Moles, the smaller sized, oval or round uniformly dark spots on the body are not cause for alarm. It is estimated that 1 in 100 babies are born with moles and that people with lighter or fairer skin are more likely to have moles. Numbers of moles can range from 10 to 40 or more depending on the skin coloration and other inherited factors. It is also common for moles to develop as a child grows and to have changes in the color and number of moles as the child reaches adolescence and adulthood.1
Most people that have moles do not develop skin cancers or melanomas. Moles can be flatter or raised and can fade or become darker in a uniform way over time. Any changes in the shape, size, surface, color or number of moles on the body is often an early sign of changes in the cells in the tissue that can be an indication of skin cancer or melanoma. For this reason early detection of any changes in any aspect of moles on the body is essential for medical interventions and immediate treatment.
Checking your moles starts with carefully monitoring the ABCD and sometimes the E of the mole itself. Each mole has to be checked individually on a regular basis that is typically between one and three months.2 Body maps are a simple way to complete a routine self-exam with accuracy for early detection of the changes. Recording the ABCD and E of the mole and noting any changes is essential in early detection and treatment of skin cancers and melanoma.
Moles that display irregularities in the categories listed below are known as dysplastic nevi or atypical moles. These are the most problematic and most likely to become cancerous in the future.3
Asymmetry (A)
The A in ABCD and E of moles stands for asymmetry. A normal mole is round or oval in shape and, if a line is drawn through the center, will be symmetrical on each side. Moles that are asymmetrical or different on each side of an imaginary center line are much more likely have the potential to become melanoma or skin cancer.
Drawing the outline of the asymmetrical mole or taking a picture or digital image is a simple way to record the shape of the mole and note any changes.
Border (B)
A defined, smooth line type of border is a normal feature of a mole. Moles that have irregular, fuzzy, notched or scalloped types of edges are typically dysplastic nevi. In addition the border may seem to fade away into the skin in a splotchy type of pattern rather than have a clearly defined edge.
Color (C)
It is very normal for moles to fade or darken over time and, as long as the color change is universal over the mole, there is rarely a problem. Many people find that moles fade as they age and children’s moles may become darker as they approach adolescence.4 Color changes within the mole are a concern. Colors that change in the mole from light to dark, tan to chocolate or different shades of brown or blacks are indications of atypical moles. Some moles may also have a variety of colors such as reds, oranges, a blue coloration or even white patches.
Diameter (D)
The diameter or size around of the mole can be an indication of a potential risk for skin cancer or melanoma to develop. Most typical moles are less than ¼ inch or 5 millimeters across with atypical moles being much larger. Size alone is not always an a defining factor but if the mole appears to be increasing in size a dermatologist should be consulted as soon as possible. Photographing moles or recording specific measurements is important in determining just how much the mole has increased in size at each self-examination.
Evolution (E)
Evolving is a term used by the American Academy of Dermatology to designate any mole that is changing in any of the categories listed above. Evolving can also include a change in the number of moles noted on the body, often noted in clusters on the legs, chest or back. Raised skin on the mole, cracking of the skin’s surface on the mole or any flaking or scaling is also a concern.
Moles that suddenly become problematic should be checked out immediately by a dermatologist or your family doctor. This includes moles that start to itch, bleed or become painful or highly irritated by touch. Moles that are located along the waistband or other areas where tight clothing is in contact with the skin often exhibit these symptoms.
Checking your body routinely with a self-examination body map is important to determine if any changes are occurring with the moles on your body. If any changes are noted be sure to provide as much information as possible to your dermatologist or family physician. Bumps under the skin, even without discoloration at the skin’s surface should also be carefully recorded and monitored for any changes. Pain in these atypical lumps or bumps is not normal and should be immediately checked by your physician.
Family doctors are not always experts on moles and dysplastic nevi. If you have any concerns it is important to ask for a referral to a dermatologist as quickly as possible and avoid any delay.
References
1 Moles (n.d.). Retrieved from American Academy of Dermatology: www.aad.org/skin-conditions/dermatology-a-to-z/moles
2 About Skin Self-Exams. (2011). Retrieved from American Academy of Dermatology: www.aad.org/skin-conditions/skin-cancer-detection/about-skin-self-exams
3 What You Need To Know About Moles And Dysplastic Nevi (1999, June 30). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/wyntk/moles-and-dysplastic-nevi/page8
4 Moles (2009, December 5). Retrieved from Mayo Clinic: www.mayoclinic.com/health/moles/DS00121/DSECTION=symptoms5 How To Examine Your Skin. Retrieved July 30, 2011, from American Academy of Dermatology: www.aad.org/skin-conditions/skin-cancer-detection/about-skin-self-exams
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