Everyone has moles, sometimes 40 or more.  Most people think of a mole as a dark brown spot, but moles have a wide range of appearances.

At one time, a mole in a certain spot on the cheek of a woman was considered fashionable.  These were called “beauty marks.”  Some were even painted on.  However, not all moles are beautiful. They can be raised from the skin and very noticeable, they may contain dark hairs, or they may be dangerous.

Moles can appear anywhere on the skin.  They are usually brown in color but can be skin colored and various sizes and shapes.  The brown color is caused by melanocytes, special cells that produce the pigment melanin.

Moles probably are determined before a person is born.  Most appear during the first 20 years of life, although some may not appear until later. Sun exposure increases the number of moles, and they may darken.  During the teen years and pregnancy, moles also get darker and larger and new ones may appear.

Each mole has its own growth pattern.  The typical life cycle of the common mole takes about 50 years.  At first, moles are flat and tan like a freckle, or they can be pink, brown, or black in color.  Over time, they usually enlarge and some develop hairs.  As the years pass, moles can change slowly, becoming more raised and lighter in color.  Some will not change at all.  Some moles will slowly disappear, seeming to fade away.  Others will become raised far from the skin.  They may develop a small “stalk” and eventually fall off or be rubbed off.

Recent studies have shown that certain types of moles have a higher-than-average risk of becoming cancerous.  They may develop into a form of skin cancer known as malignant melanoma.  Sunburns may increase the risk of melanoma.  People with more moles than average (greater than 100) are also at risk for melanoma.

Moles are present at birth in about 1 in 100 people.  They are called congenital nevi.  These moles may be more likely to develop a melanoma than moles which appear after birth,

Moles known as dysplastic nevi or atypical moles are larger than average (usually larger than a pencil eraser) and irregular in shape.  They tend to have uneven color with dark brown centers and a lighter, sometimes reddish, uneven border or black dots at the edge.  These moles often run in families.

People with dysplastic nevi may have a greater chance of developing malignant melanoma and should be seen regularly by a dermatologist to check for any changes that might indicate skin cancer.  They should also learn to do regular self-examinations, looking for changes in the color, size or shape of their moles, or the appearance of new moles.  Sunscreen and protective clothing should be used to shield moles from sun exposure.

Recognizing the early warning signs of malignant melanoma is important. Remember the ABCD’s of melanoma when examining your moles.

A stands for ASYMMETRY; one half of the mole does not match the other half.

B stands for BORDER;the border or edges of the mole are ragged, blurred, or irregular,

C stands for COLOR; the color of the mole is not the same throughout or it has shades of tan, brown, black, red, white, or blue.

D stands for DIAMETER; while melanomas are usually greater than 6mm (about the size of a pencil eraser), they can be smaller.  They can also change, bleed, or itch.

If a mole displays any of these signs, it should be checked promptly by a dermatologist.  It is important to remember that not all moles look alike.  Moles may be skin colored or pink, light tan to brown, and even blue to black.  They may be round or oval,. or their shape maybe slightly irregular.  They may be· flat or raised, large or small, with .or without hairs, mottled or evenly colored. If the appearance of a mole worries you or if it changes suddenly in any way, you should consult a dermatologist,

There may be darkened spots on the skin that are not moles.  Freckles are the most common.  Unlike moles, they are rarely larger than the size of a pea, although sometimes they may seem to be large because they blend into one another.  Sun exposure may make freckles darker; freckles may fade completely in the winter.  While moles may appear anywhere on the skin, freckles are ordinarily limited to sun exposed areas such as the face, neck, and upper back.  Blondes and redheads freckle most easily.

After middle age, a person may acquire other dark areas that are not moles.  Brown, wart-like growths that appear on the face or trunk and look as if they have been stuck onto the skin may be harmless growths called seborrheic keratoses.

Multiple small gray-brown spots that may appear on wrists, backs of the hands, forearms, and face are actinic lentigines.  These are also called “liver spots;’ “age spots;’ or “sun spots,” although they have nothing to do with liver or age.  They are not cancers. Both actinic lentigines and seborrheic keratoses are easily diagnosed by a dermatologist.

The majority of moles and other blemishes are benign (non-cancerous).  They will never be a threat to the health of the person.  Spots or blemishes that warrant medical concern are those that do something out of the ordinary – those that act differently from other existing moles.  This includes any spot that changes in size, shape, color, bleeds, itches, becomes painful, or moles that appear when a person is past twenty.

If you notice a mole that does not follow the normal patterns, a dermatologist may be able to assure you that the mole is harmless, or confirm that it is cancerous.  He or she may remove the mole or part of it (biopsy) to study it under a microscope.

This is a simple and harmless procedure.  If the growth was only partially removed and it is found to be cancerous, then the entire lesion and an extra margin of safety will need to be removed.

A person may wish to get rid of moles that are irritating them, or simply because they are unattractive.  The most common methods of removal include numbing and shaving the mole off, or cutting out the entire lesion and stitching the area closed.

Most procedures used to remove moles take only a short time and can be performed in a dermatologist’s office. Sometimes a mole will recur after it is removed.  If a mole has been removed and begins to reappear, the patient should return to the dermatologist. 

Many people wonder if it is safe to shave over a mole.  Irritation will not cause a mole to become cancerous, but a person might want to have moles that are frequently shaved over removed because they are annoying.

Some moles with hairs are considered unattractive.  The hairs can be clipped close to the skin’s surface, or removed permanently with electrolysis or laser.  Moles can also be excised (cut out and stitched together) to remove the mole and the hair.

Moles may be made less noticeable if they are disguised with makeup.  Cosmetics specifically designed to cover blemishes provide more complete coverage than ordinary cosmetics.

Most moles cause no problems.  But occasionally a mole may be unattractive, annoying, or changing.  If you see any signs of change or want a mole removed for cosmetic reasons, consult a dermatologist.