Moles : Causes & Treatment

When thinking about moles, we are immediately reminded about all the celebrities whose moles were just as famous, made headlines and also made some of their careers,—think Cindy Crawford and Marilyn Monroe. These famous women and their moles had many other women pencilling in fake moles while the rest of us felt naturally blessed and flaunted our facial moles as beauty spots.

Although we have been warned about taking utmost care of our skin in order to prevent any sort of skin ailments, what we tend to forget is paying special attention to moles. So how does one differentiate or know what to look for? What are the indications that a mole may turn cancerous, and how to figure out if a mole is just benign?

While checking for moles may not be the most glamorous way to spend your time, it is crucial to determine your skin’s well being and overall health.   Learn more about moles and whether you should be concerned or not in this blog.

What’s a mole?

In medical terms moles are known as ‘nevus’ or ‘nevi’. Moles, especially singular ones on the face have been known as ‘beauty marks’ or ‘beauty spots’ and have been going in and out of fashion for hundreds of years. But not anymore! Nowadays, an increasing number of people want their moles removed. A survey in the UK showed that the number of people wanting their moles removed had increased by a whopping 127%.

Most moles typically show up in the initial 30 years of life. The average person has anywhere between 10 to 40 moles on their body. They are less than 1/4 inch in diameter and can appear anywhere on your body, alone or in groups. Common areas where moles appear include the face, hands, ears, eyelids, lips, palms, scalp, soles, genitals and anal areas. Most moles range in colour to match your normal skin tone—from light brown to black. As the years pass, moles can either become raised or change their colour.

Why do moles occur?

Our genetic makeup is the primary reason for the appearance of moles. This along with the amount of sun exposure, especially during childhood and teenage years, are the main reason for moles. It has been noticed that moles are more common and prominent, in light-skinned people. It can appear and disappear due to hormonal changes, as well as during pregnancy and at the onset of puberty.  There is also a high chance that their numbers are probably going to diminish in old age.

Is there more than one kind of a mole?

The most common type of moles are:

• Common nevi: A normal mole that is pink, brown or black with a distinct edge.
• Congenital nevi: These are the moles that you are born with. However, their occurrence takes place in about one in 100 people. These moles have an increased chance of developing into melanoma (skin cancer), than moles which appear after birth. In case this kind of mole expands to more than 8 millimetres in diameter, it is more predisposed to turning cancerous.
• Dysplastic nevi: These moles are generally larger in size and are irregularly shaped. They usually have brown centres and turn lighter towards the edges. They are usually hereditary and people with this kind of mole have a greater chance of developing skin cancer. If you notice any visible changes in this type of mole, then it must immediately be shown to a dermatologist.

Moles versus skin-tags: What’s the difference?

While most moles are benign, if they start to grow larger or change in colour, it is important to mention it right away to your doctor. If it does prove to be cancerous, they will perform a surgery and remove it safely.

Skin tags are entirely benign, and often occur at the age of 50. The most commonplace area they grow in is the folds of skin, on the creases of your groin or in the armpit region. Sometimes, pregnant women can also develop skin tags owing to hormonal changes. Over time, they become hyperpigmented and are held together in place by a thin stalk known medically as a peduncle.

Are all moles cancerous?

No. Most moles are benign and do not cause cancer. Yet, sometimes, moles become malignant. This implies they are cancerous and should be removed immediately. It is important to watch out for all kinds of moles.

 How do I determine if a mole is problematic or not?

The size and the number of moles are indications that your mole might be problematic. If a mole is bigger than an inch or if you have more than 50 moles, it is best to do a monthly self-examination and a yearly full-body moles examination by a dermatologist.

The ABCDE rule is a good method to check for any moles that may become dangerous. Look out for:

A – Asymmetry: The shape of one half of the mole does not match or correspond with the other half

B – Border: If the border is irregular; edges are blurry or ragged

C – Colour: An uneven colour. There are varying colours within a single mole that can range from black, brown, white, red, pink, grey or blue

D – Diameter: There is a visible increase in the size of the mole

E – Evolving: The mole has undergone a change over the past few weeks and does not resemble your other moles

 What are the popular solutions for mole removal?

Mole removal is a clinical procedure and should be performed after consultation with an experienced dermatologist. Home removal remedies for mole removal should be avoided as there is a high-risk of infection that can hinder the healing process and also result in scarring of the skin.

Post-consultation, a dermatologist might suggest either a surgical or non-surgical procedure. Size, type and location of the mole are some major factors to be considered while making this decision.

Non-surgical mole removal procedures

• Cryotherapy, or “cryosurgery,” is a non-invasive procedure that uses liquid nitrogen to freeze and eradicate growths on the surface of the skin. This procedure targets the damaged skin cells at the cellular level and completely destroys them. Once frozen, the mole blisters and scabs over and the wound heals in three to six weeks. This simple procedure treats a wide range of moles. Other than being a completely non-invasive procedure, some of its other benefits are low recovery time and low risk of infection.
• Radiofrequency is the most common mole removal procedure. Your dermatologist will use a device called the Ellman Radiosurgery electrode loop to perform a layer-by-layer removal of the mole while cauterising the skin. The wound from the procedure will blister and scabs will form within 7-10 days. Some of its benefits are: reduced scarring, minimized downtime and low discomfort.
• Laser mole removal is an effective and aesthetically appealing alternative for mole or skin-tag removal, rather than the cut and stitch method (surgical). High bursts of light and thermal energy are passed through the skin to break down the pigment of those cells. The very first sitting helps in flattening the mole, while future treatments are required to fully eliminate the pigment. Once the laser has been applied to the desired area, the healing process will commence. During the first week, you will experience some scabbing, which will shed naturally over time. However, the scab will return during your consecutive treatments and shed naturally as it did during the first session. Removing your mole with laser will require at least 2 to 4 sessions with evident results from the very first session.

 Surgical removal of moles

For cases, where a mole is located in a critical area such as close to the eye or on the neck, a surgical procedure is recommended. This is also true for deep-rooted moles. The surgery is usually a basic outpatient procedure, generally done in a single sitting, under general anaesthesia. Depending on the size and nature of your mole, you may require a second setting. Surgical removal of moles is done via one of the following two methods.

• Shave excision, where the dermatologist will use a thin surgical blade to first shave away the mole followed by electrosurgical feathering with a dermal loop electrode. Stitches are not needed in this procedure.
• Surgical excision, which is more like traditional surgery, will involve the dermatologist cutting out the entire mole, right down to the subcutaneous fat layer. This will be followed by stitches to close the incision.

The recovery time and cost depends upon the size, type and location of the mole.

Can moles be avoided?

Here are some tips:

• Avoid the sun during peak hours
• Wear sunscreen daily with at least SPF 30 or higher
• Wear sun-protective clothing and accessories when you go out in the sun
• Get your skin examined yearly
• Avoid tanning lamps and beds

Discuss your ‘mole’ concerns with your dermatologist

Examining your moles increases the early detection and treatment of melanoma and other kinds of skin cancer. Dermatologists recommend that you examine any changes to your skin at least once a month. With skin cancer being the most common form of cancer, it is important to protect yourself against it with routine checking. And in case you notice any visible changes, schedule an appointment with a dermatologist immediately.