DEAR DOCTOR K:
I have many moles, some flat, some raised. Should I be worried about them?
Yes, you should. I worry about mine.
Everyone has moles. They usually appear during childhood or adolescence. Most moles never become a problem, but sometimes they can become cancerous, causing a potentially deadly skin cancer called malignant melanoma.
Moles are small, pigmented spots on the skin. They can be flesh-colored, yellow-brown or dark brown. They can be flat or raised. They are usually no more than 1 to 10 millimeters (less than half an inch) in diameter. Over the years, you may develop more of them.
Still, some moles do turn cancerous, so you should keep an eye on them. A relative of mine died of malignant melanoma, and I’ve kept a close eye on my own moles.
If patients are at risk for melanoma — because someone in their family has it, or because they have had atypical moles or melanoma in the past, or because they got a lot of sun exposure, I recommend that they regularly inspect their skin. Use a mirror for hard-to-see areas, or have a family member regularly inspect the skin on your back and the backs of your arms and legs, the areas that you cannot see very well.
Not every brownish, pigmented thing on your skin is a mole. For example, many people have little brownish bumps on their skin called seborrheic keratoses. They aren’t moles and don’t turn into melanoma.
The things to look for when you are examining a mole are basically the size, the color and the border — and any changes in size, color or border. A common or typical mole has an even color throughout and a distinct, regular border.
Some moles, called atypical moles, have different physical characteristics than common moles — and they are more likely to turn into cancer.
Atypical moles are usually larger in diameter (5 to 12 millimeters). They may have a mixture of colors, including tan, dark brown and sometimes pink or black. The border is often irregular and indistinct and fades into the surrounding skin. Atypical moles usually appear on sun-exposed skin. But they can occur elsewhere, and they continue to develop after age 35. I ask my patients to bring any such moles to my attention.
You should inspect all of your moles, especially atypical moles, regularly for any abnormal changes. See a dermatologist if they:
- Get larger suddenly;
- Develop an irregular border;
- Become darker or inflamed;
- Show spotty color changes;
- Begin to bleed, crack or itch;
- Become painful.
If the appearance of your moles suggests they may be cancerous, they should be removed and examined under a microscope. If they are found to be cancerous, additional skin in the surrounding area also must be removed.
Do not ignore warning signs. Melanoma is the deadliest form of skin cancer, but early diagnosis could save your life.