What is a mole?
A mole is a growth on the skin that develops when pigment cells (melanocytes) grow in clusters. Moles are very common, and most people have between 10 and 40 moles. Moles can be brown, black, pink, red, skin-colored, or purple. They can be flat or raised. They are usually round or oval-shaped. Most moles are harmless, but some moles can develop into melanoma, which is a dangerous form of skin cancer.
What does a normal mole look like?
A normal mole is usually smaller than 6 millimeters wide (about the size of a pencil eraser). It has a distinct border that separates it from surrounding skin. The color should be uniform, with shades of brown or black. The surface should be smooth, with no scaling or oozing. Over time, a mole may darken or develop light patches, but its overall appearance should remain stable.
What are the ABCDEs of moles?
Dermatologists use the ABCDE rule to assess whether a mole may be becoming cancerous:
A – Asymmetry – One half of the mole does not match the other half.
B – Border – The edges are ragged, notched, or blurred.
C – Color – The mole has uneven colors or shades.
D – Diameter – The mole is larger than 6 millimeters.
E – Evolving – The mole is changing in size, shape, color, or texture.
What types of moles should I worry about?
Here are some specific characteristics that may indicate a concerning or atypical mole:
– A mole that is asymmetrical or has an irregular border (see ABCDEs above).
– A mole larger than 6 millimeters (1/4 inch).
– A mole with uneven coloration or multiple colors (blue, black, brown, white, red, etc).
– A mole that has changed over time in size, shape, or color.
– A mole that bleeds or itches spontaneously.
– A mole that has an unusual appearance compared to your other moles, such as a pink or red bump.
– A mole with any signs of inflammation, scaliness, oozing, or crusting.
What does melanoma look like?
The most dangerous form of skin cancer is melanoma. Warning signs of melanoma in an existing mole include:
– Asymmetry – two halves of the mole do not match.
– Irregular border – ragged, blurred, or notched edges.
– Color variation – multiple colors like black, brown, blue, white, red.
– Diameter greater than 6 mm (about the size of a pencil eraser).
– Evolution – any change in the mole’s appearance over time.
Melanoma can also arise in areas of normal looking skin. Signs to look for include:
– A new dark spot that does not look like a normal mole.
– A new spot with multiple colors – black, blue, brown, white, red, etc.
– A spot that changes over time in size, shape, or color.
– A spot that looks different from your other moles.
– Any new spot that is itchy, painful, scaly, swollen, or bleeding.
Who is at higher risk for melanoma?
You have an increased risk of developing melanoma if you:
– Have fair skin, light hair and eye color.
– Have many moles or unusual moles.
– Have a family history of melanoma.
– Had blistering sunburns as a child.
– Spend a lot of time in the sun.
– Use tanning beds.
– Have a weakened immune system due to illness or medication.
– Are older than 50.
When should I see a dermatologist about a mole?
You should make an appointment with a dermatologist if you notice any of the following:
– A new mole that does not look typical.
– A mole that is changing in size, shape, or color.
– A mole that looks different from your other moles.
– A mole that bleeds, itches, or is painful.
– A mole larger than 6mm (about the size of a pencil eraser).
– A mole that has an irregular border, more than one color, or asymmetry.
You should also see a dermatologist once a year for a full body skin exam if you are at higher risk for melanoma due to family history, unusual moles, or sun exposure history.
How are abnormal moles evaluated?
If a dermatologist finds a suspicious mole during an exam, they may use one or more of the following techniques:
Visual exam – With the naked eye under bright light, the doctor assesses the mole’s border, color, diameter, and texture. They look for signs of melanoma based on the ABCDE criteria.
Dermoscopy – A special microscope shines light on the mole to allow better visualization of structures below the skin surface, helping distinguish melanoma from benign moles.
Biopsy – The mole or part of it is surgically removed and sent to a lab for microscopic examination to confirm a diagnosis. A biopsy is the only definitive way to diagnose melanoma.
How are abnormal moles treated?
If a mole looks concerning, the dermatologist will likely perform a biopsy. If it is melanoma, treatment depends on the stage:
**Stage 0**
Only cancer cells in the epidermis – Excision of the mole alone is often curative.
**Stage I**
Cancer is 2mm or less in depth – Wider excision is done to remove cancer cells under the skin.
**Stage II**
Cancer is 2mm-4mm in depth – May involve lymph node removal to check for spread.
**Stage III**
Cancer has spread to nearby lymph nodes – Removal of affected nodes plus immunotherapy drugs.
**Stage IV**
Cancer has spread to distant organs – Immunotherapy, targeted therapy, chemotherapy, radiation.
Even if a mole is not cancerous, a dermatologist may recommend removing atypical moles to prevent progression to melanoma. They may also recommend more frequent skin exams for patients with abnormal moles.
How can I stay safe in the sun?
To protect your skin and prevent melanoma, be sure to:
– Apply broad spectrum sunscreen with SPF 30 or higher to exposed skin whenever out in the sun. Reapply every 2 hours and after swimming or sweating.
– Wear protective clothing like wide-brimmed hats, long sleeves, and sunglasses when possible.
– Seek shade during peak sun hours between 10am and 2pm.
– Avoid indoor tanning beds, which emit UV radiation that damages skin and increases melanoma risk.
– Examine your skin monthly and note any new or changing moles to show your dermatologist.
– See a dermatologist annually for a full body skin cancer screening exam.
How often should I get skin cancer screenings?
The American Academy of Dermatology recommends the following skin exam frequency:
– **General population:** Get a full body skin exam every year. Do monthly self-exams at home.
– **Higher risk:** Get a full body skin exam every 6-12 months if you have risk factors like fair skin, sun exposure, abnormal moles, etc.
– **Special high risk:** If you have multiple melanoma risk factors or a strong family history, your dermatologist may recommend exams every 3-6 months along with frequent self-exams.
Skin exams allow early detection and treatment of not just melanoma but also other common skin cancers like basal cell carcinoma and squamous cell carcinoma. Finding skin cancer in early stages greatly improves prognosis.
Can moles return after being removed?
After surgical mole removal, there is a small chance that the mole may grow back in the same area. Reasons for mole regrowth include:
– Incomplete removal – All mole tissue was not excised during the initial procedure.
– Underlying melanocytes – Cells left in the surrounding skin regrow the mole.
– Sun exposure – UV radiation can trigger melanocyte proliferation.
Moles that return after removal are rarely cancerous. But any regrowth should be re-examined and may need to be re-excised. Be sure to apply sunscreen and monitor the area for changes. Let your dermatologist know if a mole grows back after surgical removal.
Can I get melanoma under a fingernail or toenail?
Yes, melanoma can develop under and around nails. Subungual melanoma usually affects nails of the hands rather than feet. Signs to watch for include:
– Pigmented nail streaks – Tan, brown, black streaks in nail plate.
– Nail bleeding – Unexplained bleeding under or around a nail.
– Nail bruising – Brown or black patches under a nail.
– Nail detachment – Separation of the nail from the nail bed.
– Nail thickening.
– Nail splitting or crumbling.
– Nail breakage.
– New pigmented spot on nearby skin – Hutchinson’s sign.
Subungual melanoma is rare, accounting for around 1-2% of all melanomas. But it can be aggressive if not treated early. See a dermatologist promptly for any concerning nail changes to determine if a biopsy is needed.
Can children and teenagers get melanoma?
Melanoma is rare in children. But it does sometimes occur, so skin checks and sun protection are important for kids too. Risk factors for melanoma in children include:
– Fair complexion with light hair and eyes.
– Numerous moles and freckles.
– Family history of melanoma.
– Giant congenital moles present at birth.
– History of blistering sunburns in early childhood.
– Use of tanning beds as a teen.
– Certain genetic disorders like xeroderma pigmentosum.
A study found the rate of pediatric melanoma rose around 2% annually between 1973 and 2009. Melanoma is curable over 90% of the time in children if caught early. Teach kids to avoid tanning, apply sunscreen, and report any new or changing moles to stay safe.
What is the most deadly form of skin cancer?
Melanoma is by far the most deadly form of skin cancer. Though it accounts for only about 1% of skin cancer cases, melanoma is responsible for the vast majority of skin cancer deaths. This is because melanoma is more likely to spread beyond the skin to other parts of the body than basal cell carcinoma and squamous cell carcinoma.
Key stats on melanoma:
– Melanoma accounts for about 73,000 skin cancer cases in the U.S. annually.
– About 9900 people in the U.S. die from melanoma each year.
– Melanoma has a 5-year relative survival rate around 92% when detected early in stage I. This drops to around 15% for stage IV melanoma.
– Melanoma is the 6th most common cancer diagnosis among U.S. men and women.
So while basal cell carcinoma is the most frequently occurring skin cancer, melanoma is the deadliest form. Take precautions against sun exposure and monitor your skin closely for changes to catch melanoma early when it is highly treatable.
What does skin cancer feel like to touch?
Skin cancers like melanoma and squamous cell carcinoma can vary in texture:
– **Smooth -** Feels soft and even when rubbed against the skin.
– **Firm -** The lesion feels solid and does not depress with pressure.
– **Hard -** Very firm with a rough texture, like a callus.
– **Lumpy -** Bumps or nodules can be felt within or on the surface.
– **Ulcerated -** Breaks open on the skin, causing oozing, crusting, and bleeding.
– **Painful -** Hurts when touched due to nerve involvement.
Any new growths that feel abnormal, or existing moles that have changed texture, should be evaluated promptly. Use the ABCDE criteria and make note of the lesion’s texture when doing self-exams. Contact your doctor if you notice concerning changes.
Table 1. Comparison of Benign vs. Cancerous Skin Lesions
| Characteristics | Benign Skin Lesion | Cancerous Skin Lesion |
|---|---|---|
| Borders | Well-defined, smooth | Irregular, notched, or blurred |
| Color | Uniform color throughout | Multiple colors present |
| Size | Usually less than 6mm | Often larger than 6mm |
| Evolution | Remains stable over time | Changes size, shape, color, or texture |
| Symmetry | Uniform round or oval shape | Two halves appear different |
| Elevation | Flat or evenly raised | Bumpiness, lumps, or ulceration |
| Sensation | Not painful or itchy | May be painful, itchy, or tender |
Conclusion
Most moles are benign, but abnormal moles can sometimes develop into melanoma skin cancer. Use the ABCDE system to identify moles that may be of concern based on their asymmetry, border, color, diameter, and evolution. See a dermatologist right away if you notice any new or changing moles with warning signs. Catching melanoma in its earliest stages means better outcomes. Protect your skin from sun damage, do regular self-checks, and get annual skin exams to stay vigilant about this dangerous form of skin cancer.