Moles

Overview

Moles are a common type of skin growth that often appear as small, dark brown spots. They are caused by clusters of pigment-forming cells (melanocytes) and can vary in color, shape, and size. Most people have 10 to 40 moles that appear during childhood and adolescence, and they may change in appearance or fade over time. While most moles are harmless, occasionally they can develop into skin cancer, especially malignant melanoma. Being aware of changes in your moles and other pigmented patches is important for detecting skin cancer. If a mole looks unusual, grows, or changes, it is recommended to make an appointment with your doctor.

Understanding the disease

Symptoms

The symptoms of moles are typically small, dark brown spots on the skin. Moles can have various colors, shapes, and sizes. They often appear during childhood and adolescence and can change in appearance or fade over time. While most moles are harmless, it's essential to be aware of changes in your moles and other pigmented patches to detect skin cancer, particularly malignant melanoma. If a mole looks unusual, grows, or otherwise changes, it's best to consult with a doctor.

Risk Factors

The risk factors for developing moles include:

1. Genetics: Inheriting genes from parents or family members increases the likelihood of having more moles.
2. Exposure to sunlight: Prolonged exposure to sunlight, especially during childhood and adolescence, can lead to the development of more moles.
3. Fair skin: Individuals with fair skin are more prone to developing moles.
4. Age: Moles tend to appear during childhood and adolescence and may change in appearance or fade over time.
5. Hormonal changes: Hormonal fluctuations, especially during pregnancy or using hormonal birth control, can lead to the appearance of new moles or changes in existing moles.
6. Sun exposure during childhood: Excessive sun exposure during childhood can result in the formation of more moles. It's important to monitor the appearance of moles and other pigmented patches on the skin to detect any changes that may signal skin cancer, especially melanoma. If you notice any unusual changes, consult a healthcare professional for further evaluation.

Development

Moles develop when cells called melanocytes grow in clusters, producing melanin, the natural pigment that gives skin its color. They can vary in appearance, including different colors, shapes, sizes, and textures. Most moles appear during childhood and adolescence and may change in appearance or fade over time. New moles may form until about age 40. While most moles are harmless, it's important to monitor them for any changes in appearance, such as those listed under the ABCDE criteria (asymmetrical shape, irregular border, changes in color, and large diameter), as these characteristics can indicate melanoma or other skin cancers.

Assessment and Diagnosis

Triage

You should see a doctor if a mole looks unusual, grows, or otherwise changes, as these may be indications of potential skin cancer. Pay attention to the ABCDE guidelines: A for asymmetrical shape, B for irregular border, C for changes in color, and D for diameter larger than 1/4 inch (about 6 millimeters). If you notice any of these signs, consult your doctor for further evaluation and advice.

Diagnosis

Your doctor can diagnose moles by performing a skin exam, looking for any suspicious or abnormal moles that may require further evaluation. If your doctor suspects that a mole may be cancerous, they may recommend removing a sample of the mole for testing, known as a biopsy. The type of biopsy procedure used will depend on the situation, and your doctor may recommend either a punch biopsy or an excisional biopsy to determine whether the mole is melanoma. Regarding the diagnosis of cancer, your doctor may use several approaches, including a physical exam, laboratory tests, and imaging tests such as CT scans, MRI, PET scans, ultrasound, and X-rays. These methods help identify any abnormalities that may indicate the presence of cancer.

Management and Treatment

Complications

Potential complications of moles include the main risk of melanoma, a type of skin cancer. Moles that are large, irregular in shape, or have an increased number (more than 50) are considered risk factors for melanoma. Additionally, a personal or family history of melanoma can increase the risk of a mole becoming cancerous. It is essential to be aware of changes in your moles and other pigmented patches and to conduct regular self-examinations of your skin to detect any signs of skin cancer, especially malignant melanoma.

Preparing for medical consultation

To prepare for an appointment for moles, you should:

1. List any changes you've noticed or any new symptoms you're experiencing, even if they seem unrelated to the reason for the appointment.
2. Bring a list of all medications, vitamins, or supplements you're taking.
3. Note the location of any moles that have been removed in the past and bring the biopsy report, if you have one.
4. Avoid wearing makeup or opaque nail polish to your appointment, as these products can interfere with a thorough exam.
5. Prepare a list of questions to ask your doctor, including:
   • "Do you think this mole might be cancerous?"
   • "What's the most appropriate course of action?"
   • "How can I tell if a mole needs to be looked at?"
   • "Can I prevent more moles from developing?"
6. Consider discussing mole removal with your doctor if the mole bothers you or if you notice suspicious changes in it. Mole removal is usually done on an outpatient basis and may leave a permanent scar.
7. Be ready to share information about your family history of atypical nevi, melanoma, or other cancers, as well as any history of peeling sunburns or frequent exposure to ultraviolet radiation.
8. Don't hesitate to ask questions during your appointment and request any brochures or printed materials for further reference. Remember to be proactive in your skin health and discuss any concerns with your doctor to ensure the best care.