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Mole or Melanoma: When to Worry?

Published on Sep 26, 2017 and last reviewed on Oct 07, 2022   -  5 min read

Abstract

This article sketches the various aspects of the mole, from its morphology to the preventive measures.

Mole or Melanoma: When to Worry?

What Is a Mole?

A mole or nevus is a black or brown spot present in the skin. It is usually round, has a uniform color with smooth edges, and often measures less than 6 mm in diameter. They are often acquired during childhood or adolescence. Most of them will never cause a problem. If new moles arise with age or there is a change in it, there is always a risk of it turning into a melanoma. Melanoma is a grave disease that mostly arises from an innocent-looking mole. If a mole is present on the body, here is how you can know if it is just a mole or melanoma.

What is Melanoma?

Melanoma is a severe type of cancer that occurs in the cells called melanocytes (cells that produce melanin). It not only occurs in the skin but also in the eyes and, rarely, inside the body, like in the nose or throat.

What Can Increase the Risk of Getting Melanoma?

The factors that can increase the risk of getting melanoma:

  • Exposure to UV radiation.

  • Fair skin.

  • Women.

  • People under the age of 40.

  • Light color eye.

  • Freckle or sunburn.

  • Blond or red hair.

  • Family history of skin cancer.

  • Unusual mole.

Where Does the Mole Appear?

Mole can occur anywhere in the body, irrespective of whether the area is exposed to the sun. Normally moles will be in uniform color like tan, brown or black with a distinct border which can separate it from the surrounding skin. Moles can start forming right from childhood until the age of 40. Moles can change their appearance over time and sometimes they may also disappear.

Do Moles Have Different Appearances?

Yes, moles have a variety of shapes, and a recurring pattern in a patient constitutes 'signature' lesions.

They are usually oval or round and size can range from smaller than 6 millimeters in diameter to the size of a pencil eraser. But melanoma usually is asymmetrical in shape and uneven around the edges.

Common mole signatures include:

  • Brown or pink type.

  • Fried-egg.

  • Eclipse.

  • Inverse pattern.

  • Targetoid or cockade.

  • Shrapnel or ladybug pattern.

  • Perifollicular hypo or hyperpigmentation pattern.

  • Cheetah phenotype, etc.

What Is ABCDE of Melanoma?

  • A - Asymmetry - one-half of the mole is different from the other.

  • B - Border - irregular borders.

  • C - Color - has a variety of shades.

  • D - Diameter - larger than 6 mm.

  • E - Evolving - changing size, shape, color, and border with time.

When to Worry About a Mole?

All the symmetric changes occurring in a mole, such as an increase in size with age, a uniform darkening after sun exposure or after a chronic trauma, etc., are not signs of malignancy. However, if there is bleeding, ulceration, or an increase in number after 50 years of age, it is a red flag for malignancy.

Who Should Be Tested?

Patients with the following increased risk factors should be screened annually or bi-annually.

  1. Moles with an irregular shape and which increase in number.

  2. Familial atypical multiple mole melanoma syndromes.

  3. A large congenital nevus.

  4. Persons with fair skin and blond or red hair.

  5. A family history of melanoma.

  6. A previous history of melanoma or other skin cancer.

  7. Low immunity (immunosuppressants, Human Immunodeficiency virus, etc.).

  8. Advanced age.

  9. Male sex.

  10. Exposure to sun rays and UV (ultraviolet) rays.

  11. Xeroderma pigmentosum.

What Does Having a Risk Factor Indicate?

It is significant to know that anyone can get melanoma. Not all persons who have multiple risk factors will have the disease. It is also possible that melanoma may arise in people with few or no risk factors.

Can Melanoma Be Found at an Early Stage?

Yes, it can be detected at an early stage. If it is done, the success rate of the treatment is very high (99 to 100 %).

How to Do a Skin Self-Examination?

Your eyes and a full-length mirror are all that is required.

  1. Thoroughly examine all the body areas, including the scalp, palms, back of your thighs, etc., every month.

  2. Check for the appearance of new moles and the size, shape, color, and texture of the existing ones.

  3. Clicking pictures of the involved area will be an added tool for comparing the progress.

  4. Never inspect using a magnifying lens as it may intensify the ruggedness of the borders. The more magnified a mole is, the more attenuated and uneven edges it appears to have, which causes a lot of anxiety.

When to Approach a Physician for a Mole?

In patients with a family history or a history of melanoma, if you find any mole which does not fit into the signature lesion category, a mole having an irregular border to a naked eye is sore or bleeds, it is always better to get examined by a dermatologist using a dermatoscope.

What Are the Tests to Be Done?

  • Serial dermatoscopy.

  • Digital epiluminescence microscopy (DELM).

  • Biopsy.

  • Chest X-ray.

  • Reflex transmission imaging (RTI).

  • CT scan (computed tomography).

  • MRI scan (magnetic resonance imaging).

  • PET scan (positron emission tomography).

Should I Get All the Moles Removed?

No, the doctors will not always remove all the moles, as most are harmless. By removing a few or all of them, the risk of melanoma development does not decrease. It is also possible for a melanoma to develop de novo (from the beginning).

What Preventive Measures to Be Taken to Avoid Melanoma?

Certain risk factors like age, gender, family history, etc., cannot be prevented. However, the following precautions can be taken.

  • Limit exposure to UV rays, including tanning beds and solar lamps.

  • Use sunscreen creams with high SPF (sun protection factor).

  • Always seek shade.

  • Keep an eye on abnormal moles.

  • Avoid weakening the immune system (with drug abuse, multiple sex partners, etc.).

Conclusion:

The mole that appears after the age of 50 years should be consulted with the doctor, because it has high chances of developing into a melanoma which can spread to other parts of the body and cause life-threatening complications.

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Frequently Asked Questions


1.

What Type of Cancer Is Melanoma?

Melanoma is a type of skin cancer that arises from the melanin-producing cells or melanocytes. It is a serious condition which, left untreated, can be life-threatening.

2.

In Which Region Do Melanomas Start?

There is no specific site for melanomas to occur, and they can appear anywhere on the skin. Apart from the skin, they can also occur in the eyes, genitals, anal region, and mouth too. But women most commonly develop melanomas on the legs, and men can develop it commonly on the chest and back. Also, melanomas most commonly appear on the neck and face.

3.

How Does One Develop Melanoma?

Though it is unclear how only certain moles transform into melanomas, it is believed that genetic mutations cause melanomas. Certain risk factors increase the risk of melanoma, such as,
Ultraviolet rays exposure from the sun and man-made sources like tanning beds, UV lamps, etc.
- Family history.
- Fair skin.
- Having many moles.
- Weak immune system.
These factors necessarily need not cause melanoma.

4.

Can One Have Melanoma Without Knowing It?

While aggressive melanomas grow and spread rapidly, less aggressive melanomas can be developing in a person without their knowledge. People can have a slow-growing melanoma for a decade and not know it. There are certain signs and symptoms that might be indicative of melanoma, such as,
- A mole that is changing its size, shape, or color suddenly.
- The sudden appearance of new, unusual pigmented lesions.
- Non-healing skin sores.
- Itchiness or pain in an otherwise healthy mole.

5.

Do Melanomas Appear Raised or Flat?

Melanomas can either appear raised or flat. Most melanomas appear as flat lesions.

6.

How Does One With Melanoma Feel?

A person may have melanoma and feel completely normal. Most of the time, they do not experience any symptoms, but when they do, they may experience itching, bleeding, oozing, or pain in the lesion. In advanced stages of melanoma, people may feel lethargic and tired and feel like not eating anything.

7.

Do Melanomas Cause an Itching Sensation?

Melanomas may or may not itch. Most of the time, melanomas do not present with any sign. But itching, soreness, bleeding, or pain can also be present.

8.

At What Rates Does Melanoma Spread?

Not all melanomas grow and spread fast. And when they happen to grow fast, they can spread quickly as early as six weeks to become life-threatening. Aggressive melanomas that grow and spread quickly include,
- Nodular melanomas.
- Superficial spreading melanomas.
- Lentigo maligna melanomas.

9.

Is Melanoma Completely Curable?

Melanoma is highly curable only if detected and treated in the early stages when the lesion is confined only to the top layer of the skin. If it spreads to the deeper tissues of the skin or other body parts, it becomes difficult to cure it.

10.

Do Melanomas Always Cause Death?

Melanomas are not always fatal. When detected and treated early, even before the lesion spreads to the deeper tissues of the skin and other parts of the body, melanoma is very much curable, with five-year survival rates of 99%.

11.

Can Blood Work Detect Melanoma?

Blood tests do not detect melanoma. They are not diagnostic tests of melanoma. But blood tests are ordered before and after melanoma treatment to assess the patient’s health condition and determine the aggressiveness of melanoma.

12.

How to Identify the Spread of Melanoma?

Advanced melanomas spread to different parts of the body and are difficult to cure. Following signs and symptoms are indicative of advanced melanoma that has spread to other parts,
- Fatigue.
- Unintentional weight and appetite loss.
- Persistent cough.
- Breathing difficulties.
- Painful and swollen lymph nodes.
- Painful bones.
- Hardened skin with or without lumps in the region of melanoma.
- Headaches.

13.

What Does Melanoma Do to the Body?

Melanomas can become life-threatening or cause serious adverse effects if untreated. It can spread to other vital parts of the body like the liver, brain, lungs, bones, etc., and deteriorate their function, eventually leading to death.

14.

Can Melanomas Develop Within a Day?

Melanomas can occur suddenly and spread rapidly, or they can even develop slowly over the years. Based on their aggressiveness, their spread and growth rates vary.

15.

Do Melanomas Resolve on Their Own?

Surprisingly, in about 10 to 20% of the cases, melanomas regress on their own without treatment. It is due to the body’s immune response that these melanomas disappear. This also makes the person free from melanoma completely if it has not metastasized.

16.

Should Melanomas Be Removed Quickly?

Surgery is the preferred method of treating melanoma to prevent it from spreading. Along with the melanoma, 1 to 2 cm of normal skin will also be removed for better results.

17.

When Does a Mole Cause a Concern?

Moles with a sudden change in color, size, or shape are concerning. Unevenly colored moles, asymmetrical moles with rugged borders, newly appearing moles in adulthood, and moles with itching, flaking, or bleeding tendencies raise a concern and might be indicative of skin cancers.

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Last reviewed at:
07 Oct 2022  -  5 min read

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