Do your skin moles need checking by a doctor?

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Most skin moles are harmless — but a minority are not, which is why ‘mole awareness’ is so important. Our doctor’s guide has what you need to know

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Most people have moles and, most of the time, they’re nothing to worry about.

But if you or someone in your family has moles, it’s important to become ‘mole aware’ because, in rare cases, they can develop into a serious form of skin cancer called malignant melanoma.

Mole awareness simply means knowing where on the body your moles are and checking them regularly for changes in size, colour and shape.

What are skin moles?

The good news is, most moles are round or oval shaped, coloured, benign (non-cancerous) tumours on the skin. They can be flat or raised, rough or smooth and even hairy.

Moles are not usually present in babies and often begin to appear in children and young adults.

Although most moles are harmless, some people have them removed for cosmetic reasons by laser treatment, mole ‘shaving’ or excision.

Why is checking your moles so important?

‘Melanoma develops in cells called melanocytes which produce melanin — the pigment that gives the skin its colour,’ says Dr Vasiliki Vanky, Livi doctor.

‘This happens when something goes wrong in the melanocytes and they start to grow out of control. It can occur on all parts of the skin — even on nails and eyes — but usually on areas that are exposed to the sun like the legs, trunk and head.’

In fact, melanomas are most commonly found on the back in men and the legs in women. They’re rarely found in areas that are protected from sun exposure, like the scalp and buttocks.

Melanoma is one of the fastest rising forms of cancer. Melanoma of the skin (and eye) reaches 90,000 new cases annually in Europe and kills around 20,000 people each year.

But early diagnosis and better treatment mean that someone diagnosed with skin cancer has a positive chance of surviving it. The five-year survival rate in Europe is above 86%, and more women than men survive the disease.

How is skin cancer (malignant melanoma) treated?

‘The main treatment for most melanoma is surgery, called wide excision,’ says Dr Vanky. This is where the skin cancer is removed. ‘Sometimes melanoma can be treated with immunotherapy which stimulates a person’s own immune system to recognise and destroy cancer cells. Other types of treatment are chemotherapy and radiation.’

Who is at risk of developing skin cancerous moles?

‘Your risk of developing melanoma depends on several factors,’ Dr Vanky explains. These include:

  • Your lifetime exposure to UV radiation, not only from the sun, but also from tanning beds and a history of sunburn
  • Having fair skin and blonde or red hair
  • A family member that has had skin cancer
  • Having many moles (see below) or unusual moles
  • A weakened immune system

What’s the risk in people with darker skin?

People with darker skin can also get skin cancer but have more natural protection against it, as they have more melanin in their skin. However, this can mean that people of colour can often miss vital signs of melanoma and then present as a patient when the disease is more advanced.

In African or Asian people, the cancer is often a type of melanoma called acral lentiginous melanoma, which develops on the soles of the feet, the palms of the hands or under the nail.

How can I know which mole changes to report?

Early diagnosis of skin cancer is critical. Report any new mole that arises on your skin, a sore or spot that does not heal, any existing mole that starts changing or any spot, mole or lesion that looks unusual to a GP.

An easy guide is to think of the ABCDE of features that can help you spot if a mole is becoming cancerous:

A. Asymmetry: A healthy mole is usually round because it grows evenly. See your doctor if your mole has an irregular edge or is growing unevenly.

B. Border: Normal healthy moles tend to be round, with smooth, clearly defined borders. Melanomas often have ragged or blurred edges.

C. Colour: Normal moles are usually one colour. But melanomas are often uneven in colour and can have two or three shades of brown or black, or shades of red and pink. Be especially aware of any moles that are darkening, as this can also be a possible sign that it’s becoming cancerous.

D. Diameter: Melanomas are usually larger than 6mm (approximately the width of a pencil). But this is not a sure sign of malignant melanomas, as a perfectly healthy mole can be larger while a cancerous mole can be smaller.

E. Elevation or enlargement: A melanoma will often change in size, shape and colour over time and may become raised above the skin’s surface. Inflammation or swelling is another sign that it could be cancerous. Often, the original mole remains the same size but the area around or under it appears to spread or swell.

Any other signs to watch for?

Any new mole changes like bleeding, crusting or itching may also be caused by melanoma, so report these immediately.

Another sign to look out for is the ‘ugly duckling’ mole, which simply looks different to other moles on your body. One study showed that skin cancer is 4 to 10 times higher in people with unusually shaped or large moles. The risk is nearly 7 times higher in people with more than 100 common moles compared with people with fewer than 15.

Scientists also think that around 10% of melanomas — at any age — may be linked to an inherited gene called CDKN2A.

What about skin cancer and children?

Malignant melanoma is incredibly rare in children and the majority of cases are related to damage caused by UV light on children with white skin.

In children under 11, there are further signs to look out for as the melanoma is more likely to be red in colour, there may be bleeding or bumps, the colour is often uniform and it could be any size.

This article has been medically approved by Dr Vasiliki Vanky, Livi medical doctor

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