According to the American Association of Dermatology moles are very normal physical traits, and most adults will have one or more on their body with numbers closer to 20-40 not unusual. These moles develop as a child ages with the possibility of new moles developing until midlife. However, the vast majority of people will not develop new normal or typical moles after the age of 20. There are also moles that are present at birth, known as congenital moles, that may be normal or atypical but that do increase the risk of possible later melanoma if they are very large in size.1
What Causes Moles?
Moles occur because of increased pigmentation of the skin. This is typically caused by increased production of melanocytes, the pigment producing cells of the skin, which develop in clusters. This change is caused by sun exposure or skin burning or blistering as well as genetic factors. Since these moles develop after birth they are often known as acquired moles and usually occur on the back, shoulders, chest, arms and legs, the areas most often exposed to the sun. For most people the more the melanocytes are exposed to the sun the darker the mole becomes. Generally as people age the moles fade slightly, with some actually seeming to disappear with time.2
What A Normal Mole Looks Like
Normal moles have common general characteristics just as atypical moles also have generalized features. Understanding what a normal mole looks like compared to an atypical mole is essential in helping to determine if there is a possibility of melanoma or skin cancer.
Normal moles can occur anywhere on the body. People with lighter skin, eye and hair colors often have more moles, both normal and atypical, than individuals with darker skin, eye and hair colors. Depending on the skin coloration the moles may be darker or lighter in color. Lighter skin tones tend to have lighter colored moles which may be just slightly darker than flesh color through to tan or light brown. Darker skin tones usually have darker pigmentation in the mole that results in a dark brown to black coloration of the mole itself.3
Moles, both normal and atypical, can be located as a single mole or they can be grouped together. Most moles will not overlap each other and overlapping moles may be problematic as they may actually be asymmetrical moles, not separate areas of pigmentation.
Symmetry and Shape
Normal moles have symmetry or are equal in shape and size when divided down an imaginary center line. This is because they are circular or oval in shape. Circular moles have multiple lines of symmetry, just as equal pieces of pie are made by simply cutting with straight lines through a center point. Oval moles will have fewer lines of symmetry but when divided equally through the center point either vertically or horizontally they will match. It is not important to have complete symmetry but the sides should be very close to each other. The biggest concern is obvious asymmetry where one side is very different than the other.
Color
As mentioned above there are a variety of different colors of moles based on the melanocytes and pigment production in the skin. However, a normal mole has a consistent color from the border or edge of the mole through the center. Atypical moles may have a blotchy or spotty appearance or may have a gray, orange or yellowish color which is not considered to be normal. Moles may also have hairs growing within the mole itself; this is not abnormal and is not an indication of any complication or possible increased risk for skin cancer.
Borders
The borders or edges of the normal mole are very clearly defined. It is as if a pencil where used to draw the edge with a clear distinction between the mole and the surrounding skin coloration. In addition the border is very smooth and regular in shape, typically round or oval. Borders of the mole that are blended, fuzzy or blurry or seem to spread gradually into the surrounding skin are not considered to be typical or normal. In addition borders that are scalloped, notched or ragged or jagged in appearance are also considered to be atypical.
Texture
A normal mole can be raised off the skin surface slightly and may also be somewhat rounded in shape from the edges to the center. Even if the change is from a flat mole to a bump or rounded shape the mole is uniform in the surface texture that is smooth and feels similar to the surrounding skin. Moles that have very rough surfaces, cauliflower types of surfaces or that feel different than the surrounding skin are not normal.
Often abnormal moles are characterized as feeling scaly or almost like very coarse sandpaper. Smaller moles may not provide enough surface area to actually feel but you will notice that they look pebbly when closely examined under bright direct light.4
Changes Are The Key
The most important factor to keep in mind is that any mole, including a normal mole, can start to change or evolve over time. Any changes in a normal mole or an atypical mole can be symptoms of skin cancer or melanoma, but this is not always the case. Early examination by a dermatologist can help determine if the change is cancerous and also greatly increase the chance of removing the cancer before there are any further complications.5
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 Moles: Causes. (n.d.). Retrieved from Mayo Clinic: www.mayoclinic.com/health/moles/DS00121/DSECTION=causes
3 Skin Cancer – Risk Factors. (n.d). Retrieved from Mayo Clinic: www.mayoclinic.com/health/skin-cancer/DS00190/DSECTION=risk-factors
4 Pictures of Ordinary Moles and Dysplastic Nevi. (n.d.). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/wyntk/moles-and-dysplastic-nevi/page8
5 Skin Cancer Prevention and Early Detection. (n.d.). Retrieved from American Cancer Society: www.cancer.org/Cancer/SkinCancer-Melanoma/MoreInformation/SkinCancerPreventionandEarlyDetection/skin-cancer-prevention-and-early-detection-skin-exams
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