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You will be surprised to know that every adult has around 10 to 40 moles that can appear anywhere on the body. Visible as brown or black growths on the skin, they first appear at  birth or during early childhood and usually continue to develop until the age of 50.  As you start to grow old, they slowly tend to disappear or fade away.

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Types

Although most moles are categorised as ordinary moles, there are other common types of moles that you might not be aware of. The medical terminology for moles is Nevus. Here are the most common types of moles:

Common nevi: These moles are normal. They are characterised by a distinct edge and may vary in colour from pink to brown.

Dysplastic nevi: They are also called atypical moles. These are quite large in size and irregular in shape. Usually, dysplastic nevi are those moles that occur because of hereditary factors. They are also quite uneven in colour. Any changes in moles need to be checked by a proper physician to rule out any health or skin problem.

Congenital nevi: This kind of mole occurs during birth and is more likely to turn into melanoma as you age. About one per cent of children are born with a congenital mole. They are classified according to their size, such as small – less than 1.5 cm; medium – 1.5 to 19.9 cm; and large – more than 20 cm (about 8 inches).

Spitz nevi: They are very closely related to melanoma. They are pink in colour, a bit raised and shaped like domes. They vary in colour from brown to red to black. They may bleed or ooze. They typically show up in the first two decades of life.

Acquired moles: These moles appear on the skin after birth. They are most commonly seen in light-skinned individuals. Melanoma (skin cancer) may occur if an individual has more than 50 of these moles.

 

Symptoms

A mole on your body shows the following traits:


  • They are usually single-coloured and mainly brown, but can also appear in other colours, namely red, pink, blue, tanned, skin toneor even colourless.

  • They are always circular.

  • They could be flat or even a little raised.

  • They usually don’t change in appearance for months or years.


 

However, there are a few things you should know about moles, such as:

  • They may not look alike all the time.

  • You may develop moles of different types (and not necessarily similar appearance) on the body.

  • Some moles also grow with hairon them.

  • They could change in appearance due to any disease or skin cancer.

Causes And Risk Factors

Causes

Moles are small clusters of skin cells known as melanocytes that grow in a group rather than all over the skin. They are mainly caused by overproduction of pigment (melanin) in the skin which imparts your skin colour. Typically, moles do not signify any health risk. However, there are a couple of unusual moles which end up being cancerous in nature.

Risk factors

Getting too much exposure to sunlight can increase your chances of getting moles.

Prevention

Though moles are harmless, the best way to prevent some types of moles is to limit your amount of exposure to the sun. Daily usage of sunscreen, with a 30 or more SPF, can help. Wearing clothes that cover most of your skin or shield you from the sun, like long sleeves and hats, can prove useful. More importantly, avoiding exposure to the sun from 10 am to 2 pm, when the sun is the strongest, can further prevent moles. Monthly examination of moles for any irregularities is important for detecting any changes that you may observe in the moles. If changes are detected, a visit to a dermatologist would be required. You should also visit a dermatologist if your moles itch, bleed, start oozing, have a scaly appearance, or become painful.

Keep in mind certain points during your monthly examination of moles:


  • You should perform this examination preferably after a bath.

  • Use a mirror for examining your moles.

  • Follow a simple head to foot examination to not miss out any spots on your body.

  • Pay special attention to skin folds, groin, and between fingers and toes.

  • Track the moles on your body. Taking a photo with a date and measuring them with the size will help. This way, you can understand if they are changing in size.

  • Any further changes in size, colour or shape will warrant a visit to the dermatologist.


 

The A to E changes in a mole which you should pay attention to are as follows:

  • Asymmetry: Any changes between the two halves of the mole.

  • Border: Irregular or blurred edges of the mole.

  • Colour: Any changes in colour within the same mole, such as shades of various colours like black, blue, brown, white, tan, or red.

  • Diameter: Changes in the diameter of the mole to more than a pencil’s eraser.

  • Elevation/ Evolution: Changes in the height of the mole or its appearance.

Diagnosis

If there is a change in the colour or shape of the mole, and of course the size of the mole, you should immediately consult a dermatologist. A dermatologist is a qualified skin specialist who will check your mole and scrutinize it before telling you whether the spot on the skin is a mole or not. They may use a derma scope, which is a magnifying lens, for closer inspection of the mole. The dermatologist may also perform mole mapping. This is a procedure where the dermatologist may take photographs or map the mole’s location on your body and then compare these pictures and locations over months and years. Also, if your doctor suspects any clinical condition such as skin cancer, they might recommend a biopsy (this is a test that microscopically examines a small part of the mole) and few tests to rule out or confirm cancer.

Treatment

There are two procedures involved in treating and removing moles permanently. These are:


  • Surgical Excision: In this case, your dermatologist will cut out the mole and then stitch the skin to close the openings. If the mole is caused due to cancer, further testing is carried out to determine its malignancy. If the examination is carried out with a microscope’s help, the process is known as a biopsy.

  • Surgical Shave: Your dermatologist will remove your mole with the help of a blade. However, this process requires precision, and follow-up may be needed if the mole grows back.


There are also a few things you should remember about moles and their removal procedure:

  • You should never think of shaving a mole as it can cause any infection to spread and can also lead to the appearance of a scar.

  • If your mole contains cancerous cells, a couple of them may stay behind and eventually spread to other parts of the skin.

  • If the mole comes back, you will have to make a quick visit to the hospital and get yourself tested for melanoma (skin cancer).

Lifestyle/management


  • The UV light from the sun is responsible for the development of mole into cancer. If there are many moles on your body, you have to be extremely careful about being in the sun.

  • Check regularly for any changes or irregularities like presence of pus, swelling or bleeding.

  • Make use of clothes that cover the skin thoroughly; wear sunglasses and a hat to protect your face from direct rays of the sun.

  • Try to stay in areas where there is shade, usually in the afternoons ( from 11 am to 3 pm)  when sunlight is potent.

  • Apply a high factor sunscreen whenever you are out in the sun( more than Sun Protection Factor 15 ).

  • Avoid using sun beds or sun lamps that use UV light or fake tanning.

Prognosis And Complications

Prognosis


  • The UV light from the sun is responsible for the development of mole into cancer. If there are many moles on your body, you have to be extremely careful about being in the sun.

  • Check regularly for any changes or irregularities like presence of pus, swelling or bleeding.

  • Make use of clothes that cover the skin thoroughly; wear sunglasses and a hat to protect your face from direct rays of the sun.

  • Try to stay in areas where there is shade, usually in the afternoons ( from 11 am to 3 pm)  when sunlight is potent.

  • Apply a high factor sunscreen whenever you are out in the sun( more than Sun Protection Factor 15 ).

  • Avoid using sun beds or sun lamps that use UV light or fake tanning.


Complications

Melanoma (skin cancer) is the most pertinent complication of a mole.

References


  1. Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/4410-moles. Accessed on: March 6, 2021.

  2. Moles: Who gets and Types. AAD. Available at: https://www.aad.org/public/diseases/a-z/moles-types. Accessed on: March 6, 2021.

  3. Congenital Melanocytic Nevi. NCBI. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740346/#:~:text=Clinically%2C%20congenital%20melanocytic%20nevi%20are,or%20more%20in%20greatest%20diameter. Accessed on: March 6, 2021.

  4. Moles: Signs and symptoms. AAD. Available at: https://www.aad.org/public/diseases/a-z/moles-symptoms. Accessed on: March 6, 2021.

  5. Strazulla LC, et al. JAMA Dermatol. 2016;152(12):1408

  6. Moles: Diagnosis and treatment. AAD. Available at: https://www.aad.org/public/diseases/a-z/moles-treatment. Accessed on: March 6, 2021.


 

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