Moles are small to large areas of the skin that have a different pigmentation than the surrounding skin area. The coloration of the mole can vary from a light tan to flesh color through to very dark brown or almost black colorations. Moles may be raised significantly above the surface or they can be level with the surface of the skin. Moles are produced by excessive pigment in one area of the skin, which is a result of increased melanocyte activity that is triggered by sun exposure.1
The National Cancer Institute reports that most people have between 10 and 40 moles on their body that may change in intensity, size and shape over the course of the person’s life. Typically moles are round or oval in shape and typically are smaller than 5 mm in size, which is roughly equivalent to the size of the eraser end of a pencil. Moles may develop into adolescence and up to the age of 40, however new mole development after the age of 20 can be problematic.2 They may also fade over time as the individual ages and they can also decrease in size.
The Relationship Between Moles and Skin Cancer
Although many people associate moles with melanoma and other forms of skin cancer, the presence of moles alone is not the most important indicator. The most important factors are actually the shape, size and color of the mole and if it is changing over time. Moles that are considered to be typical should be monitored through regular self skin examination.
Moles that are atypical are called dysplastic nevi. An atypical mole is large, irregular in shape, has borders that are not clearly defined, varies in color and is not symmetrical from a center line. This grouping of factors, often referred to simply as the ABCD of moles, can more accurately predict the possibility of melanoma and skin cancer development.
Risk Factors and Moles
Atypical moles, especially if more than four are found on the body, are more likely to pose a risk of developing skin cancer. In addition there are other risk factors that may be associated with a condition known as FAMMM or Familial Atypical Multiple Mole Melanoma. While FAMMM is related to a greater risk of skin cancers and melanomas in families there is also research that shows it may also be linked to higher rates of non-melanoma types of systemic cancers.3
The common identifiers of FAMMM include:
- Atypical moles on the body
- More than 50 moles on the body
- Family history of first degree relatives with melanoma
First degree relatives are those that are immediately related including children, siblings or parents.
Other risk factors for developing moles and dysplastic nevi throughout your life can include:
- Excessive burning or tanning of the skin
- Use of artificial light for tanning, particularly in tanning beds
- Family history of any type of skin cancer
- Weakened immune system because of autoimmune diseases or other health conditions
- Skin coloration that is very fair or a skin that burns easily
- Exposure to ultraviolet radiation
- The presence of large numbers of freckles
Factors that include genetics and family history of skin cancers and melanomas cannot be controlled, but individuals with these risk factors can be diligent in completing skin self-exams and working with body maps to accurately record all moles and any changes that they note.4 Early detection of changes in moles based on the ABCD information will allow the best opportunity for treatment to prevent any spread of the melanoma.
Basal and squamous types of skin cancers, which are not as aggressive as melanoma, can be very effectively managed with early intervention. It is important to keep in mind that not all moles or skin irregularities are cancerous and most people with moles, even atypical moles, do not develop skin cancer or melanoma.
Education and Knowing Your Skin
People that have any of the risk factors for FAMMM, atypical mole syndrome or skin cancers, which includes anyone with existing moles, should be completing regular skin exams and should keep accurate documentation of their existing moles. This simple examination can be completed in just a few minutes and parents can examine children as well as teaching the kids the procedure.
Education about the risk factors of skin cancer and the importance of avoiding excessive ultraviolet light exposure through outdoor tanning or artificial light source tanning is also essential. Kids and adults alike should practice skin safety in applying a good quality high SPF sun screen and wearing appropriate clothing when sun exposure is possible.5
Talking to your doctor is also an important factor in learning about moles and skin cancer. If you have any risk factors for skin cancer it is important to be proactive about requesting a skin exam and discussing any concerns you may have with moles, freckles or irregular patches on your skin. This request is particular important as most doctors do not routinely include skin exams in a year check up unless the patient has a history of melanoma.6
Patients with atypical moles, a family history or personal history of skin cancer and melanoma or patients with other types of cancer plus skin concerns should also consult with a dermatologist. These specialist doctors can often detect minor changes to moles that may go unnoticed by family doctors that are as experienced in early detection of melanoma and skin cancers.
References
1 Moles: Who gets and types. (n.d.). Retrieved from American Academy of Dermatology: www.aad.org/skin-conditions/dermatology-a-to-z/moles/who-gets-types
2 WhatYou Need To Know About Moles and Dysplastic Nevi. (2002, September 16). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/wyntk/moles-and-dysplastic-nevi/page2
3 Bergman, W et al. (1990). Systemic cancer and the FAMMM syndrome. British Journal of Cancer 61 (6) , 932-936.
4 Melanoma Monday Mole Map. (n.d.). Retrieved from American Academy Of Dermatology: www.melanomamonday.org/documents/08_96%20Melanoma%20Monday%20Mole%20Map.pdf
5 Prevention of Melanoma. (n.d.). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/wyntk/moles-and-dysplastic-nevi/page5
6 Mona Saraiya, M. M. (2004). Skin cancer screening among U.S. adults from 1992, 1998, and 2000 National Health Interview Surveys. Preventative Medicine, Volume 39, Issue 2 , 308-314.
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