, the process is typically straightforward and can be performed in a dermatologist’s office.

The Mole Removal Procedure

1. The area around the mole is numbed with a local anesthetic
2. The mole is either shaved off or cut out, depending on its characteristics
3. If necessary, a few stitches may be used to close the wound
4. The removed tissue is sent to a laboratory for analysis

It’s important to note that even if a mole is removed, you should continue to monitor the area for any changes or regrowth.

Prevention: Protecting Your Skin from Harmful UV Rays

While some moles are determined by genetics, you can take steps to prevent the formation of new moles and protect existing ones from harmful changes. Here are some essential sun protection measures:

• Apply broad-spectrum sunscreen with at least SPF 30 daily
• Wear protective clothing, including wide-brimmed hats and sunglasses
• Seek shade, especially during peak sun hours (10 am to 4 pm)
• Avoid tanning beds and sunlamps
• Reapply sunscreen every two hours, or more frequently if swimming or sweating

By incorporating these habits into your daily routine, you can significantly reduce your risk of developing problematic moles and skin cancer.

The Role of Technology in Mole Monitoring

Advancements in technology have introduced new tools for monitoring moles and detecting potential skin cancers. While these should not replace professional medical advice, they can be useful supplements to your skin care routine.

Smartphone Apps

Several smartphone apps allow you to take photos of your moles and track changes over time. Some even use artificial intelligence to assess the risk level of a mole based on its appearance.

Dermatoscopes

These handheld devices magnify and illuminate the skin, allowing for a more detailed examination of moles. While primarily used by professionals, some models are available for home use.

Total Body Photography

This technique involves taking high-resolution photos of your entire body to create a baseline for future comparisons. It’s particularly useful for individuals with numerous moles.

While these technologies can be helpful, they should not replace regular self-examinations and professional check-ups. Always consult a healthcare provider if you have concerns about a mole.

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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The Truth About Mole Changes & Skin Cancer | Henry Ford Health

Warmer weather and longer days are on their way in Michigan, and with the changing season comes more time spent outdoors in summer attire and more sun – which is accompanied by ultraviolet (UV) rays. Whether you have one mole or 100, it’s crucial you are aware of the proper shape and color these marks should have – and what to do if you notice changes.

Regardless of the number and appearance of your moles, they are common. And they do change over the course of their lifetime. But how do you know if these changes are healthy and normal or indicate something worse – like skin cancer?

Laurie Kohen M.D., a dermatologist at Henry Ford Health, works with high-risk patients who have numerous irregular moles, and is an expert in assessing if a mole is suspect.

What exactly is a mole?

A melanocyte (mole) is a specific type of pigment-producing cell that resides in the skin. These melanocytes are found periodically in “normal” skin, but can grow in nests to form moles.

Wherever there is skin, a mole can form – meaning they can develop in even inconspicuous places, like under your nails and on the scalp.

Is it normal for moles to change over time?

Short answer: Yes.

“There are normal changes that can occur in moles,” Kohen says. “For example, moles on the face can start out as brown patches, and over time as we grow older, these moles can raise up, lose color and simply become flesh-colored bumps.”

Moles can lighten or darken in color, and raise or flatten. Sometimes, moles can even disappear altogether.

Environmental factors we’re exposed to on a daily basis, like UV light from the sun or indoor tanning and radiation — and even certain medications — can make moles more likely to develop changes or irregularities.

What changes should you look out for?

There are a few indications that a change in your moles could be concerning, Dr. Kohen says.

First, if a mole has multiple colors in it, it could be cause for concern.

“If you have a mole that started out as brown in color and suddenly has black or red (or both) in it, you should get it checked out by your dermatologist,” she says.

If you notice moles that are spontaneously bleeding, this could be another sign that something isn’t right. But before you jump to conclusions – this bleeding could simply be caused by accidental scratching or a mole getting caught on clothing, too. However, it’s best to get a professional evaluation.

In addition, if you notice your moles are continuing to grow into adulthood, you should see a specialist.

“Moles in children and teens continue to grow in proportion to the person, but at some point that growth should stop,” Kohen says. “If you notice a mole that looks like it’s getting bigger, especially as an adult in your 40’s and 50’s, you should have it checked out.”

Furthermore, developing new moles after age 50 is rare. If you notice new moles appearing on the skin, talk with your dermatologist.

What are the best ways to protect my skin and moles?

You’ve heard it before: The number one protector is sunscreen. Wearing SPF 30 or higher, and re-applying every 2-3 hours is crucial for protecting against skin cancer. But did you know that UV rays can reach our skin even if we are wearing long sleeves and pants?

Choosing photo protective clothing with Ultraviolet Protection Factor (UPF) 50 or higher will protect your non-exposed skin from these harmful rays.

“It’s important to remember that melanoma – the most dangerous form of skin cancer – runs in families, so it’s extremely necessary to protect yourself especially if you have a family history of skin cancer,” Kohen says. “Wear enough sunscreen, reapply when necessary and keep tabs on your moles. If you notice changes, check in with your doctor or dermatologist.”

Have concerns about the appearance of your moles? Overdue for a skin cancer screening? Schedule an appointment with a dermatologist by calling 1-800-HENRYFORD (436-7936) or visiting henryford. com.

Dr. Laurie Kohen is a dermatologist who sees patients at Henry Ford Medical Center – New Center One and Henry Ford Medical Center – Troy.

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.