A mole is a harmless collection of pigment cells (called melanocytes) in the skin. These pigment cells are found throughout the skin, but are are crowded together in moles. The medical term for a mole is a benign melanocytic naevus (pronounced ‘nee-vus’). Some moles are completely flat and dark (called a junctional naevus) some are slightly raised and brown (called a compound naevus) and some are fleshy and the same colour as the rest of the skin (called an intradermal naevus).
At what age do moles develop?
Most moles are not present at birth, but develop from about the 2nd year of life onwards until middle age. About one in a hundred babies is born with a pigmented mole birthmark (called a congenital melanocytic naevus). Adults can develop new moles in their 30s and 40s but if they notice a new mole should keep a very close eye on it to check it doesn’t develop any warning signs of skin cancer.
I’ve noticed a mole that is changing. What should I do?
Remember that moles normally change slowly as people get older, generally becoming paler and more raised with time. Many women notice that their moles change during pregnancy. This is normal. However it is wise to be extremely cautious if you notice new mole or a mole that is changing, because rarely it may be a sign of malignant melanoma, a serious form of skin cancer. The golden rule is
‘If in doubt, get the mole checked out’
If you are concerned about a mole you should see your GP who can refer you to an NHS or private dermatologist.
How should I keep an eye on my moles?
In the same way that women and men are encouraged to perform self examination to detect breast and testicular cancers, it is very worthwhile keeping a regular eye on your skin and developing a mental picture of your moles, so you are able to tell if one has changed. Skin cancer is unique because unlike any other cancer, when it is at its early stage it is visible on the outside of the body, which gives a good opportunity for complete cure. Once skin cancer has spread internally, treatment is much more difficult. A good idea is to obtain a full length mirror and to examine yourself without clothes every 3-4 months. A partner may be able to help keep an eye on moles on your back.
What are the warning signs of malignant melanoma?
If you notice one or more of the following you should arrange to see a doctor:
A new or existing mole that is changing SIZE
A new or existing mole that is changing SHAPE
A new or existing mole that is changing COLOUR
Melanomas sometimes also ITCH or BLEED.
Only about half of melanomas come from a pre-existing mole. The rest occur in normal skin.
Remember that all these changes can occur in completely normal moles as well.
What treatments are available?
I have lots of moles. Does that mean I’m likely to get skin cancer?
If you have lots of completely benign moles you do not have a particularly increased risk of skin cancer. People who have many (more than 50) moles which are larger than a few millimetres and which have irregular shape or colour (called an atypical or dysplastic naevus) do have an increased risk of melanoma, particularly if someone in their family has had a melanoma. In this situation it is certainly worth making regular visits to a dermatologist. However you are still much more likely not to develop melanoma than to develop one.
Should I put factor 50 just on my moles?
Some people apply high factor sun block just to their moles before sunbathing, leaving the rest of their skin unprotected. There is no good evidence that this is helpful and dermatologists generally wouldn’t recommend it. If you are worried about your moles you should follow sensible sun protection precautions: Avoid the sun between 11am and 3pm, use a high factor sun block all over (SPF 40 or more), and cover up with clothes or under a parasol when the sun is at its strongest. Most important of all is to avoid sunburn, which definitely increases the risk of melanoma.
How are moles removed? What about laser removal?
If a dermatologist removes a mole to make sure that is it not a skin cancer, an elliptical excision or punch excision is usually performed. If a raised mole is being removed for cosmetic reasons or because it is catching a shave excision is usually done.
Patients sometimes ask whether it is possible to have moles removed by laser. Whilst it is possible to do this, most dermatologists wouldn’t recommend this approach. Removing a mole by laser doesn’t allow it to be sent off for analysis, and whilst it may reduce the dark colour of a mole, it doesn’t always get rid of the pigment cells which could still have the potential to develop into a skin cancer.