Moles, Melanoma and Mole Mapping

What are moles?

Moles are localised areas in the skin that contain more of the pigment melanin.

No one quite knows why we get moles. Dermatologists use the term melanocytic naevi to describe moles. Most moles are round or oval, flat and brown in colour. But when you look closely, there are differences in size, shape and colour and they can be raised or hairy.

Babies are usually born without any but then develop them over the first few months of life. You can go on developing new moles well into adulthood.

We do know that moles run in families, so if your mum and dad have them, then the chances are you will too. We also know that moles are affected by hormones, so they may change as you pass through puberty, pregnancy or the menopause.

Most moles are completely harmless and will not cause any problems. Sometimes, moles in obvious places, such as on the face and neck, can cause problems with self-image, especially in teenagers who may become self-conscious about how their moles make them look.

Raised moles (known as skin tags) can also be a problem if they catch on clothing or rub during your daily routine or when playing sports. Raised moles on the jaw line in men can also cause issues with shaving, as they will often get caught by the razor and bleed.

While most moles, even the nuisance ones, can be ignored without risking your health, some moles can develop into an aggressive form of skin cancer called melanoma. Malignant melanoma is much less common than other skin cancers but is the most serious, and importantly its numbers are increasing.

The good news is that melanomas can usually be treated successfully with no impact on your lifespan if they are diagnosed and treated early enough. This is why it’s important to keep an eye on your moles to spot worrying signs early.

Things to look out for

• A mole changes its appearance.
• A new different mole.
• A new, solitary, different skin lesion.
• It grows over a few weeks, becoming larger than 6 mm in diameter.
• It grows and becomes much more domed than previously, even if its diameter does not increase.
• It loses its regular smooth border and starts to look smudged, as if someone has tried to rub it out.
• It changes colour, or becomes two-coloured.
• Itching and bleeding are also warning signs but this can happen if a mole constantly catches on clothing.
• Inflammation or reddening around the mole.

How often should I check my moles?

There is no set frequency recommended for checks and generally checking every three months is sufficient, unless you are at high risk when you should do it monthly. Moles that are abnormal usually stand out from the other moles on your body- ‘the ugly duckling’. If you have any concerns it is best to seek medical assessment.

High Risk factors are:

• Sun exposure
• Family history or personal history of melanoma or other skin cancer

Melanoma

Melanoma is the third most common skin cancer, but is the most common cause of skin cancer-related death.

Melanoma is a malignant tumour arising from melanocytes. It is among the most common forms of cancer in young adults and typically presents as a new or changing deeply pigmented skin lesion. Lesions are often on sun-exposed anatomic locations in fair-skinned people.

The prognosis depends on the stage at diagnosis: 99% of patients with early melanoma will be cured with simple excision, while less than 10% of patients with metastatic disease will live beyond 5 years, although this statistic will change with the current era of new therapeutic agents.

Diagnosis

A diagnosis of melanoma is made by combining the following:

• A clinical history is taken
• Examination of skin and dermoscopy
• Biopsy

Prevention of malignant change

As with most medical problems prevention is important.

Burning of the skin is one of the biggest triggers for melanoma.

• Avoid excessive sun exposure ‘don’t bake don’t burn’
• Avoid sun beds
• Use factor 50 sun screen if you are in the sun – remember you can still burn in Britain so sun screen should be used in the summer if you are outdoors for any time

What is mole mapping?

Mole mapping is a technique whereby a person’s moles (naevi) are catalogued or ‘mapped’. The Moles are examined with a dermoscope which magnifies the features of the mole. The images created can then be used as part of a person’s skin cancer surveillance program.

In addition to dermoscopy it is important to take a history of any suspicious moles as this helps diagnosis in combination with the appearance of a mole.

Mole mapping is the standard annual examination in some countries, such as Australia and often expats enquire of mole mapping services. This screening service is not however available on the NHS.

At the ROC clinic we offer mole mapping with dermoscopic imaging which allows a more detailed image of the mole to be recorded and stored. This can be repeated annually to look for any changes. The advantages of this procedure are that changes can be seen in the mole before they are visible to the naked eye and earlier detection of melanoma may be possible.

Even if you have mole mapping performed it is still advisable to consult your doctor if you see any changes when self-checking between routine visits.

If there are any moles that are causing nuisance or concern these can be removed at the clinic. Do contact the clinic if you have any questions.

Remember