Moles, for many of us, are black/brown patches on our skin, which, most of the time, hardly even catches our attention. They differ in number, shape and size and appear on most people. On average, an adult has up to 30 moles which may be perfectly placed beauty spots as in the case of Cindy Crawford or Mariah Carey! Most are benign, though sometimes unsightly and bothersome but some can change into potentially deadly cancers.
The term mole or melanocytic nevus can occur anywhere on the skin, including the scalp, ears, eyes, lips, genital area, palms of the hands and even soles of the feet. They may be black, brown, reddish-brown, blue or even skin coloured and may be perfectly flat or raised. They may darken on exposure to sun or during pregnancy. The number of moles increases during puberty but may reduce in old age. Moles can differ in size, shape and appearance bumpy, smooth, flat, protruding or even hairy but they usually have clean edges and are symmetrical. Most moles appear in the first 3 decades of a person’s life.
Mole or naevus occurs when cells in the skin grow in a cluster instead of being spread throughout the skin. During the first trimester of pregnancy, the developing foetus makes melanocytes the special cells that make the pigment melanin to give the skin its natural colour. These clusters are generally spread evenly throughout the skin. Sometimes, random areas acquire a cluster which can grow into a mole. The colour of a mole depends on how deep the cluster of cells resides within the skin.
What are factors are responsible for the development of a mole?
Congenital nevi are moles that appear at birth or shortly after. Congenital nevi occur in about 1 in 100 people and are often referred to as birthmarks. They can be hairy and are classified based on their size. They can develop into melanomas and the risk of melanoma transformation increases with increasing size of the mole. Therefore, they should be kept under close supervision. It should be noted, however, that congenital naevi increase in size proportionally as the child grows.
Exposure to sun: Sunlight can act as a catalyst for the development of or changes in a mole. Any exposure to the sun during childhood can potentially increase the risk of developing melanoma later in life. Although it is more common for sun-exposed skin to have more moles, it is not uncommon for moles to occur in covered sites such as the soles and genital region.
Genetics: Moles can run in families and these can be darker and larger in size than average moles. Sometimes described as atypical moles, these moles require regular checks and sometimes removal.
Hormonal changes: Moles can change during pregnancy. New moles can appear. Existing moles can change colour and size.
When and how frequently should I get a mole-checked?
It is important to get a new or existing mole checked out, especially if it:
- is a new mole
- changes shape, size or colour
- starts itching, crusting, ulcerating or bleeding
One must get the moles checked regularly to notice changes if any, focusing on the ABCDE principles, to avoid any risk of melanoma
An asymmetry (if you draw a line in the middle, the lesion is not evenly halved)
B border (the border is not even)
C colour (the lesion is multicoloured-shades of brown, black, blue, white)
D diameter (the lesion measures more than 6mm)
E evolving (the mole is visibly changing)
Having moles examined is essential for your health. As a minimum, this should occur once per year.
How to care for your moles –
Most cancer changes are due to excessive exposure to sunlight and following the steps below can help.
- Avoid sunbeds regular use increases the risk of skin cancer
- Sun protection measures should be taken when the UV index (5 categories solar UV forecast) reaches 3 or more (the higher the value, the faster you burn when out in the sun)
- Protective clothing (close weave, high UPF rated fabric covering as much of the skin as possible)
- SPF 50+ with 5* UVA rating
- Apply 15-20 minutes before leaving the house and then again at least every 2 hours
- Please cover all areas of exposed skin, including the back of the neck, ears, top of the feet, face and the scalp.
- Use a lip balm with at least SPF30+.
- Get help from someone else for the hard-to-reach areas like your back and shoulders.
- Re-apply after swimming or episodes of excessive sweating.
- A wide brim hat or legionnaire hat is ideal (close weave or UPF rated fabric)
- Look for the European CE mark, indicating a safe level of protection
- High EPF provides the best protection
- Ensure that they are wider than the eyes to prevent UV rays from getting through the top and sides
- Avoid going out when the sun’s intensity is at its peak (usually between 11 and 3 pm).
Always use a combination of the above measures to ensure better protection.
The factors below indicate people at increased risk and, hence, require regular monitoring
- Red hair, blue eyes
- Multiple moles or freckles
- Family history of melanoma
- Previous sunburn (excessive, including sunbed use)
Unsure of the type of mole you have?
If you are concerned about any of your moles, get them screened by one of our expert Consultant Dermatologists at Pall Mall Medical. If you are considering mole removal based on a negative effect on your appearance, or you are concerned about the possible health risks, our dermatologists can evaluate and discuss the possible risks with you. Book a Consultation with our Dermatologists