Skin Lesions and Moles

 

Skin Lesions and Moles

It can be unnerving to find something new growing on your skin. Fortunately, most skin growths are benign or non-cancerous. In fact, several types of skin lesions are very common, such as moles, skin tags, freckles, seborrheic keratoses, and benign lentigines. However, some growths can develop skin cancer. Moles are skin conditions that are most commonly evaluated for cancer.

Please keep reading to learn more about identifying concerning growths, telling the difference between typical and atypical moles, and looking out for changes in atypical moles that increase the risk of developing melanoma, a type of skin cancer.

Is a mole a skin lesion?

Yes, moles are a type of skin lesion. They are colored spots / brown or black growths on the skin. Moles come in different shapes and sizes. They can appear anywhere on the body. They can occur alone or in clusters. Normal moles usually appear during childhood, up to age 20. However, some moles can appear later in life. Most adults have 10-40 moles on their body. Moles are more likely to form on sun-exposed skin. Lighter-skinned people with a lot of sun exposure are more likely to develop these growths. Over time, some moles remain the same while others undergo changes in appearance. There can be changes in the mole's color, it can become raised, or hairs develop. Occasionally, a mole can disappear on its own.

What type of skin lesion is a mole?

The majority of moles are benign (non-cancerous) skin growths and are harmless. These are called benign moles or common moles. Most normal moles do not turn into cancer unless you have more than 50 of them on your skin.

Congenital nevi are moles that you are born with. They are also called congenital melanocytic nevi or CMN. Congenital nevi occur on normal skin and are a type of birthmark. They look like regular moles and are raised, round / oval patches of colored skin.

Moles can be concerning, however, if they look different from existing moles or develop after the age of 20. If you notice changes in preexisting moles in terms of color, size, shape, or height, it is important to have them checked out by a dermatologist (skin doctor). You should also see a doctor for any moles that itch, ooze, bleed, look scaly, or are painful or tender.

Why do moles develop?

Moles occur when cells called melanocytes in the skin grow in a cluster instead of being spaced apart. Melanocytes are the pigment producing cells that give you your natural skin color.

What's the difference between typical vs atypical moles?

As noted, the majority of moles are typical moles or benign moles. They are non-cancerous skin growths and are not harmful. They rarely develop into cancer, unless they number more than 50. Sometimes, such moles slowly disappear on their own.

Atypical moles, also called dysplastic nevi or atypical nevi, are less common. They occur in 2-18% of the global population. These are more common in some European populations and individuals with fair skin. The more atypical moles you have, the greater your risk of developing melanoma, one of the most deadly skin cancers. The presence of 10 or more atypical moles increases your risk of melanoma 14-fold.

Because of the increased risk of an atypical mole turning into melanoma, it is important to know which type of mole you have and what changes to watch out for. This can help with early diagnosis and treatment if it is skin cancer. Experts recommend doing monthly self-exams of your entire body, including the skin in less obvious parts like the scalp, soles, palms, between the toes, and under the fingernails. You should be especially vigilant for any new moles or a changing mole that looks different from other existing moles.

How do I know if a mole is skin cancer?

As mentioned, you should examine your skin thoroughly every month (ask someone to help or use a mirror). Pay special attention to sun exposed areas, such as the face including the ears, neck, arms, hands, and chest.

You do not need to be concerned if your moles do not change over time. However, if you notice changes in an existing mole or develop a new mole, you should see a dermatologist. You can also consult a dermatologist if you want a mole removed for cosmetic reasons.

Skin growths are considered suspicious if they show the following warning signs. These are called the ABCDEs of cancerous lesions. If a mole shows the following signs, get it checked out by a dermatologist without delay:

Asymmetry — One half of the mole is different from the other half.

Border — The mole has uneven edges or borders that are irregular, blurred, or ragged.

Color — The color varies or the growth has dark brown, black, tan, blue, white or red shades.

Diameter — The size of the mole is larger than a pencil eraser.

Elevation/Evolution — The mole appears raised or elevated from the skin or is changing (evolving) over time.

What do non cancerous (benign) moles look like?

Most moles are benign and do not change over time. A normal mole is a flat spot or bump and is a single color (tan, brown, pink, red, pink, blue, skin color, or clear). These types of moles are less than 5 mm or 1/4 inch in size (smaller than a pencil eraser). They have an even round shape and well-defined border.

An atypical mole displays slightly different characteristics. Many atypical moles are flat or raised and measure more than 5 mm or 1/4 inch in diameter (bigger than a pencil eraser). They have an uneven shape with irregular borders and contain a mix of colors, for example, dark brown centers with tan, black, pink, or white. The surface can be rough, scaly, or smooth. Atypical nevi can form anywhere on the body including the scalp and torso, but they are rare on the face. As noted, atypical moles have an increased risk of developing into cancer.

What does a developing melanoma look like?

Melanoma is a type of skin cancer that develops in melanocytes (pigment producing cells) in the skin. Although it is less common than non-melanoma skin cancers, it is the major cause of death from skin cancer. Early detection of melanoma is critical and can vastly increase the chances of a cure. The first sign of a developing melanoma is frequently a change in the appearance of an existing mole. You should look out for the ABCDE changes (listed above) and see a doctor if you notice these changes in a mole. Keep in mind that while some melanomas may show all the ABCDE features, others may only display one or two of these characteristics. More advanced melanomas can ooze or bleed or become itchy or painful.

What to do if I have moles?

You should examine your skin every month with a full-length mirror. Pay attention to sun exposed areas but also check less obvious parts of your body such as your scalp, backs of your arms, palms, soles, in between the fingers and toes, under the fingernails, back of the neck, behind the ears, and between the buttocks. Ask someone to help or use a mirror. If you notice different types of moles, keep a record of their appearance or take a photo.

If you notice any changes in certain moles or new moles, get them checked out by a dermatologist. If the dermatologist believes it looks suspicious, they might take a biopsy. If you are diagnosed with melanoma, your family members should get skin exams too, since it runs in families.

If you have atypical moles or a family history of skin cancer, see a dermatologist every 6-12 months for a thorough skin exam. Familial atypical mole melanoma syndrome is an inherited condition in which there are multiple atypical moles or dysplastic nevi. While these are benign, they are linked to an increased risk of developing melanoma.

How are moles treated?

Most moles do not need to be treated. However, benign moles may need to be removed if they are rubbing against clothing or appear unattractive. A dermatologist may also advise removal of certain moles that appear suspicious for cancer.

A mole can be usually be removed during an office visit by a dermatologist using surgical excision or surgical shave. The entire mole or part of it is removed with a surgical blade. The doctor may remove some surrounding skin as well. The specimen will be examined in the laboratory under a microscope for cancer cells. Your skin will heal after mole removal. If a mole grows back in the same area, see your doctor immediately. This could be a sign of cancer.

While it may seem convenient just to cut it off, you should never try to remove a mole at home. This can cause bleeding, infection, and scarring. Plus, if the mole contains cancer cells, some cancer might remain in the skin and could even spread.

What are some other types of benign skin growths?

Skin Tags

These are harmless, painless, non-cancerous skin growths that are extremely common. They consist of a small piece of skin connected by a thin stalk. Skin tags can occur anywhere on the body, but they are more common in areas with skin folds.

How are skin tags treated?

Small tags might fall off on their own. Most skin tags don’t need treatment unless they are bothersome or you want them removed for cosmetic reasons. Doctors can remove them by freezing (cryotherapy), surgical excision, electrosurgery (burning), or ligation (tying it off with a surgical thread). A small skin tag can usually be removed without anesthesia. Removal of more than one skin tag or larger skin tags might require local anesthesia.

Freckles

These are small brown spots that often appear in areas that get sun exposure. They occur due to overproduction of melanin skin pigment and are usually harmless.

Seborrheic Keratoses

A seborrheic keratosis is a type of non-cancerous skin growth that forms due to growth of skin cells called keratinocytes. It is more common in older individuals. Seborrheic keratoses are typically tan, brown, or black in color and appear waxy, scaly, and raised (warty appearance). You might want to get seborrheic keratoses removed if they cause symptoms like itching, are chronically irritated, or appear unattractive.

How are seborrheic keratoses treated?

A doctor can remove seborrheic keratoses with medical procedures like cryosurgery (freezing), electrocautery (burning), surgical excision, laser ablation, or applying bleaching agents like hydrogen peroxide (do not try this at home).

Finding a dermatologist for treatment of skin growths

The MeTime app makes it easy to connect with leading dermatologists in your area. You can chat with experts, share photos, do a video consultation, and get quotes. If you have a new mole you want to get checked out or an existing one that is changing, get in touch with a dermatologist without delay. Download the MeTime app today.

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