What are moles and 5 reasons to consult your dermatologist

Moles are mostly normal, first let’s get this thing straight. These moles (also known as naevi) are clusters of normal skin cells known as melanocytes. They develop during childhood or puberty and persist throughout life. Mostly these moles are harmless, especially in the Indian context. These moles can sometimes become cancerous and therefore you need to get it checked annually.

So what does a normal mole look like?

A normal mole is either black/brown/skin coloured and can be flat or raised from the skin surface. Sometimes, moles can be present at birth and have hair attached to it when it is known as congenital hairy naevus. Fortunately, these kinds of moles are rare. Usually, a person will have 10 to 40 moles in the entire body which can range from a few mm to a few cms. Generally, these moles do not create a concern except for cosmetic reasons.

A typical mole has the following features:

  • Shape: Usually moles are oval or round but can have variegated appearance too as is seen in ink spot lentigo.
  • Size: Size of moles vary from few mm to few cms. Rarely they can be large enough to cover most of the body parts when it is known as bathing trunk naevus.
  • Colour: Colour can vary anywhere from brown, tan, pink, black or skin coloured.
  • Texture: Usually the texture is smooth or pitted. Sometimes, some of these moles can have hair in them known as hairy naevus.

You might also experience your moles changing over time. Your moles may gradually increase in size, change colour or become raised over time. If you do not notice any “red flags” related to your moles, you must not worry about these changes as it is part of maturation of a mole.

What causes a mole?

A mole is caused when a cluster of normal cells aggregate at one place. If these aggregates are of melanocytes, the “moles” are known as melanocytic naevi. Based on  the type of cluster of cells, the type of naevi can vary.

What are the different types of moles?

Moles are commonly defined into 3 main types

  • Common naevi: These are the normal moles that everyone has  on their body.
  • Dysplastic naevi: These moles have dysplastic or precancerous changes when seen under a microscope. That means they can have colour variegation, irregular borders, asymmetry and they can be larger than a common naevi. Such moles are likely to develop into cancer in future and must be closely monitored.
  • Congenital naevi: These are rare. Seen in <1 % cases. These are likely to develop precancerous changes. Such moles are present since birth and can be large enough to cover an entire body part.

How do I know if a mole is cancer?

Moles that are likely to show cancerous changes look different as goes by the idiom “ugly duckling”. A sinister precancerous mole will look and feel different and might have symptoms of pain, ulceration and bleeding. A self examination is often enough to find the suspicious mole. When in doubt, always consult a dermatologist in Delhi for the same.

So when should you consult a dermatologist for moles?

A mole can be a sign of precancerous changes where the ABCDE rule comes into play. 

  • A stands for asymmetry: Asymmetrical mole is likely to be a sinister sign. 
  • B stands for border: An irregular border is considered omnious
  • C stands for colour variegation: Colour variation is dangerous
  • D stands for diameter: Diameter more than 6 mm requires close watchfulness.
  • E stands for evolving: Sudden bleeding/pain/ulcer formation in a preexisting mole should be examined by a dermatologist.

While you should be aware of these sinister signs related to moles, you must also know that such changes are very rare in the Indian context. Usually the Australian and Caucasian population needs an annual or 5 yearly check up of their moles. Skin cancer like BCC or SCC or melanoma is more common amongst the whites. In India, the commonest skin cancer is BCC which is locally ulcerative and the most benign type of all different skin cancers.

How are moles treated?

Moles are treated primarily for 2 different reasons. Either they need to be removed for aesthetic purposes as “it does not look good” or they need to be removed as part of precancerous changes.

For aesthetic reasons, normal moles are removed usually on the exposed part of the body such as the face. They can be removed via any ablative procedure like ablative CO2 laser or radiofrequency ablation. 

However, if the moles are to be removed for suspicion of cancer, first an excision biopsy should be done to confirm dysplastic changes followed by surgical excision of those moles.

At Influennz, Dr Geetika Srivastava, AIIMS passed out dermatologist can differentiate types of moles and provide mole removal treatment for the same.

Takeaway message

Moles, or nevi, are a commonplace part of the skin. Moles are much more complex than simply being cancerous or not cancerous. While self-examination is often helpful, you must annually get yourself tested for any suspicious lesions. Moles are more likely to develop in later childhood and adulthood, but you can be born with moles, too.

Most moles don’t become cancerous — but when they do, they can be life-threatening if not caught early. Knowing your own skin and doing self-checks are important.

It’s also important to see your dermatologist regularly for checkups and to notify them if you see any sudden changes in your skin.