Home > Skin Mole

Table of Contents

• What are Moles?
• Types of Moles
• Malignant Melanoma
• When to See a Doctor
• Moles and Pregnancy
• Classification
• Treatment
• Brochures

" Nevi, melanocytic nevi (NMN) or skin moles appear as small brown, black or tan spots on the skin. They are quite common and may be genetically influenced. Moles, also referred to as benign acquired tumors, can appear anywhere on the skin, including the scalp, between the toes and fingers, on the palms and soles and under the nails.

Moles may appear at any age, but most of them develop by the age of 20 to 30 years. They are sometimes mistaken for freckles or other skin growths.

Moles are characterized by color (tan, black, pink, skin-tone, no color, blue) and shape ( round, slightly raised, flat on the skin) and  if they change in appearance over time.

Moles in children are normal and may just appear. The moles grow as the child gets older. Skin cancer is rare in children. A

Approximately 1 in 100 individuals are born with a congenital (at birth) mole. People born with moles are considered at higher risk for melanoma (skin cancer). Skin moles are not contagious and may regrow after removal. Excessive sun exposure and pregnancy can result in the development of additional moles later in life. 

Any change in color, shape or mole size should be evaluated by a Dermatologist." 

What are Moles?

Skin Moles occur when skin pigment cells called melanocytes grow in clusters. These cells give the skin its natural color, but when they group together, they form dark spots, which we call moles. These spots may become darker after constant exposure to the sun, during adolescence, and during pregnancy.

If the melanocytes proliferate deeper into the skin it causes the mole to rise above the skin's surface creating what is called a compound naevus. If they lose their pigmentation they turn into intradermal or cellular naevi.

Inherited genes and exposure to the sun especially before adulthood are major factors that determine the development of moles. They are more common in people who are prone to develop freckles and in individuals with light skin complexions, blonde or red-haired, and with blue or green eyes. However, moles occur in people of different skin colors and races, including Caucasians, Asians, Africans, and Indians.

Tip: It is a good idea to make a personal body mole map to track moles. A camera can also be used to record any moles that need to be watched. Every month check the mole skin map against what is happening on your body.

Types of Moles

Some moles appear at birth and these are called congenital nevi. These common moles may be more likely to develop into cancer (melanoma) than those that appear after birth. Regular moles have symmetrical shapes, regular borders, uniform in color, and are small (no bigger than the size of a pencil eraser). They may be flat or raised, and may have hair on them.

Dysplastic Nevi

Irregular or atypical moles are called dysplastic nevi and are usually asymmetrical (oddly shaped), having irregular borders, with multiple colors. They tend to be bigger than the size of a regular pencil eraser, often flat or nearly flat. People who have more than 20-25 atypical moles have a greater likelihood of developing skin cancer or melanoma. However, the irregular moles themselves are not likely to become cancerous.

Halo Nevi

Halo nevi have a pigmented macule with surrounding depigmentation. Inside they have what is called a lymphocytic infiltrate.

Blue Nevus

Blue nevi are smaller, less raised and less aggressive. They tend to be located on the feet and hands They are often mistaken for melanomas because of their elevated surface and irregular shape and blue/black or blue/gray color.  It is formed deep into the dermis. The color comes from the significant amount of melanin in the cells when compared to surrounding skin.

Blue nevi usually appear when young.

Vascular Naevi

Vascular naevi are often present in newborns .They come from the superficial capillary networks.

There are several types of vascular naevi:

Port-wine stain

A port-wine stain is a type of vascyular Naevi that is also called a capillary haemangioma.  it is red-purple in color, flat, irregular and large. This type of mole commonly affects the face.

If it does not improve over time it can change into a thicker, darker and more nodular mole.

Salmon Patch

50% of newborns have a salmon patch. It takes the form of pink patches on the eyelids. These type of moles clear quickly with the exception of any that are on the back of the neck.

Strawberry Naevus

Strawberry naevus are also known as capillary cavernous haemangioma. They are found in 1% of newborns. They appear after birth as a red nodule and reach full size at 1 year of age. The naevi usually resolve by age 7 and can appear on any skin area.

Epidermal Naevi

These types of naevi are warty looking and have some color. They appear when a child is born or when very young. When found on the scalp they are removed since they could become cancerous (called naevus sebaceous).

Malignant Melanoma

A melanoma refers to a cancerous tumor of the melanocytes. It is common in older people, but can be seen in younger people, particularly in sun exposed skin areas. In men it is more commonly found on the back and on the legs in women.

Melanomas tend to start where there is a pre-existing mole. It is more common in people with multiple moles, or that have a family history, or if you burn easily.

Any mole changes should be checked by a doctor for skin cancer evaluation.

The characteristic ABCDEs of melanoma include:

• A: Asymmetrical shape 
• B: Borders of the mole are irregular, ragged, or blurred.
• C: Color of the mole is not uniform, having shades of brown, tan, black, white, blue, or red
• D: Diameter is larger than that of a pencil’s eraser
• E: Evolving or changing in shape, size,or color

Source: AAD

Basal Cell Carcinoma

A basal cell carcinoma is a skin malignancy (cancer). It is formed in the epidermis and is commonly seen in in middle to later in life.

It is triggered by exposure to the sun (temple, eyelids, nose, face) and also chronic scarring. There may be some genetic predisposition. Incidence is greater in men and faired skin people.

In basal cell carcinoma the tumor starts from the epidermis and invades lower into the dermis. The tumor grows slowly, are in one area and are often not diagnosed for 2 years after they begin to form.

Treatment involves removal via excision or cryosurgery.

When to See a Doctor

You should see a Dermatologist when a mole has:

• Grown
• Has crusted over and bleeds without healing
• Changed
• Looks unusual
• Black or brown to black colored streak underneath a nail
• Pigmented mass in your mouth
• Dark spot on the eye

How to examine your skin for signs of skin cancer.

Moles and Pregnancy

Skin changes that commonly occur during pregnancy are increased pigmentation, greater prominence of existig melanocytic naeve and the development of abdominal stiae and spider naevi.

Classification

Moles are classified based on their evolution.

Moles are also classified based on when they occur:

• Congenital nevi: present during 1st 6 months after birth
• Acquired nevi: occur later in life and are more likely to become malignant

Classification is also based on size:

• Small nevi: under 1.5cm in diameter
• Medium nevi: 1.5 to 19.9cm in diameter
• Giant nevi: greater than 20 cm in diameter

Diagnosis

Skin Mole are mostly not dangerous. When moles grow they can itch. Persistent itch can be an early indicator of a malignant change.

Only moles that look different from existing moles, those that appear after age 30, and those that change in color, size, and shape must checked especially if they ooze, bleed, or become painful. A dermatologist may request for a biopsy of the suspicious mole to determine if it is cancerous.

Moles are characterized using the ABCDE rule above. 

Moles do not become cancerous because of an injury.

A Dermatologist will differentiate a mole diagnosis from conditions such as:

• Solar lentigo
• Flat atypical neus
• Lentigo maligna
• Seborrheic keratosis

Treatment and Mole Removal

True regular moles do not need treatment, but one may opt to have them surgically removed for cosmetic reasons. They are not treated with lightening creams, bleaching, freezing, or using other chemicals. Note that insurance will not pay for cosmetic mole removal.

Moles will be removed from the genitals or scalp if they are difficult to track.

Types of Mole Removal

Moles removal is performed in a doctor’s office by:

• Punch biopsy: area to be biopsied in anesthetized. Typically a 4mm punch is used to punch out the mole. Stitches are used to close the wound.

• Shave mole removal: use of a surgical blade to shave the mole off. Do not attempt at home since this could result in infection, a scar or failure to test a mole that might be cancerous
  
• Surgical excision: Dermatologist cuts out the mole and stitches the wound closed 
• Laser treatment 
• Cryotherapy mole removal: hardening the mole via freezing

Irregular moles need to be sampled or surgically removed and evaluated for cancer. The dermatologist removes the entire mole with some normal skin around it, and closes the wound with stitches.

Brochures

References