What Are Moles?

Moles, clinically called melanocytic nevi or nevus (singular, nevi plural) are growths on the skin that are uniformly pigmented, usually various shades of brown or black, sometimes even blue.

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As the years pass, benign moles usually transform slowly, becoming raised and/or changing color. Often, hairs develop on the mole. Some moles may not change at all, while others may slowly disappear over time.

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If you are unhappy with the appearance of your moles, and would like to have them removed for cosmetic reasons, you can learn more about your moles and the removal procedures at Dr. Mole. Get educated. Get rid of them. 

What does a normal mole look like?

Moles are usually flat or slightly raised, thickened and often protrude from the skin surface. They are generally symmetrical with a smooth border but may become dome-shaped or papillomatous (wart-like) and wobbly to palpate. They are often brown but can also be pink, blackish or even blue. The color tends to be evenly distributed throughout the lesion (homogeneous), although sometimes more pronounced in the center and fades to the edge, but occasionally more pronounced at the edge. Some lighten with age. The pattern (especially under a dermatoscope) tends to progress from having a globular rim in young people, to a predominantly reticular (netlike or honeycomb) structure in adults, and then homogenous in older people. Moles may darken after exposure to the sun, during the teen years, and during pregnancy.

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Where can moles form?

Anywhere on the skin. Yes, ANYWHERE, from head to toe. Moles on the palms & soles compared to face and body take on different dermascopic appearances, which is what it looks under a Dermascope. (A Dermasope is a hand-held microscope used to help distinguish between benign and malignant lesions or moles, especially helpful in the diagnosis of melanoma.)

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Most moles appear in early childhood and during the first 30 years of a person's life. The number of moles that an individual has (normally between 10-40 moles by adulthood) is related to genetic factors and exposure to UV radiation. Greater exposure normally results in the development of a larger number of moles.

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It’s important to know where all your moles are, and if any seem suspicious or irritated, have them all examined by a professional. 

What causes a mole?

Moles occur when cells that produce pigment in the skin (melanocytes) grow in a cluster instead of being spread throughout the skin. The underlying cause of this is unknown.  

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Common Types Of Moles

• Compound Nevi are the most common moles. They are benign moles presenting as clusters in the dermal/epidermal junction. They arise in childhood and young adulthood, are less than 1 centimeter, usually start flat but over time can become raised, are brown or black, symmetrical and may have one or two hairs.

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• Congenital Nevi are moles that are present at birth. Congenital nevi occur in about one in 100 people. These moles may be more likely to develop into melanoma (cancer) than are moles that appear after birth. A mole or freckle should be checked if it has a diameter of more than a pencil eraser or any characteristics of the ABCDE’s of melanoma (see below).

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• Blue Nevi are homogenous blue-grey moles derived from melanocytes in the dermis. They are thought to be generally harmless. These moles present mainly in older children and young adults and tend to be smaller than 1 centimeter. Unlike melanoma, once a blue nevus appears it tends to remain unchanged throughout life. It is more common on the face but can arise anywhere. 

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• Dysplastic Nevi are moles that are typically larger than average (larger than a pencil eraser) and irregular in shape. They tend to have uneven color with dark brown centers and lighter, uneven edges. These nevi are more likely to become melanoma. In fact, people who have 10 of more dysplastic nevi have a 12 times higher chance of developing melanoma, a serious form of skin cancer. Any changes in a mole should be checked and mapped by a dermatologist to evaluate for skin cancer.

How do I know if a mole is cancer?

The only way to know for sure if a mole is cancerous is to have a complete biopsy. 

 

The vast majority of moles are not dangerous. Moles that are more likely to be cancerous are those that look different than other existing moles or those that first appear after age 30. If you notice changes in a mole's color, height, size, or shape, tell your doctor. You also should have moles checked if they bleed, ooze, itch, or become tender or painful.

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Examine your skin with a mirror or ask someone to help you. Pay special attention to areas of the skin that are often exposed to the sun, such as the hands, arms, chest, neck, face, and ears. If a mole does not change over time, there is little reason for concern. If you see any signs of change in an existing mole, if you have a new mole, or if you want a mole to be removed for cosmetic reasons, let us know.

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Basal cell carcinoma (BCC) is the commonest from of skin cancer accounting for almost 80% of all skin cancers. Melanoma is another form of skin cancer. The most common location for melanoma in men is the chest and back and in women, it is the lower leg. Melanoma is the most common cancer in young women between the ages of 19 and 32, and more common now with over use of UBV tanning beds.

 

The following ABCDEs are important characteristics to consider when examining moles.

 

If a mole displays any of the signs listed below, have it checked immediately by a dermatologist. It could be cancerous.

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• Asymmetry. One half of the mole does not match the other half

• Border. The border or edges of the mole are ragged, blurred, or irregular

• Color. The color of the mole is not the same throughout or has shades of tan, brown, black, blue, white, or red

• Diameter. The diameter of a mole is larger than the eraser of a pencil

• Evolution. The mole is changing in size, shape, or color

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Benign vs. Malignant

Moles more likely to be benign (harmless) are as follows:

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• Those growing gradually and symmetrically through puberty - that you've had a long time without change

• Brown moles that gradually become dome-shaped and soft/wobbly to palpate while maintaining a regular symmetrical edge

• Brown moles that are one color and have have not changed in color, size, or shape in many years  

• Or two colors where the colors are similar (two shades of brown) AND where the pigment is arranged in a symmetrical fashion (darker center and lighter edge)

• Moles that change rapidly (over a few days) becoming swollen, inflamed and crusty AND which then settle back down to their original appearance - these moles are likely to have been traumatized or become acutely infected

 

Lesions suspicious of melanoma may have the following characteristics: 

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• Shape - any mole that has lost its symmetry 

• Border - any new or old and changing mole with an irregular border.

• Color - any mole that has three or more colors. Any new or old and changing mole that has two or more colors with an uneven distribution of pigment. Any new or old and changing mole which differs in color to your other moles (black, pink or any other unusual color)

• Persistent growth of either a new mole that arises after puberty OR new growth in any long-standing mole. Most lesions that grow persistently need examination even if they are symmetrical in shape and color, the main exceptions are those that become dome-shaped and soft/wobbly to palpate while maintaining a regular symmetrical edge. Sometimes it is difficult to know whether or not a mole has grown and whether or not it is continuing to grow

• Bleeding moles without a history of trauma - even with a history of trauma if the bleeding does not settle or the mole looks abnormal it should still be referred

• Nodules and plaques - any new solitary nodule or plaque where a benign diagnosis (i.e., dermatofibroma) cannot be made with confidence. 50% of nodular melanomas are hypo/amelanotic and so may present as a red-pink elevated lesion.

• Nails - a new pigmented line in a nail or unexplained destruction of a nail

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Moles are to be taken seriously! 

 

If a mole is at all suspicious but has no characteristics of melanoma, Dr. Gillaspie will either refer to a dermatologist for a second opinion or may monitor the mole for a minimal period of four months. It will be photographed with a digital dermascopic camera upon your initial examination and then rephotographed after four months, compared and reevaluated. If a mole has not changed during that 4 month period and it has no characteristics of melanoma, Dr. Gillaspie will proceed with removal. If there are any changes whatsoever, you will be referred to a dermatologist for a complete biopsy.

 

Dr. Gillaspie is progressive in her field by being active in her continuing education so as to keep abreast of the most modern studies in benign and malignant skin lesions. She stays current on the advancements in increased technology and evaluation methods for various dermatological skin lesions in order to provide her patients with the best possible options for their cosmetic skin concerns, while ensuring they receive the highest level of medical expertise for treatments.

How Are Moles Treated?

Dermatologists biopsy all moles whether benign or suspicious. Most dermatologists will either remove the entire mole, or first take just a deep tissue sample of the mole to examine thin sections of the tissue under a microscope (a biopsy). This is a simple procedure, however, it may leave a scar and indentation. If the dermatologist cuts out the entire mole and a rim of normal skin around it, it leaves an open wound that needs to be stitched closed. The result is a noticeable scar and larger indentation where the mole once existed. Is this necessary for obviously benign moles? No.

 

Once Dr. Gillaspie has determined that your mole(s) is not changing or suspicious, she will proceed with removal using the Ellman Surgitron, which utilizes radio-wave technology and high-frequency energy to make cosmetic-enhancing incisions. If effect, the mole is "air-brushed" off. Healing is usually rapid and virtually bloodless, with little or no bruising. Suturing is unnecessary. A special cellulose powder will be applied to aid the healing process and minimize scaring. Your scar, if any, will be a slightly lighter tone than the surrounding skin initially, but will fade over the next three to six months.

 

If you do not like the appearance of your benign moles, you don't have to live with them for the rest of your life. The results you'll receive with Dr. Gillaspie's advanced skin and precision will give you the results you're looking for!

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To see other patients actual results, check us out on Instagram (drmolepdx)

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