The Mole Truth: misconceptions around moles
“Sun protection doesn’t need to be complicated or expensive; it needs to be consistent. Keep it simple, but do it forever.” ~ Hillary Fogelson, melanoma survivor.
Moles are mysterious. They may also be unsightly. And they may be dangerous. In the 17th century a visible mole could be interpreted in many unpalatable ways, and you could find yourself in hot water because of a number of superstitions associated with moles. And it was hardly useful to know whether the mole itself was benign or not.
However, even today, much of their imagined malignancy may be untrue. The important thing to do with moles is keep an eye on them, and to have them tested if necessary. There is no point whatsoever though, to have them removed for peace of mind. Prophylactic removal of moles does not reduce the overall melanoma risk.
Moles are common skin growths – benign tumours – that result from a natural process in the skin. Melanin is the natural pigment that gives skin its colour – and is produced in cells called melanocytes located in the bottom layer of the skin. Melanocytes tend to be spread evenly throughout the skin. Exposure to sunlight stimulates transfer of melanin pigment from the melanocytes to the skin cells (keratinocytes) to give skin a tan.
But sometimes these melanocytes don’t distribute evenly and instead grow in clusters, causing moles to form. Moles can form anywhere on the body, but they tend to grow more often on areas exposed frequently to the sun, such as the hands, arms, chest, neck and face.
A common mole is one that is usually about 5-6 mm in diameter, has distinct edges, a smooth, flat, or dome-like surface, and even pigmentation. These moles are not necessarily only found on skin regularly exposed to the sun, and have a low potential to turn into skin cancer.
However, moles that exhibit irregular features such as fuzzy borders, variation in colour, size larger than most moles, and display both flat and raised components, may carry an increased risk for skin cancer. If a person has many moles of this nature, the higher the risk for melanoma. Regular self-examinations are important to detect any changes in these types of moles.
Keep an eye on moles that:
- are asymmetrical
- have irregular borders
- change colour
- have different colours in one mole
- are larger than 6mm in diameter
- change over time.
If you notice any changes in a mole’s color, height, size, or form, you ought to have a skin specialist look at it. If moles bleed, itch, seem scaly, or become sensitive and painful, it wise to have them checked as well. However, most melanomas are completely asymptomatic.
- Moles only become cancerous when exposed to sunlight. No, not true. Cancerous moles can grow anywhere, whether the area of the skin has been exposed to sunlight or not.
- Malignant tumours will always be darker and uneven. No, not true. Some malignant tumours may appear perfectly round and have unnoticeable colour variations – which is why you have to have all moles regularly checked.
- If a mole doesn’t hurt it isn’t cancerous. No, not true. If you leave a mole unchecked until the point of hurting or bleeding, you would be in trouble – bleeding may already signify an advanced stage of melanoma.
- Every melanoma follows the ABCD rule: Asymmetry (one half of the mole doesn’t match the other). Border irregularity. Colour that is not uniform. Diameter greater than 6 mm. Not true. Even though this rule may be helpful in distinguishing good from bad, it does not apply to nodular melanoma or amelanotic (melanoma that displays no pigment) melanoma. All moles should be regularly checked.
- Skin moles are transmittable. Not true. They cannot spread from one individual to another individual or affect another individual in any way.
Dermatology is a specialist area of medicine dealing with both the medical and surgical aspects of the skin, nails, hair and its associated diseases. The aim of our society includes providing education to our members regarding safe and effective practices within dermatology, mentoring our registrars, as well as enlightening patients in this regard with the aim of maintaining excellent standards.
For more information, find us at: www.sasds.co.za