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Moles & Melanoma

Moles or melanocytic naevi are collections of melanocytes, the pigment producing cell in the skin. Almost everyone has moles, most develop in the first two/three decades of life and some are present at birth. Many moles disappear later on in life. Moles can be found anywhere on the skin, genitalia, palms and soles, eyes and scalp. The number of moles that one develops is usually a hereditary factor. Some unusual naevi such as the so called dysplastic moles tend to run in families. There are many different types of moles the majority of which are benign and easily recognisable during clinical examination. There are many less common, unusual looking moles which are benign but can cause diagnostic confusion both in the clinic and under the microscope.

Why a mole would need treatment?

  • The single most important reason to remove a mole is diagnostic uncertainty. The main concern of course if whether the lesion is actually a melanoma for which the mole will be checked under the microscope.
  • The second most common reason to remove a mole is when they become a nuisance by catching on clothings, hairbrush or razor whilst shaving.
  • And finally for cosmetic reasons.

What to look for?

  • An enlarging mole
  • Change in shape particularly getting an irregular edge
  • Change in colour
  • Getting darker, being multi shaded
  • Asymmetry
  • Itchy, painful or inflamed
  • Crusted or bleeding

What is the advice?

Make sure you are familiar with the normal appearance of your skin and any moles that you have.

This is very important if you are fair skinned, have many moles or a tendency to freckle or burn in the sun. Get your partner to look at areas of skin that you cannot easily see. If you think you have a mole that could be a melanoma, go to your GP. Not all melanomas will develop from a pre-existing mole.

In fact according to various studies, only 15-50% of histological samples of malignant melanoma show evidence of a pre-existing mole. The majority of melanomata develop as a melanoma. Multiple mole removal therefore is not recommended for prevention and by the same token UV protection is important for the entire exposed skin and not just for the moles.

Some sun smart advice from Cancer Research UK

  • Spend time in the shade between 11am and 3pm.
  • Wear a t-shirt, hat and sunglasses.
  • Use sunscreens with at least a sun protective factor (SPF) of 15. Of course the higher the SPF the better amount of UVB protection. For UVA protection we have star rating of up to five on UK sunscreens. The minimum recommended is 4 stars.
  • Look for a high SPF, total block, a silver circle with letters UVA inside is a European mark indicating good UVA protection.

Early detection of skin cancer delivers the best chances for survival. When melanoma is detected early the cure rate is over 95% because it can be removed before it starts spreading to any other parts of the body. The ability to detect significant changes in existing moles and of course a possible melanoma is critical in early detection process. The recommendation is that any routine cancer related check ups should include a skin examination by a Healthcare professional qualified to diagnose skin cancer, usually a Dermatologist or Dermatology Specialist Nurse.

Automated and computerised full body photography is rapidly developing, becoming the standard of care for record keeping particularly for patients with multiple moles.