Moles are growths on the skin that are usually brown or black; they may be located, alone or in groups, anywhere on the body. A birthmark is a colored mark that appears soon after a baby’s birth. Although many moles and birthmarks are completely benign and pose no health risk, some people choose to remove them because they consider them unattractive. Regularly using a strong sunscreen, and monitoring birthmarks and moles for changes, is highly recommended.
What are the Different Types of Moles?
Moles form when too much melanin is clumped together in a small patch of the skin. There are four different types of moles that are commonly seen. They include:
- Congenital moles are present at birth. Congenital moles may be any size. Larger congenital moles may harbor a risk of skin cancer so should be monitored carefully.
- Dysplastic Nevi are moles that are considered abnormal. They are usually present at birth and tend to grow or change over time. Irregular borders, large size, and an uneven surface may indicate skin cancer.
- Acquired Nevi are moles that develop throughout life. Acquired Nevi aren't necessarily cancerous but having a large number of these moles could indicate that your risk for skin cancer is higher.
- Spitz Nevi are moles that are oddly shaped and colored are difficult to distinguish from melanoma skin cancer. These moles can bleed or leak fluid, appear raised or even multi-colored, and may need to be biopsied to ensure there are no cancerous cells developing.
Most moles and birthmarks are harmless. However, some atypical moles have the potential to be or become malignant. Atypical moles may be asymmetrical, or have irregular borders and uneven coloring; they can be located anywhere on the body, including areas not exposed to the sun.
Diagnosis of Moles and Birthmarks
A thorough physician-performed examination of the skin is necessary to determine whether a mole or birthmark needs immediate treatment or simply to be checked on a recurring basis. When a mole is diagnosed as atypical, it may need immediate treatment. A patient with an atypical mole may have a personal or family history of melanoma, which increases the possibility of malignancy.
A mole should be examined by a physician if it is:
- Larger than 6 millimeters
- Itching or bleeding
- Rapidly changing color, size or shape
- Located in a difficult-to-monitor area (such as the scalp)
Most birthmarks are benign, but some have the potential to become malignant or may indicate systemic disease. A large congenital mole that is present at birth has a greater risk of becoming malignant; this is especially true if the mole covers an area larger than the size of a fist. Café au lait spots can indicate a number of rare systemic diseases, such as Maffucci syndrome or Gaucher disease.
Treatment of Moles and Birthmarks
Depending on its depth, location and color, as well as factors that include the patient’s skin type and age, treatment for a benign mole or birthmark includes:
- Laser or pulsed-light therapy
- Surgical removal
If a mole is irregular and needs to be evaluated further, either the entire mole is removed, or a small tissue sample taken, in order to biopsy it. If only a small section of tissue is taken and it is diagnosed as malignant, the entire mole will be removed, along with a margin of normal skin around it. Cutting into a malignant mole will not cause cancer to spread. If the malignancy is caught early enough, this may be the only treatment needed.
A melanoma that has spread beyond the skin requires more aggressive treatment, which may include:
- Surgery to remove affected lymph nodes
- Radiation therapy
- Biological therapy to boost the immune system
- Targeted therapy (attacks vulnerabilities in cancer cells)
Depending on the type and severity of the malignancy, a combination of treatments may be used. Possible, although rare, complications of surgical removal of moles and birthmarks include infection, allergic reaction to the anesthetic used, and nerve damage.
How Do I Know if a Mole is Cancerous?
It can be challenging to tell if a mole is cancerous just by looking at it, but your doctor can learn a lot by examining your skin. To confirm a skin cancer diagnosis, your doctor may take a sample of cells or tissue from the suspicious growth. Pathology testing of the cells can discover the type and severity of skin cancer, or, conversely, rule out that disease. If you notice a new mole or growth on your skin, watch it closely for signs of changes to its texture, color, size, borders, and symmetry. Schedule an appointment with us if a mole bleeds, itches, grows larger, or changes in any way.
How Often Should I Have a Skin Check from a Doctor?
The Skin Cancer Foundation recommends receiving skin cancer screenings once a year. If you've previously had skin cancer or you have a higher risk of developing this common disease, your doctor may advise you to come in more often. Your annual exams are a complement to your monthly self-examinations in which you observe all of the skin on your body, from your head to your toes.
When Should I Be Concerned about a Birthmark?
Most birthmarks are benign and present no cause for alarm. However, you may want to schedule a dermatology appointment for your child if their birthmark looks inflamed or infected or if it bleeds or itches. If the birthmark changes in size, color, or texture, you may want to have it checked. Your dermatologist can also discuss ways to treat a birthmark that could present a cosmetic problem as your child grows.
What's the Difference Between Moles and Freckles?
Moles and freckles seem similar because they are both caused by too much melanin in a localized area of the skin. Both can be present at birth and both can worsen with exposure to ultraviolet light. A few characteristics are all that separates them. One is that freckles tend to be light brown or reddish, whereas moles are usually darker in color. Moles are often raised, as well, or have a slight texture to them when you run a finger across the skin. Freckles are flat. Freckles usually occur in clusters, whereas you might have just one or two moles in an area of the body. Freckles also do not present a risk of skin cancer, whereas moles are associated with this disease.
Is Having Moles Dangerous?
It generally is not considered dangerous to have some moles on your body. A normal mole is simply an overgrowth of melanocyte cells in a very small area of the skin. The concern related to moles is that DNA damage to the melanocytes, which often occurs due to sun exposure or the use of tanning lamps, can cause the cells to begin growing abnormally. The abnormal growth and division of melanocyte cells could result in skin cancer. If you have a mole that doesn't look like others or you have questions about various moles and spots on your skin, schedule a consultation with us! We can help you gain a better understanding of your skin.
Risks Factors for Malignant Moles
Certain factors may increase the risk of melanoma, including:
- Fair skin
- History of sunburn
- Family history of melanoma
- Excessive UV-radiation exposure from the sun or tanning beds
- Living close to the equator or at higher elevations
- Having several moles or unusually shaped moles
- Weakened immune system
Surgical removal leaves a scar, the severity of which depends on the size, location and type of birthmark, mole or melanoma. Prior to treatment, a patient should be informed about the type and location of a potential scar.
Schedule Your Mole Removal Consultation in Sarasota
If you are experiencing moles and are seeking treatment, visit Sarasota Dermatology. Our providers, including Dr. Elizabeth Callahan, are experienced in moles treatment and have been serving the Sarasota community for over 15 years. At SkinSmart Dermatology, we treat a wide variety of skin problems and care for every individual patient with a personal touch. Schedule an appointment by calling 941-308-7546 or fill out the form on our contact page.