January 2019

Ask Dr. Mikell: When a Moles isn’t a Mole

Author: Oswald Lightsey Mikell, MD

Moles are quite common and can occur anywhere on the skin. Most moles are acquired as one ages, and in some cases will wither away in old age. Although moles are a normal skin condition, care should be taken if they exhibit changes in size, shape or color. Most moles are harmless, but in rare cases, moles may become cancerous. Monitoring moles and other pigmented patches is an important step in detecting skin cancer, especially malignant melanoma. Not all melanomas develop from pre-existing moles, but many begin in or near a mole or other dark spot on the skin.

Q: When should I be worried about a mole?
A: Moles that look different and moles that change color, size, shape, height or condition are suspicious. Many moles are hereditary and passed from generation to generation in genes. These inherited moles may be larger than average and have irregular shapes or color. These atypical moles may develop into melanoma skin cancer.
Dermatologists use a simple test for determining the problem potential of a mole. Use this A to E skin self-examination guide:
• A is for Asymmetrical Shape. Look for moles with irregular shapes, such as two very different-looking halves.
• B is for Irregular Border. Look for moles with irregular, notched or scalloped borders—the characteristics of melanomas.
• C is for Changes in Color. Look for growths that have many colors or an uneven distribution of color.
• D is for Diameter. Look for growths that are larger than about 1/4 inch (6 millimeters). This is the least important, however. If the other features are present, they are more important.
• E is for Evolving. Look for changes over time, such as a mole that grows in size or that changes color or shape. Moles may also evolve to develop new signs and symptoms, such as new itchiness or bleeding.

Q: What should I be doing to spot potential problems at an early stage?
A: Become familiar with the location and pattern of your moles. Examine your skin carefully on a regular basis. You may want to consider having a dermatologist check your moles.

Q: How are moles removed?
A: Cosmetic removal of moles is a simple procedure done under a local anesthetic in the doctor’s office by cutting with a scalpel. If the mole is suspicious, your dermatologist may remove the entire mole or a segment for biopsy. If the mole is cancerous, the entire mole should be completely removed and the wound closed. Some superficial growths, called seborrheic keratosis, which many patients think of as moles, can simply be frozen in the office.

Q: Is there any way to prevent moles?
A: The easy answer is no. However, sun exposed parts of the body generally have more moles, so the number, size and color may be reduced by limiting sun exposure, using sun block and avoiding sunburn.
If you have questions or concerns, call Dermatology Associates of the Lowcountry (843) 689-5259 (Hilton Head); (843) 705-0840 (Bluffton / Okatie); or (843) 525-9277 (Beaufort) to schedule a consultation. Any abnormality of the skin should be looked at and possibly biopsied to be sure it is not cancerous.

??Dr. Oswald Mikell of Dermatology Associates of the Lowcountry is board certified in dermatology and cosmetic surgery. For information, visit www.dalcdermatology.com.

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