Moles & Nevus
Everyone has moles and they are considered normal to have. They tend to be more frequent in those with fair skin and can be found in numbers of 40 or more.
Most people think of a mole as a dark brown spot, but moles have a wide range of appearance. Although some people refer to moles as a “beauty mark,” not all moles are beautiful. They can be raised from the skin and very noticeable, they may contain dark hairs, or they may be dangerous.
The Normal Mole
Moles can appear anywhere on the skin, alone or in groups. They are usually brown in color and can be various sizes and shapes. The brown color is caused by melanocytes, special cells that produce the pigment melanin.
Most moles appear during the first 20 years of a person’s life, although some may not appear until later in life. Sun exposure increases the number of moles.
Each mole has its own growth pattern. At first, moles are flat and tan, pink, brown or black in color, like a freckle. Over time, they usually enlarge and some develop hairs. As the years pass, moles usually change slowly, becoming more raised and lighter in color. Some will not change at all. Most moles will slowly disappear, seeming to fade away. Others will become raised so far from the skin that they may develop a small “stalk” and eventually fall off or are rubbed off.
This is the typical life cycle of the common mole and can occur over 50 years.
Moles may darken, with exposure to the sun.
Different Types of Moles
Certain types of moles have a higher-than-average risk of becoming cancerous. Some may develop into a form of skin cancer known as malignant melanoma. Sunburns may increase the risk of melanoma. People with many more moles than average (greater than 100) are also more at risk for melanoma.
Moles are present at birth in about 1 in 100 people. They are called congenital nevi. These moles may be slightly more likely to develop a melanoma than moles which appear after birth. When a congenital nevus is more than eight inches across, it poses greater risk for developing melanoma.
Moles known as Clark’s nevi are larger than average (usually larger than a pencil eraser) and irregular in shape. They tend to have uneven color with dark brown centers and lighter, sometimes reddish, uneven borders or black dots at edge. These moles often run in families.
Persons with Clark’s nevi may have a slightly greater-than-average chance of developing malignant melanoma. These people should be seen regularly by a dermatologist to check for any changes that might indicate skin cancer. They should also learn to do regular self skin exams.
Recognizing the early warning signs of malignant melanoma is important. Remember the ABCD’s of melanoma when examining your moles.
A stands for ASYMMETRY, when one half of the mole doesn’t match the other half.
B stands for BORDER, when the border or edges of the mole are ragged, blurred or irregular.
C stands for COLOR and CHANGES, when the color of the mole is not the same throughout or if it has shades of tan, brown, black, red, white or blue.
D stands for DIAMETER, when the diameter of a mole is larger than 6mm, about the size of a pencil eraser.
Some dermatologists add the letter E for elevation that is, if a mole starts to become elevated, it should be examined.
If a mole displays any of these signs, it should be checked promptly by a dermatologist.
The majority of moles and other blemishes are benign (they are NOT cancer).
Occasionally, a mole may become a cancerous growth. Therefore, it’s best to get medical advice if you notice a mole that does not follow the normal pattern. A dermatologist may be able to assure you that the mole is harmless. To accomplish this, he or she may study a sample of it under a microscope for an accurate diagnosis.
The dermatologist will remove the mole, or part of it, so that thin sections from the mole can be cut and examined under a microscope. This is a simple and harmless procedure. If the growth was only partially removed and it is found to be cancerous, then the entire lesion and an extra margin of safety will need to be removed.
A person may wish to get rid of moles that are in areas of trauma, where clothing can irritate them, or simply because they are unattractive. The most common methods of removal include numbing the spot and then shaving the mole off, or for some moles, cutting out the entire lesion and stitching the area closed. However, for insurance companies to cover these procedures, the moles must be symptomatic.
Most procedures used to remove moles take only a short time and can be performed in a dermatologist’s office. Sometimes a mole will recur after it is removed. If a removed mole does begin to reappear, the patient should return to see the doctor.