What are common moles?


Moles are very common small dark graying or brown lesions on the skin. Often the term nevus (single mole) or nevi (many moles) is used instead of moles. Moles appear brownish because of the presence of pigmented cells. Individuals with dark skin or complexion generally develop moles that are darker than people with fair skin. In the majority of cases, moles first appear during childhood. The number of moles an individual has does vary from 5-30. With advancing age, some of the moles may spontaneously disappear or fade. The majority of moles are benign and harmless. It is the rare mole that develops into a cancer. Nevertheless, all individuals who have moles should monitor them as this is one way of detecting the dreaded melanoma.

What are features of moles?

The majority of moles are dark brown or gray in color but moles can be of many shapes, size and colors. Some moles may be blue, red, tan or even pink. In addition, the texture of a mole can vary from wrinkled, rough or smooth. While most moles are flat, some may even be raised. In rare cases, moles may even have hair growth. The mole shape can vary from round to oval. The size of a mole is also variable. Most moles are less than 5 mm in diameter or the size of a tip of a pencil. However, some moles can be large especially those that occur in newborns. These moles may cover the entire limb, back or the face.

Where do moles develop on the body?

Moles can occur almost anywhere on the body. However, the most common sites are the face, underarm, under the nails, scalp, chest and between the web spaces of fingers and toes. Most people have 5-30 moles which develop before the third decade of life. While in most cases moles remain unchanged in size or color, some may disappear with advancing age or fade with time. During teenage growth and pregnancy, moles tend to be become larger and darker primarily because of the influence of hormones.

What is a melanoma?

Melanoma is a rare type of skin cancer that develops from the pigmented cells, called melanocytes. Melanoma is a dangerous cancer because unlike other skin cancers, it tends to invade the adjacent tissues and spreads to other parts of the body (eg brain, eyes, liver) very quickly. The earlier melanoma is identified, the better the prognosis. There are several types of melanoma and they usually occur on parts of the body exposed to the sun. Melanomas can also develop from moles in rare cases. In rare cases melanoma may develop in the eye, underneath the nail and in the intestine. In men, melanoma is most frequently observed on the neck, back and head area, whereas in women, it is often found on the legs or back. Melanomas tend to be most common in Caucasians and in people with fair skin. In African Americans, melanoma may occur under the nails or the sole of the foot.

What are signs that a mole is cancerous?

Everyone who has a mole should be educated on how to monitor a mole. When a stable mole develops the below features, one should be suspicious about development of a melanoma. The following ABCDE mnemonic is used to assess moles for cancer:

- A is asymmetry. If the mole suddenly changes it shape or size on one side.
- B is for border. Always inspect the border of the mole for irregularity, notched or uneven borders.
- C is for color. Observe the mole for any sudden color change or presence of uneven colors.
- D is for diameter. Most moles are small but if the mole suddenly starts to grow by more than 7 mm, one should become suspicious.
- E is for evolving. Observe moles for changes in shape, size, color and height. Most of all, look for presence of bleeding, pain or if the mole suddenly becomes very dark.

When should I see a healthcare provider?
One should see a healthcare provide if your mole starts to-
  • Become painful
  • Bleed
  • Itch or burn
  • Grow
  • Changes color
  • Develops when you are more than 25 years of age and have never had a mole before.
  • Has any of the ABCDE features mentioned above.

Who deals with moles?

Moles are usually treated by a skin doctor (dermatologist). However, stable moles may be followed by a general practitioner.

Why do moles occur?

Moles develop when the pigmented cells in the skin, the melanocytes, form into a group or a cluster. Because melanocytes produce the pigment melanin, most moles are dark in color.

What are complications of moles?

The chief complication of moles is development of a melanoma.

What are risk factors for moles turning into melanoma?

Some people with moles have a slightly higher risk of developing a melanoma from a mole. These factors include: - Having a large mole since birth. Moles acquired at birth are referred to as congenital nevi. In general, large moles have a slightly higher risk of becoming cancerous compared to smaller moles. - Having an unusually shaped mole. Also known as dysplastic moles these moles run in families and often have irregular borders that are light in color. Dysplastic nevi can occur on any part of the body but tend to be more common in areas of skin that is exposed to sun.  However, some dysplastic nevi can also occur in non-sun exposed areas like the back and blow the waist line. The majority of dysplastic nevi do not turn into a cancer but in individuals with more than 5 dysplastic nevi, the risk of melanoma is high. The more dysplastic nevi an individual has, the greater the risk for melanoma. - Individuals with more than 50 moles have a higher risk of melanoma than those who have less than 20 moles. - Individuals with a family history of melanoma.

How is diagnosis of melanoma made?

When there is a change in your mole, the healthcare provider cannot tell if it is a cancer or a melanoma by just looking at it. However, before proceeding to a biopsy the healthcare provider will do a thorough check of your skin. The biopsy is done in the office and is relatively painless; the tissue obtained is then looked underneath a microscope to look for cancer cells.

What is treatment for moles?

The majority of moles need no treatment except observation. Your healthcare provider will only perform a biopsy if he or she suspects that there may be a cancer. Moles may also be removed if they are in an area of your body where they are causing problems. For example a mole on the face may repeatedly bleed during shaving or a mole in the groin area may be prone to friction from clothes. Removal of a mole requires a small surgical procedure done in the doctor’s office. Over the years, many different techniques have been developed to remove moles and the type of technique depends on where the mole is located on the body, the size and doctor experience.

Are there any home remedies to conceal moles?
Some people may become self-conscious about their moles. In such cases, one may use makeup or concealers to hide the mole. There are many types of concealing creams on the market and one may have to try a few to decide which is the best agent.

Hair on moles may also reflect poor cosmesis. In such cases, the hair may be plucked with tweezers, removed with a depilatory agent or a laser. Anytime you irritate a mole, you have to observe it to ensure it does not change into something more sinister or becomes infected.

Can I prevent moles?

There is no way of preventing moles because most are acquired at or after birth. However, one must observe the mole to ensure that it does not turn into a melanoma. Become familiar with your mole and regularly examine it for changes. Take a picture so that you can compare it later on. Use a mirror to look at your back and closely examine the web spaces between your fingers and toes. If you have numerous moles (> 30), see a skin doctor once every 12-24 months to have a thorough check up.

How can I protect my skin/moles?

There are several things you can do to protect the moles and your skin.

  • Avoid prolonged exposure to the sun, especially from 11 am to 3 pm. If you go out, use a sunscreen with a high SPF. Apply the sunscreen at least 30 minutes before you venture outside.
  • When going out, wear long sleeved garments and a hat to cover your arms and face.
  • Avoid tanning salons as the UV rays emitted can significantly increase the risk of developing cancer.