Moles

What is a skin mole, and what does it look like?

The skin, the body’s largest organ, can develop moles. Moles, medically known as ‘nevi’ (singular ‘nevus’), are skin growths that vary in colour, ranging from the natural skin tone to black or brown. Moles can form on any part of the skin or mucous membranes and may appear alone or in clusters.

Most moles emerge during early childhood or within the first two decades of a person’s life. Generally, it is common to develop between 10 and 40 moles by adulthood.

On average, the life cycle of moles is around 50 years. Over time, they tend to change gradually, becoming lighter in colour and elevated. Hair may also grow on the mole. Although some will remain unchanged, others may slowly fade with time.

Types of skin moles

• Common nevi: These standard moles are small skin growths that can be tan, brown, or pink with defined edges.
• Congenital nevi: Present from birth, congenital moles affect 1 in 100 people. These are at a higher risk of developing into melanoma compared to moles that emerge later in life. A mole exceeding 8 millimetres in diameter is more likely to become cancerous.
• Dysplastic nevi: Irregular in shape and larger than a pencil eraser, dysplastic nevi are uneven in colour, with dark brown centres and lighter, jagged edges. Often inherited, individuals predisposed to dysplastic nevi may develop over 100 moles. Those with dysplastic nevi have an increased risk of melanoma. Therefore, any noticeable changes in a mole should prompt an immediate consultation with a dermatologist for a skin cancer evaluation.

How common are moles?

Moles are very common, with most individuals having between 10 and 40.

Where do moles mostly appear?

Most moles form on areas of the body exposed to sunlight (ultraviolet radiation). Prolonged exposure to the sun increases the likelihood of developing more moles.

Are moles infectious?

No, skin moles are not infectious.

Do moles cause pain?

If a mole becomes painful or tender, it’s essential to consult a dermatologist.

Are moles itchy?

If your moles become itchy, contact a dermatologist immediately.

Do moles normally bleed?

If your mole starts bleeding, visit a dermatologist.

Are moles and pigmented lesions the same?

The term “pigmented lesion” refers to any type of lesion, including age spots, sun freckles, and regular moles. While most pigmented lesions are benign, regular check-ups with a dermatologist are advisable if you have numerous or unusual lesions. This enables your dermatologist to monitor for any changes that might indicate a concern. If necessary, a skin biopsy may be performed to determine if a lesion is benign, melanoma, or another form of skin cancer.

What does it mean if I develop a new mole after the age of 30?

If you notice a new mole after the age of 30, you should be cautious. While it’s probably harmless, it’s wise to consult a doctor.

Symptoms

While moles are usually small brown spots, they can vary in colour, size, and shape:

• Colour and texture: Moles can range from brown, black, tan, blue, red, or pink. They may be smooth or wrinkled, flat or elevated, and some may even grow hair.
• Shape: Most moles are either oval or round.
• Size: Moles are generally smaller than 1/4 inch (around six millimetres) in diameter, roughly the size of a pencil eraser. However, congenital nevi, present at birth, can be larger and may cover areas of the face, limbs, or trunk.

Moles can form anywhere on the body, including under the nails, on the scalp, between fingers and toes, and in the armpits. Most people develop between 10 and 45 moles by the age of 40. Over time, moles may change or disappear, and they may become larger and darker during puberty or pregnancy due to hormonal changes.

Groups of brown spots around the cheeks, eyes, and nose, known as dermatoses papulosa nigra, are a form of seborrhoeic keratosis. These are non-cancerous, waxy growths that appear in black, brown, or tan and primarily affect Black women. Though they pose no risk of becoming melanoma, they can be removed for cosmetic reasons.

Unusual moles that could indicate melanoma

Moles that have irregular edges, are asymmetrical in shape, or change in size, colour, or shape may indicate skin cancer. The ABCDE guide helps identify warning signs:

• A - Asymmetry: One half of the mole looks different from the other.
• B - Border: Look out for uneven, jagged, or scalloped edges.
• C - Colour: Moles with multiple or uneven colours, or those that change colour, should be monitored.
• D - Diameter: Be cautious of moles larger than a quarter inch (6 mm).
• E - Evolving: Pay attention to moles that change in shape, size, colour, or height. New symptoms like itching or bleeding should also be monitored.

Cancerous or malignant moles can vary significantly in appearance. Some may exhibit all the signs above, while others may only show one or two abnormal traits.

Causes

Moles occur when skin cells known as melanocytes form in clusters. Typically, melanocytes are evenly spread throughout the skin, producing melanin, the natural pigment responsible for skin colour.

Diagnosis and Tests

Why should I check my skin for moles?

The skin is the body’s largest and most visible organ, making it crucial to take preventive measures to avoid skin cancer. This is particularly important if you have:

• Fair skin.
• Numerous moles on your body.
• A family history of skin cancer or unusual moles.

Limiting sun exposure and applying sunscreen regularly can reduce the risk of melanoma or other forms of skin cancer. Dermatologists recommend examining your skin every month.

Although most moles are benign, any changes in appearance or colour should be assessed by a dermatologist. Additionally, you should have moles checked if they become itchy, bleed, ooze, develop scales, or become painful.

What to look for when examining a skin mole

While most moles are non-cancerous, those that look different from others (known as the “ugly duckling sign”) or appear after the age of 30 may warrant medical concern. If you notice changes in the colour, size, shape, or thickness of your moles, visit a dermatologist immediately. Moles that become itchy, ooze, bleed, develop scales, or become painful or tender should also be examined.

Use a mirror to check your skin or ask someone to help, particularly for areas that are hard to see. Pay special attention to skin frequently exposed to sunlight, such as the face, legs (especially in women), arms, back (especially in men), hands, and chest.

The ABCDEs are significant indicators of potentially malignant moles. If your skin mole exhibits any of the following signs, have it examined by a dermatologist as soon as possible:

• A - Asymmetry: One half of the mole looks different from the other half.
• B - Border: The edges are irregular, ragged, or blurred.
• C - Colour: The mole may have uneven colours or multiple shades like brown, tan, blue, black, red, or white.
• D - Diameter: The mole is larger than a pencil eraser.
• E - Elevation/Evolution: The mole changes or becomes raised over time.

In men, melanoma typically develops on the back, whereas in women it often occurs on the lower legs. Melanoma is also a common cancer affecting women aged 25 to 29.

How do dermatologists assess moles?

Benign moles usually don’t require removal, as this can leave a scar. However, if a dermatologist is concerned about a mole, they will perform a skin biopsy, taking a small sample of the mole for microscopic examination. Diagnosis is typically made within a week. If the mole is found to be cancerous, complete removal will be necessary.

If you notice any concerning changes or are worried about a mole, see a dermatologist for an evaluation.

Management and Treatment

Who treats or manages moles?

Your GP may refer you to a dermatologist for further evaluation if needed.

Is mole removal necessary?

In most cases, normal moles don’t need to be removed. Removal may leave a scar, so it’s often better to leave benign moles alone.

How is a mole removed?

You should never attempt to remove a mole yourself using over-the-counter solutions or treatments such as freezing, burning, or laser removal. Aside from the risk of infection, you could accidentally remove a skin cancer (like melanoma), which could spread if not detected early. Identifying unusual moles early is crucial in preventing melanoma.

What are the best at-home remedies for moles?

Doctors advise against using home remedies for mole removal. If you have concerns, contact a dermatologist.

Prevention

Are moles preventable?

Moles are naturally occurring skin growths, and thus cannot be prevented. However, you can take steps to reduce the risk of skin cancer or detect it early:

• Limit exposure to sunlight.
• Use sunscreen daily.
• Check your moles monthly for any irregularities.

Taking these precautions is particularly important if you have many moles, fair skin, or a family history of unusual moles or skin cancer.

Regular self-examinations and limiting sun exposure improve the chances of detecting melanoma or other skin cancers early. Dermatologists recommend checking your skin each month. Most moles are harmless, but any changes in appearance, size, or colour should be reviewed by a professional. Moles that are itchy, bleeding, oozing, scaly, painful, or tender should also be examined.

How should I check for moles?

• Examine your skin at least once a month, preferably after a shower or bath when the skin is damp.
• Use a full-length mirror and a hand mirror for closer inspection. Ask someone for help with areas you can’t see, like your back.
• Follow a routine, examining your skin in the same way each time, starting from your head and working downwards. Check all areas, including hidden spots like between the toes and fingers, soles of the feet, and the backs of the knees.
• Remember to thoroughly check your neck and scalp for moles.
• Keep a record of your moles by taking photographs, using a ruler for scale, and noting the date. This will help track any changes. Consult a dermatologist if a mole changes in size, shape, colour, or border, or if you have a sore that won’t heal. Any new moles after the age of 30 should also be checked.

Since many growths that appear after the age of 30 are not moles but benign, age-related swellings, it’s important to contact your dermatologist if a new mole raises suspicion. They will perform a thorough examination and may take a biopsy if necessary.

Moles can appear on any surface of the skin, including mucosal areas such as the eyes, mouth, and genitals. In addition to regular dermatologist visits, you should also have yearly check-ups with an ophthalmologist, gynaecologist, and dentist to monitor moles in these areas if you have a history of melanoma or a family history of the disease.

Outlook / Prognosis

What complications are associated with moles?

The most serious complication is that some moles may develop into melanoma.

How long do moles last?

Moles may have a lifespan of up to 50 years.

Can moles disappear on their own?

Yes, some moles may disappear on their own over time, with 50 years being the maximum lifespan for most.

Living with Moles

How can I care for my moles?

Apart from checking them once a month, there’s no need to treat moles differently from other areas of skin.

A Note from MD.co.uk

Generally, moles are common and harmless. However, it is important to remain vigilant by regularly checking your skin for any irregularities. Ask someone close to help with areas you cannot see easily. If a mole displays any of the following signs, have it examined immediately:

• Asymmetry: One half of the mole is different from the other.
• Border: The edges are jagged, blurred, or uneven.
• Colour: The mole contains multiple shades or has an uneven colour.
• Diameter: The mole is larger than a pencil eraser.
• Elevation/Evolution: The mole changes over time, becoming raised or altered in shape, size, or colour.

If you have any concerns, don’t hesitate to speak to your doctor.