Moles: When Should I Worry
I was recently diagnosed with a pre-melanoma on my leg.
It all started when I noticed a mole on my left leg had changed. My colleague removed a part of the mole and sent it off for tests. The results indicated that my mole was melanoma in situ, which means the malignant tumor was still confined to the upper layers of the skin and had not spread. A second excision was performed to remove the mole entirely, and theres no reason to believe that I wont be fine.
Had I not noticed the change in the mole, it may have become a malignant melanoma, and my situation could have been dramatically different.
Malignant melanoma, which starts out as a mole, is the most dangerous form of skin cancer, killing almost 10,000 people each year. The majority of melanomas are black or brown, but they can be almost any color skin-colored, pink, red, purple, blue or white. Melanomas are caused mainly by intense UV exposure.
If malignant melanoma is recognized and treated early, like in my case, it is almost always curable. However, if it has time to spread to other parts of the body, it becomes very difficult to treat and can lead to death.
Identifying Malignant Melanoma
The ABCDE Criteria can help you identify moles that could be malignant melanoma. Being aware of these criteria may very well save your life.
B = BorderBenign moles typically have a regular, round border. Cancerous moles tend to have irregular borders. If the border isnt smooth, you should get your mole checked out.
Melanoma On The Scalp
Melanoma that grows on the scalp can be a dangerous form of skin cancer, as its much harder to detect than melanoma that grows on an unobscured area of the skin. Whats more, this type of melanoma grows at a much faster rate since there are many more blood vessels and tissues to aid this process. Therefore, its beneficial to conduct regular scalp skin checkseven more so if you are bald or have thin hair.
Heres how to conduct a scalp skin check:
- Stand in a well-lit room with a handheld mirror.
- Part a section of your hair and use the mirror to examine your scalp.
- Look for moles, blemishes and red patches as you inspect your scalp, as these can be indications of melanoma.
- Continue parting your hair and examining your scalp until you have looked over your entire head.
While its helpful to have a friend or family member to assist you with the scalp skin check, this is something you can do on your own. If you see anything suspicious, make note of it and report it to your dermatologist right away.
Melanoma: What Can Cause A Mole To Change Besides Skin Cancer
Weve been alarmed by the media when it comes to changing moles to See your doctor immediately if you have a changing mole to rule out skin cancer.
The words changing mole can dredge up the deepest fear in many people: skin cancer.
Moles, just like the rest of our bodies, can change over time, says Adarsh Vijay Mudgil, MD, double board certified in dermatology and dermatopathology, and founder of Mudgil Dermatology in NY.
Subtle change over the course of years is not a melanoma, continues Dr. Mudgil.
Drastic change can indicate trouble, and any such lesion should be biopsied.
Melanoma
However, melanoma usually will not cause changes in a mole that you can detect from one day to the next.
Melanoma skin cancer kills about 9,000 Americans yearly. Skin cancer can also disfigure.
- So what can cause a mole to change besides skin cancer?
- If 1,000 people have a changing mole, nobody knows how many of those will be melanoma.
If you have a changing mole, you should immediately make an appointment with a dermatologist.
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Tips For Screening Moles For Cancer
Examine your skin on a regular basis. A common location for melanoma in men is on the back, and in women, the lower leg. But check your entire body for moles or suspicious spots once a month. Start at your head and work your way down. Check the “hidden” areas: between fingers and toes, the groin, soles of the feet, the backs of the knees. Check your scalp and neck for moles. Use a handheld mirror or ask a family member to help you look at these areas. Be especially suspicious of a new mole. Take a photo of moles and date it to help you monitor them for change. Pay special attention to moles if you’re a teen, pregnant, or going through menopause, times when your hormones may be surging.
How To Check Your Skin
- Make sure you check your entire body, as skin cancers can sometimes occur on parts of the body that are not exposed to the sun, such as the soles of the feet, between fingers and toes and under nails.
- Undress completely and make sure you have good light.
- Use a mirror to check hard to see spots, like your back and scalp, or get a family member, partner or friend to check for you.
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How To Treat A Bleeding Mole
If you have a mole thats bleeding because of a scratch or bump, apply a cotton ball with rubbing alcohol to sterilize the area and help stop the bleeding. You may also want to apply a bandage to cover the area. Make sure to avoid getting adhesive on the area of skin where your mole is.
Most moles dont require treatment, but moles that continue bleeding need to be examined by a dermatologist. They can determine whats going on and if youll need to have the mole biopsied.
Your dermatologist might recommend to remove the mole in an outpatient procedure at their office. There are two common ways they can do this:
- surgical excision, when the mole is cut off the skin with a scalpel
- shave excision, when the mole is shaved off the skin with a sharp razor
After the mole is removed, itll be analyzed to detect if any cancer cells are present.
Once a mole is removed, it usually doesnt come back. If the mole does grow back, speak to your healthcare provider immediately.
Complementary And Alternative Treatments
It’s common for people with cancer to seek out complementary or alternative treatments. When used alongside your conventional cancer treatment, some of these therapies can make you feel better and improve your quality of life. Others may not be so helpful and in some cases may be harmful.
It is important to tell all your healthcare professionals about any complementary medicines you are taking. Never stop taking your conventional treatment without consulting your doctor first.
All treatments can have side effects. These days, new treatments are available that can help to make many side effects much less severe than they were in the past.
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Melanomas That Could Be Mistaken For A Common Skin Problem
Melanoma that looks like a bruise
Melanoma can develop anywhere on the skin, including the bottom of the foot, where it can look like a bruise as shown here.
Melanoma that looks like a cyst
This reddish nodule looks a lot like a cyst, but testing proved that it was a melanoma.
Dark spot
In people of African descent, melanoma tends to develop on the palm, bottom of the foot, or under or around a nail.
Did you spot the asymmetry, uneven border, varied color, and diameter larger than that of a pencil eraser?
Dark line beneath a nail
Melanoma can develop under a fingernail or toenail, looking like a brown line as shown here.
While this line is thin, some are much thicker. The lines can also be much darker.
Melanoma: Changes Of Any Sort
Skin Cancer Foundation
The final photograph is of a melanoma tumor that is large and had gotten bigger over time. Any change in the size, shape, color, or appearance of a mole is an immediate red flag that melanoma may be involved.
The challenge, of course, is recognizing the changes. Unless you do a regular self-examination, you may not even notice a mole has changed unless it is bleeding or has caused a skin ulcer. This is especially true if you have lots of moles.
Another challenge is monitoring changes on parts of the body you can’t easily examine, such as the back. A friend or mirror can certainly help, but a better option may be to have a regular, full-body check-up with a dermatologist.
The Skin Cancer Foundation is among the organizations that endorse once-yearly skin exams.
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Can Changing My Diet Help Prevent Melanoma
The American Cancer Society advocates eating a plant-based diet over an animal-based diet as part of a healthy plan to avoid all cancers. Growing evidence suggests that plants pack a powerful punch in any fight against cancer because they’re nutritious, cholesterol-free and fiber-rich.
Theres no doubt that a healthy diet can protect your immune system. Having a strong immune system is important to help your body fight disease. Some research has shown that a Mediterranean diet is a healthy choice that may help prevent the development of cancer. Talk to your healthcare provider about the role food plays in lowering your cancer risks.
Some skin and immune-system healthy foods to consider include:
- Daily tea drinking: The polyphenols in tea help strengthen your immune system. Green tea contains more polyphenols than black tea.
- High vegetable consumption: Eating carrots, cruciferous and leafy vegetables is linked to the prevention of cutaneous melanoma.
- Weekly fish intake: Study participants who ate fish weekly seemed to avoid developing the disease when compared to those who did not eat fish weekly.
Types Of Skin Malignancies:
- Melanoma the least common form of skin cancer, but responsible for more deaths per year than squamous cell and basal cell skin cancers combined. Melanoma is also more likely to spread and may be harder to control.
- Nonmelanoma malignancies:
- Squamous cell cancer the second-most common skin cancer. It’s more aggressive and may require extensive surgery, depending on location and nerve involvement.
- Basal cell cancer the most common form of skin cancer. It is rarely fatal but can be locally aggressive.
These skin malignancies are typically caused by ultraviolet radiation from exposure to the sun and tanning beds.
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What Does A Common Mole Look Like
A common mole is usually smaller than about 5 millimeters wide . It is round or oval, has a smooth surface with a distinct edge, and is often dome-shaped. A common mole usually has an even color of pink, tan, or brown. People who have dark skin or hair tend to have darker moles than people with fair skin or blonde hair. Several photos of common moles are shown here, and more photos are available on the What Does a Mole Look Like? page.
Common Mole Photos
This common mole is 1 millimeter in diameter .
This common mole is 2 millimeters in diameter .
This common mole is about 5 millimeters in diameter .
This common mole is about 5 millimeters in diameter .
This common mole is about 5 millimeters in diameter .
What Is A Cancerous Mole
First things first: A mole-technically known as a nevus, or nevi for multiple moles-is a common growth that develops on your skin, either dating back to childhood, or later in life, according to the American Academy of Dermatology Association . These growths happen when your pigment cells, or melanocytes, grow in clusters creating an overgrowth on the skin, the National Cancer Institute says. Some moles may appear flat or raised, dark or light, and if you have lighter skin you could have anywhere between 10 and 40 moles on your body.
It’s important to remember that not all moles are or will turn cancerous. “When we talk about moles there are congenital moles-like birth marks-moles that are completely benign, and then there are moles with some atypic, meaning under the microscope we see atypical or odd-looking cells,”, MD, a dermatologic surgeon based in New York City, tells Health.
Congenital moles are usually small, have a round smooth surface, and are dome-shaped, according to the NCI. They’re also usually pink or brown, with the color generally coordinating to your complexion tones-lighter moles on those with fair skin and hair color, and darker moles on those people with darker skin and hair. Dysplastic nevi, or atypical moles, may be larger than common moles, with different characteristics in shape, color, and texture, according to the NCI. Many atypical moles are flat instead of round, and have an irregular border.
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Other Signs Of Skin Cancer
While moles can become cancerous, they arent the only way melanoma can creep in. Melanoma can also develop in places where there isnt a preexisting mole, Dr. Gastman says.
Melanoma can resemble a sore or a spot, a birthmark, a pimple or even a bruise. Melanoma can also show up as a dark line under a fingernail or toenail.
If you notice possible warning signs of melanoma whether in a mole or anywhere else get it checked out by a doctor. The earlier you catch melanoma, the easier it is to treat.
Can A Dysplastic Nevus Turn Into Melanoma
Yes, but most dysplastic nevi do not turn into melanoma . Most remain stable over time. Researchers estimate that the chance of melanoma is about ten times greater for someone with more than five dysplastic nevi than for someone who has none, and the more dysplastic nevi a person has, the greater the chance of developing melanoma .
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Possible Signs And Symptoms Of Melanoma
The most important warning sign of melanoma is a new spot on the skin or a spot that is changing in size, shape, or color.
Another important sign is a spot that looks different from all of the other spots on your skin .
If you have one of these warning signs, have your skin checked by a doctor.
The ABCDE rule is another guide to the usual signs of melanoma. Be on the lookout and tell your doctor about spots that have any of the following features:
- A is for Asymmetry: One half of a mole or birthmark does not match the other.
- B is for Border:The edges are irregular, ragged, notched, or blurred.
- C is for Color:The color is not the same all over and may include different shades of brown or black, or sometimes with patches of pink, red, white, or blue.
- D is for Diameter:The spot is larger than 6 millimeters across , although melanomas can sometimes be smaller than this.
- E is for Evolving: The mole is changing in size, shape, or color.
Some melanomas dont fit these rules. Its important to tell your doctor about any changes or new spots on the skin, or growths that look different from the rest of your moles.
Other warning signs are:
- A sore that doesnt heal
- Spread of pigment from the border of a spot into surrounding skin
- Redness or a new swelling beyond the border of the mole
- Change in sensation, such as itchiness, tenderness, or pain
- Change in the surface of a mole scaliness, oozing, bleeding, or the appearance of a lump or bump
More Causes That Arent Skin Cancer
Body position. Some moles, due to location, require some body contortion to get the best view. Or do they? Be aware of body contortions.
Shutterstock/Albina Glisic
One day a mole on my back appeared to be smaller and rounder: changing.
It took a few days for me to figure out that it became smaller and rounder when both shoulders were relaxed.
Historically, I had viewed it with one shoulder jutted up and forward, my back slightly twisted.
The mole is on my back and thus, I somewhat contorted myself, while sitting on the sink, to get the best, head-on view.
But this twisting and uneven shoulders stretched the skin, thereby expanding the mole and lessening its naturally round shape. I was used to seeing it this way.
So on the day I just happened to view it with a straight back and no jutting shoulder, it was actually its normal shape.
But because I wasnt used to viewing it this way, I thought the mole was changing.
Always use the same body position when examining in hard-to-view locations.
Hair. I noticed that the top of a mole on my back was white, but not the same kind of white as mentioned prior. I had never noticed this before.
After a number of examinations at different angles, I discovered that the white was actually the bright light glinting off a hair just above the mole! I then began spotting other white hairs nearby.
If I angled my back a certain way, the white part morphed into a full-fledged hair.
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Biological Therapies And Melanoma
Biological therapies are treatments using substances made naturally by the body. Some of these treatments are called immunotherapy because they help the immune system fight the cancer, or they occur naturally as part of the immune system.
There are many biological therapies being researched and trialled, which in the future may help treat people with melanoma. They include monoclonal antibodies and vaccine therapy.
The Abcde Rule Of Melanoma
National Cancer Institute
When checking for early signs of melanoma, it’s helpful to use the ABCDE rule. The ABCDE abbreviation stands for:
- Asymmetry: An irregular shape
- Border: Ragged, notched, or blurred edges
- Color: Different colors or shades within the mole
- Diameter: Diameters over 6 millimeters
- Evolving: Changes in size, shape, color, or appearance
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Examine Moles For Cancer
The majority of moles are harmless. They are a typical sort of skin development that often appear as little, dim earthy colored spots and are caused by clusters of pigmented cells. Moles are normally showing up during childhood and adolescence. Ten to forty moles are the average range that people can get. Some of which may change in appearance or blur away over time.
However, moles can become cancerous. Observing moles and other pigmented patches is a significant step in recognizing skin cancer, particularly malignant melanoma. Malignant melanoma, also known as melanoma, is a form of skin cancer that starts in the cells known as melanocytes. Melanoma looks like a mole however, its changes in shape and color. Moreover, the following symptoms can be a warning sign to you and help you to determine a normal mole from an unusual one.