MOLES

Also known as melanocytic naevi Moles are normal overgrowths of pigment-producing cells called melanocytes. Almost all of us have moles. They are not normally present at birth but appear in childhood and early teenage years.

Causes

The number of moles that develop in an individual is predominately determined by genetic (inherited) factors and to a lesser extent by sunlight exposure. Childhood and early teenage years are the times when sunlight influences the development of new moles most strongly.

Clinical presentation

Moles are generally medium to dark brown in colour, though they range from skin coloured or pink to black. The majority of moles are flat, relatively even in colour and regular in shape.  Some moles are raised and these are usually soft to touch and lighter in colour.

Moles need to be distinguished from freckles that occur on the faces of red-headed and fair-skinned children or on the shoulders following sunburns. Moles can appear anywhere including palms and soles, nails, genitals, scalp and eyes.

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Symptoms

The typical mole is a brown spot. But moles come in different colors, shapes and sizes:

  • Color and texture. Moles can be brown, tan, black, red, blue or pink. They can be smooth, wrinkled, flat or raised. They may have hair growing from them.
  • Shape. Most moles are oval or round.
  • Size. Moles are usually less than 1/4 inch (about 6 millimeters) in diameter — the size of a pencil eraser. Rarely, moles present at birth (congenital nevi) can be much bigger, covering wide areas of the face, torso or a limb.

Moles can develop anywhere on your body, including your scalp, armpits, under your nails, and between your fingers and toes. Most people have 10 to 40 moles. Many of these develop by age 50. Moles may change in appearance or fade away over time. Hormonal changes of adolescence and pregnancy may cause moles to become darker and larger.

Precautions to be taken

If you have a large number of moles or multiple dysplastic moles, you may need to have regular skin checks. Your doctor may photograph your skin so that changes in your moles can be detected at follow-up visits.  Since many melanomas arise as new spots (on normal skin), it is necessary to observe all of the skin, not only the moles. You should self-examine your skin at least every 3 to 4 months for moles that are new, growing or changing and report any significant changes to your doctor or dermatologist. It is important to avoid excessive sun exposure and protect your skin from the sun by wearing tightly woven longer sleeved clothing, broad brimmed hats and sunglasses and applying sunscreens regularly.

Take measures to protect your skin from ultraviolet (UV) radiation, such as from the sun or tanning beds. UV radiation has been linked to increased melanoma risk. And children who haven't been protected from sun exposure tend to develop more moles.

  • Avoid peak sun times. For many people in North America, the sun's rays are strongest between 10 a.m. and 4 p.m. Schedule outdoor activities for other times of the day, even on cloudy days or in winter.
  • Use sunscreen year-round.  Apply sunscreen about 30 minutes before going outdoors, even on cloudy days. Use a broad-spectrum sunscreen with an SPF of at least 15. Apply it generously and reapply every two hours — or more often if you're swimming or sweating. using a broad-spectrum, water-resistant sunscreen with an SPF of at least 30.
  • Cover up. Sunglasses, broad-brimmed hats, long sleeves and other protective clothing can help you avoid damaging UV rays. You might also want to consider clothing that's made with fabric specially treated to block UV radiation.

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