General information about moles

Moles are skin lesions that may be small or large. They can be flesh-colored, yellow-brown, light or dark brown. They can also be flat or raised, smooth, hairy, or warty. Almost everyone has a few moles. Hormonal changes often cause more moles to appear and existing ones to enlarge or darken, especially during adolescence or pregnancy. Moles are classified as either typical or atypical.

What is a Mole?

Moles, medically known as nevi, are skin lesions that we develop throughout our life. Although the look, size, shape, location and color of a mole can vary, most of the moles are round, a few millimeters in size, flat or slightly raised. They are usually skin color to dark brown. Moles that have a look different than a “normal” mole may be worrisome because skin cancers can look just like a weird mole.

Typical Moles:

These moles are usually benign, flesh-colored, yellow brown, or black. They usually appear in childhood or adolescence and can appear anywhere on the body. These types of moles are 1 to 10 millimeters in size and approximately 10 in number. These benign moles are classified based on clinical characteristics and histological appearance.

Atypical Moles:

Atypical moles look and act different than typical moles. These types of moles are usually hereditary and may develop into melanoma, a potentially fatal form of skin cancer. These moles may have irregular and ill-defined borders, be flat or slightly raised, and have a tan to dark brown color with a pink background. They often have a dark or light “target” appearance, commonly have a flatter rim than center, and the pigment often blurs at the edges or has notching. These moles are usually 5-12 millimeters large, making them larger than typical moles.

Atypical moles continue to appear after adolescence, most commonly on sun exposed skin. There may only be a few, but they can also exceed more than a hundred in number.

A biopsy of the lesions with the most severe appearances should be performed to establish a diagnosis and to determine the degree of atypia.

Halo Nevus:  

This refers to any type of dark mole surrounded by a 2 to 6 millimeter ring of depigmented skin. Such a mole can have inflammation, disappear spontaneously or, in rare cases, convert to cancer.

At what age and how do moles appear?

• Congenital moles are moles that appear at birth. These occur in about one in 100 people and are more likely to become cancerous than moles that develop after birth.
• Typical moles usually first appear in childhood or adolescence as a flat spot containing two or more shades of tan and gradually become larger and darker. They rarely appear later than adolescence in life.
• Atypical moles carry a risk of becoming cancerous and usually continue to appear after adolescence, particularly in sun exposed area.

Type of benign Moles:

• Freckles: These are not actually moles, but simply deeper pigmentations of the skin found usually on the face and arms.
• Lentigo: These are spots on the skin that are darker than the surrounding skin and usually caused by sun exposure. They are uniformly pigmented and flat with a brown to black color and sharp margins. Usually 0.5 – 4 millimeters in size.
• Junctional Nevus: These are uniformly pigmented and usually flat, but sometimes may be slightly elevated. They have a light brown to almost black color, sharp margins, and a size of 1-10 millimeters.
• Intradermal Nevus: These have a flesh to brown color and are elevated. They may be smooth, hairy, or warty and are 3–6 millimeters in size.
• Compound Nevus: These are light to dark brown, may be slightly or considerably elevated, and are 3-6 millimeters in size.

What changes in a mole are suspicious?

Changes in a mole such as asymmetric growth, irregular borders, color changes, increase in size, onset of pain, itching, bleeding, formation of ulcers, or a wounded mole that does not heal are all symptoms that indicate a need for biopsy and must be evaluated by your physician.

What should I do if I find a suspicious mole?

If you are suspicious of any mole do not hesitate to make an appointment with Dr. Shafa for an evaluation. A mole biopsy is a very simple and pain free procedure that takes no more than a few minutes. It is worth it to be on the safe side.

Should I have my moles removed to prevent complications?

No. Moles are extremely common and numerous and it is not common for skin cancer to be relative to the number of moles present. Therefore, prophylactic removal of moles is not justifiable. However, a mole should be biopsied and examined microscopically if it has characteristics of concern.

Can my suspicious mole simply be shaved off for a biopsy?

No. The specimen must be deep enough for accurate microscopic diagnosis and should contain the entire lesion if possible, especially if the concern for malignancy is high. However, wide primary excision is not needed initially, even for highly abnormal-appearing lesions, because many such lesions are not cancerous.

Does cutting through skin cancer increase the risk of cancer spreading?

No. A skin biopsy, even one that involves cutting through skin cancer, does not increase the likelihood of the cancer spreading (metastasis). Dr. Shafa uses her expertise during mole removal to avoid extensive surgery for a skin lesion, but at the same time ensures that she has removed a sufficient amount of tissue for efficient microscopic evaluation of the entire mole. Of course, Dr. Shafa’s artistic touch also ensures the best cosmetic outcome as well.

Parental concerns of moles in infants and children:

Babies may sometimes be born with a few moles called congenital moles. These must be checked for accurate diagnosis and appropriate treatment, but very few of these moles are cancerous.

Moles on the face or other frequently exposed areas of skin may be troubling for children. If a child is particularly troubled by a mole, consult with Dr. Shafa for the cosmetic removal of such bothersome skin lesions.