Moles

Should I be Worried?

Everyone has moles (or “nevi” as they are known medically) and they can appear anywhere on our bodies.  Moles can be present at birth or be acquired later in life.  They tend to increase in number during childhood, peak at adolescence and gradually fade or disappear with age. Sun exposure can increases the number of moles and can darken existing ones. Further during pregnancy, moles may also get darker and larger and new ones may appear.

Moles don’t normally pose any health threats. However, any sudden or rapid change in the size, colour or shape of a mole should be treated with extreme caution. Dermatological advice should be sought and the mole may have to be removed to exclude the possibility of skin cancer.

 

When Do I Need to Remove a Mole? 

For children, moles generally increase in size as they grow. If a mole’s size increase is disproportional to the child’s growth, then that mole may be cancerous and should be removed. For adults, a sudden or rapid change in the size, shape or colour of a mole is suggestive of skin cancer. Itching, pain, redness, swelling can also be early signs of skin cancer. You may also wish to remove a mole if it is bothering you, such as a thick mole on a man’s jaw, an area that is frequently shaved. In addition, people may also wish to remove a mole for cosmetic or “feng shui” reasons.

The most common methods of removal include numbing and shaving the mole off, or cutting out the entire lesion and stitching the area closed. Most procedures used to remove moles take only a short time and can be performed in a dermatologist’s clinic. Sometimes a mole will recur after it is removed. If a mole has been removed and begins to reappear, then the patient should return to the dermatologist.

With lasers, now we can also remove moles without causing surgical scars. However, assessment by dermatologists is crucial as only moles that are benign would be suitable for laser treatment.

 

Melonoma – Is My Mole Cancerous?

Melonoma, is the most lethal form of skin cancer and is a malignant tumor of melanocytes (skin cells which produce melanin, the dark pigment in our skin). The good news is that if detected early, melanoma can be easily treated with surgical removal.

It is therefore important to recognize the early warning signs of malignant melanoma. A useful rule-of-thumb is to remember the ABCDs of melanoma when examining your moles. A mole is potentially malignant if any of the following features is observed:

  1. Asymmetry: Where one side of a mole is different from the other side
  2. Border: Where a mole has irregular or ragged edges
  3. Colour: Where more than one colour is present in a mole – shades of tan and brown, black, sometimes even white, red or blue
  4. Diameter: Where a mole suddenly changes in shape or is larger than 6mm in diameter (approximately the size of a pencil-head eraser)

In addition to clinical examination, dermatologists can also perform a skin biopsy to ascertain, definitively, whether a mole is cancerous or not. The procedure involves numbing the area and removing the lesion. The sample is then examined under a microscope by a pathologist to ascertain whether cancer cells are present. Skin biopsy a quick and simple procedure and is usually performed in a dermatologist’s clinic or at a hospital on an out-patient basis.

 

Can I Die from Melanoma?

Although melanoma is not the most common type of skin cancer, it is considered to be one of the most leathal types of skin cancer because it can spread rapidly to the lymph system and the internal organs. Once it starts to spread, the prognosis is poor. In the United States, on average, one person dies from melanoma every hour.

However, with early detection and treatment, surgical removal of melanoma is usually effective in curing the disease and the cure rate is high, at around 95%. Since melanoma can develop in an existing mole or appear as new mole, it is important to know what your moles look like and where they are in order to be able detect changes in existing moles or identify new moles.

 

Skin Self-examination – a Lifesaver

Irrespective of age, it is advisable to self-examine your body regularly for changes in the size, number and colour of moles. It is easy and can be a lifesaver!

  1. Examine the front of your body and then the back in mirror, follow by right and left sides, with your arms raised
  2. Bend elbows, check forearms, back of upper arms and palms carefully
  3. Examine backs of legs, feet spaces between toes and your soles
  4. Look at back of neck and scalp with a hand mirror
  5. Check back and buttocks with a hand mirror

 

Skin Examination with a Dermatologist

As people spend more time at the beach and in other outdoor pursuit, skin cancer has become increasingly common in the recent years. Both the American Academy of Dermatology and the American Cancer Society have recommended annual skin examination with a dermatologist.  In particular, the following people are considered to be more at risk of skin cancer and should seek regular skin examination.

  1. Fair skinned people aged 50 and above
  2. Individuals with a previous history of skin cancer, or a family history of skin cancer
  3. Individuals who experience excessive sun exposure (e.g. those who work outdoors or sun-bed users)
  4. Individuals with numerous moles (100+) on the body

 

Summary

Most moles cause no health problems but if you see any signs of change, consult a dermatologist can either assure you that the mole is harmless, or confirm that it is cancerous. Regular self-examination and skin cancer screening is also recommended, especially for individuals who are at high risk of skin cancer. Sunscreen should also be used daily to minimize the cancerous effects of UV.

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