Moles

It’s important for us all to keep a check on moles, wherever they appear on our faces and our bodies.  Most moles are harmless, but others could turn out to have serious consequences. In this month’s journal, we’re talking about moles and what to watch out for.

What are moles?

Moles, also called naevi, are collections of the pigment-producing cells within our skin (melanocytes). Moles can be flesh coloured of various shades of pink and brown and may occur anywhere on the body (including over the palms and soles). Moles are very common and most begin to appear on the skin during childhood and adolescence, although you can develop moles in adulthood. Moles may change very gradually over time and this is rarely cause for concern.

Understanding the different types of moles

Acquired mole

When a mole appears on the skin after a person is born, it is called an acquired mole or common mole. Having fifty or more of these moles is associated with a higher risk of developing melanoma, the most serious form of skin cancer.

Congenital mole

A mole that you are born with is called a congenital mole. Around one in every hundred people is born with a mole. Congenital moles can vary in size. Intermediate and large congenital moles also increase a person’s risk of developing melanoma.

Atypical moles

Atypical moles are often:

• Larger than an eraser on the end of a pencil
• Have an odd shape i.e, they are not circular
• Show more than one colour—mixes of browns, red and pink

Atypical moles may appear anywhere on your body. Although an atypical mole is not melanoma it can look like melanoma and research shows that you have a higher risk of getting melanoma if you have:

• Four or more atypical moles
• Already had a melanoma

What changes to your moles should you be looking for?

Regular self-examination is a good practice and should be part of your routine to protect yourself against melanoma.  Get to know your own skin and look for changes by monitoring your moles using the ‘ABCDE’ method:

A for Asymmetry:

Has the shape of a mole changed? Do the two halves differ in shape?

B for Border:

Have the edges become irregular or blurry? Do they look ‘ragged’?

C for Colour:

Are there multiple colours in your moles, or is the colour uneven? Have you noticed a change in colour?

D for Diameter:

Has your mole changed size? Has it become more raised? Anything above 6mm in diameter might be suspicious.

E for Evolution:

What is happening to the mole over time? Is your mole itching or bleeding? Rapid changes in any aspect of a mole are a sign that mole should be evaluated by a healthcare professional.

Mole mapping

Professional mole mapping is a good way to keep a track on changes to the moles on your skin.  Mole mapping begins with a consultation and thorough skin examination then digital total body photographs are taken. Magnified dermoscopic images may be taken of any skin lesions that require more detailed investigation. This comprehensive ‘mole map’ is then used alongside follow-up skin examinations to track potentially problematic changes in your moles and aid in future management.

Mole Removal

If a mole looks suspicious, if it is causing discomfort, for instance catching on a bra strap or waistband or for cosmetic reasons, it can be removed.  Your dermatologist will discuss the pros and cons of moles that are being for purely cosmetic reasons.

Moles can be removed by shave excision or complete excision. With a complete excision, your skin will be repaired with stitches which will be removed after 1-2 weeks.

Moles are sent for histology after removal. This analysis uses a high-powered microscope to detect any abnormal cells.

Protecting your skin from melanoma

Physical avoidance of the sun is the best way to help prevent skin cancer and changes to your moles.

Slip, slap, slop, shade, slide (slip on a shirt, slop on some sunscreen, slap on a hat, seek shade, slide on some sunglasses), is simple but great advice.

Make sure when you’re in the sun you are wearing a broad-spectrum sunscreen (SPF 30 or higher) and reapply it every two hours.

If you perspire, go in water, or rub your skin with a towel then reapply sunscreen regardless of the two-hour guidance. I especially like Coola, Bioderma and Elta MD sunscreens.

What should you do if you accidentally remove a raised mole?

Raised moles may be accidentally cut or removed.  If this happens let it heal and then go to a dermatologist to check it.

Remember if you have a mole or other spot that is persistently itching or bleeding, or changing rapidly see a dermatologist or GP for an evaluation.