MOLES: Should I worry?

A “Mole” is a catch all word for discrete skin lesions which are pigmented in various shades of brown and beige . It is not in itself a diagnostic medical term but comprises pigmented naevus , lentigo, seborrhoeic keratosis and malignant melanoma amongst others . There are many other types of skin lesions but for this article I’ll discuss pigmented ones. If you want further information on skin lesions go to www.patient.info.

The main concern for most people on noticing a mole, particularly a new one, is that it might be malignant. In this respect malignant melanoma (MM) is by far the most serious diagnosis as it is an aggressive cancer. Fortunately MMs are relatively rare; in the UK 3 in 10,000 people will develop one (although the incidence is slowly rising). The vast majority of moles are benign but the challenge is to differentiate these from MMs.

WHO IS AT RISK?

• Fair skins
• History of excess sun exposure especially with burning
• Family history of MM
• History of immunosuppression or chemotherapy
• Those with very large congenital moles
• Age 40 plus with new moles

WORRYING SIGNS- ABCDE guide

• A- Asymmetry ; does it look irregular in outline or is there uneven thickening ?
• B- Border; is there a clear cut margin between the mole and the surrounding skin?
• C- Colour; is the colouring uneven particularly with very dark patches?
• D- Diameter; 6mm or larger
• E- Enlargement; any mole ( or part of a mole) that is enlarging over weeks needs to be assessed

These are not the only signs - see Surveillance below.

WHAT CAN I DO?
Prevention

• Avoid sunlight especially 11-3pm March-October. UVB rays are the main culprit and they pass through clouds so overcast days are not risk exempt.
• Respect your skin type!
• Use SPF of at least 15; much better to apply frequently especially after swimming. Higher SPFs confer little extra protection.
• Sunbeds are not recommended.

Surveillance

- Be aware of your risk factors; if you have any you should check your skin in a good light every couple of months. Get someone to check your back. Don’t forget to check your soles and nailbeds

• MM can crop up anywhere although most lesions are in sun exposed areas.
• Be vigilant of new moles especially if you’re 40+. Conversely moles that you’ve had since childhood are very unlikely to become malignant.
• Use the ABCDE approach to assess moles, again concentrate on moles not previously noted , particularly if larger.
• Be suspicious of any mole that looks different from any other on your body.- Report any mole that is persistently itchy, inflamed or that bleeds easily.

One useful way to survey moles is to take a high resolution photo with a ruler alongside any moles of concern and repeat 2 months later; generally benign moles will not grow appreciably in this time.

Hopefully this short guide will help you to manage your moles but if you have ANY doubts or concerns please make an appointment for further assessment.