Moles

Moles are small, pigmented spots on the skin that usually appear during childhood or adolescence, although they are sometimes present at birth.

Moles are composed of clusters of pigmented cells called melanocytes.
Normal moles are:

  • Evenly pigmented.
  • The color is the same across the mole.
  • Sharply demarcated.
  • The edges of the mole are clear-cut.
  • Symmetrical in shape and color.

Symptoms

  • Moles can vary in color.
  • They can be flesh-colored, yellow-brown or black.
  • They can be flat, raised, smooth, hairy or warty.

Warning symptoms

Although moles usually are harmless, in some cases they can become cancerous, causing a potentially deadly tumor called malignant melanoma.

For this reason, it is important to monitor moles and have them examined by a dermatologist if they:

  • Get larger suddenly
  • Develop an irregular border
  • Become darker or inflamed
  • Show spotty color changes
  • Begin to bleed, crack or itch
  • Become painful

Early detection and prevention

  • Examining the skin for change helps to detect skin cancer early when it is most treatable.
  • It is a good idea to have an annual skin examination by a dermatologist, especially for adults who have risk factors for skin cancer, such as a family history of skin cancer, or for those with a lot of sun exposure.
  • The most preventable risk factor for all skin cancers, including melanoma is sun exposure.
  • Reducing sun exposure is an easy way to reduce your risk for skin cancer.

Here's How to Be Sun Smart:

  • Generously apply a broad-spectrum water-resistant sunscreen with a Sun Protection Factor (SPF) of 30 or more to all exposed skin. Broad-spectrum provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Reapply approximately every two hours, even on cloudy days, and after swimming or sweating.
  • Wear protective clothing: such as a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses.
  • Seek shade: The sun's rays are strongest between 10 a.m. and 4 p.m. If your shadow is shorter than you are, seek shade.
  • Protect children from sun exposure by playing in the shade, using protective clothing, and applying sunscreen frequently.
  • Use extra caution near water, snow, and sand because they reflect the damaging rays of the sun, which increase your chances of sunburn.
  • Get vitamin D safely through a healthy diet that may include vitamin supplements.
  • Avoid tanning beds: Ultraviolet light from the sun and tanning beds can cause skin cancer and premature aging. If you want to look like you've been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
  • Check your birthday suit on your birthday: If you notice anything changing, growing, or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.

A Guide to skin cancer self-examination

Step 1

Step 1 Ensure the area where you will 5 be checking your skin is well lit. You will need a full length mirror, a hand-held mirror, a hair dryer, and either two chairs or two stools.

Step 2

Step 2 Remove all your clothing. To begin, raise your arms to waist 2 height with your palms facing 6 upwards. Examine your palms, fingers and forearms. Open your fingers and check the skin in between them. Turn your hands over and look at the backs of your hands, fingers, fingernails and forearms. Again, open your fingers and look at the skin in between them.

Step 3

Step 3 Now stand in front of the full length mirror. Raise your arms toward your chest. Your palms should be toward you. Look in the mirror to check the backs of your forearms and elbows.

Step 4

Step 4 Now lower your arms to your sides, with palms facing away 8 from the mirror. You should be able to see the whole front of your body. Check your face, neck and arms. Turn your palms toward the mirror and check your upper arms and shoulders. Examine your chest, stomach, pubic area, thighs and lower legs.

Step 5

Step 5 Now turn your body sideways 9 to the left. Raise your arms over your head. Your palms should be facing each other. Check the whole side of your body, starting at the top with your hands, moving to your arms, underarms, torso area, thighs and calves. Finally, turn to the right and check the other side of your body in the same way.

Step 6

Step 6 Next, stand with your back toward the full length mirror. Check your buttocks and the backs of your thighs and calves.

Step 7

Step 7 For this step, you will need the hand-held mirror. Holding up the mirror in front of you and standing again with your back to the full length mirror, look at the back of your neck, your back and buttocks. Check the backs of your arms also.

Step 8

Step 8 Staying in the same position, examine your scalp. It is recommended that you use a hair dryer (on a cold air setting) to part your hair to reveal the skin. You may find this step difficult and are encouraged to have your partner or a friend conduct your scalp examination with the aid of the hair dryer.

Step 9

Step 9 Sitting down on the chair and with your right leg resting on the other chair or stool, look at the inside of your leg from the top of your thigh right down to your ankle, using the hand-held mirror if necessary. Now do the same with your left leg.

Step 10

Step 10 Remaining seated, bring your right leg over the left leg, resting your foot on your left knee. Using the hand-held mirror, if necessary, look at the top of your foot, your toes, toenails and the skin in between your toes. Check the bottom of your foot also. Now do the same so you can examine your left foot.

Diagnosis

Your doctor can determine the type of mole you have by looking at it:

  • Common moles usually are no more than 1 to 10 millimeters (less than half an inch) in diameter. They are flesh-colored, yellow-brown or black and can be located anywhere on the body. They usually appear during childhood or adolescence.
  • Atypical moles (dysplastic nevi) are usually larger in diameter (5 milimeters to 12 millimeters). They are tan to dark brown with a pink background and may have a mixture of colors, including tan, brown, pink and black. The border is irregular and indistinct and often fades into the surrounding skin. Most commonly, atypical moles appear on sun-exposed skin, but they can occur elsewhere, and they continue to develop after age 35.

Expected Duration

Most moles never become a problem. However, moles should be inspected regularly for any abnormal changes.

Prevention

When melanocytes become cancerous, they are called melanomas. It is important to examine your moles regularly to look for any suspicious changes. Get someone else to inspect your scalp and other areas that are hard to see.

Watch for the early warning signs of melanoma by using the ABCDE criteria:

  • Asymmetry
  • Border irregularities
  • Color variation (different colors within the same mole)
  • Diameter greater than 6 millimeters (larger than a pencil eraser)
  • Enlargement

Treatments

  • Common moles do not need to be removed. However, some people choose to have them removed for cosmetic reasons.
  • If moles are raised and located in areas where clothing irritates them, such as the waistline; or if they are on the scalp and are irritated by hair brushing.
  • Most moles can be cut off in a simple in-office procedure.
  • Moles and dysplastic nevi whose appearance suggests they may be cancerous should be removed and examined under a microscope.
  • If they are found to be cancerous, additional skin in the surrounding area also must be removed.

When to Call a Professional

  • Do not ignore warning signs.
  • Have suspicious moles checked by a dermatologist. Melanoma is the deadliest form of skin cancer, but early diagnosis could save your life.
  • If a mole appears abnormal, your doctor will do a biopsy by taking some of the mole tissue so it can be examined in a laboratory.
  • Also, having a doctor check your moles once is not enough. Normal-looking moles can become cancerous later.
  • Moles must be examined from time to time, especially if you notice any changes.
  • If you have dysplastic nevi or if there is a history of melanoma in your family, you should have a physician check all of your moles regularly.
  • Your physician will recommend how often you should have them checked.

Prognosis

Although moles can become cancerous, most remain noncancerous (benign) throughout a person's lifetime and pose no health problem.

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