When do moles that change in appearance need dermoscopy?

Question

Hello doctor,

I have two moles that I am starting to be a bit concerned about. The first one is on my chest and originally looked like all of the other moles on my body. Recently, it has changed color, grown, and become bumpy (first picture).

The second mole is on my back. The same thing happened with this mole as well. It looked normal like all of my other moles, then it started growing, changing color, and now it is raised (second and third pictures).

I have a family history of skin cancer. I am currently taking Caplyta and Zoloft.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

I checked and went through the images you uploaded (attachments removed to protect the patient’s identity). I understand how worrying it can feel to notice changes in moles, especially when there is a family history of skin cancer. You did the right thing by seeking advice early.

Based on the history you have described, both moles with recent changes in size, color, and surface texture are important warning signs. From the photographs, the moles appear slightly more atypical (dysplastic) than normal moles due to their shape.

However, it is not possible to rule out early melanoma or other skin cancers based on images alone. You need a dermoscopic evaluation, which is a specialized skin examination tool that magnifies the image and shows patterns suggestive of melanoma, if present, before biopsy. Please get dermoscopy done and then a skin biopsy if needed.

The six signs that are evaluated for melanoma are asymmetry, border irregularity, color variation, diameter increasing or greater than 6 millimeters, and evolving, meaning any change in size, shape, color, or symptoms.

As you have evolving changes, color variation, and asymmetry in your moles as seen in the attached pictures, along with a positive family history of melanoma, dermoscopic evaluation is strongly recommended.

Until you are examined, please avoid excessive sun exposure, use a broad-spectrum sunscreen with SPF (sun protection factor) 30 or higher on exposed areas, and do not scratch or attempt to treat the moles at home.

Please do not panic, as many changing moles turn out to be benign, but given your history and the changes you have noticed, prompt evaluation is important and appropriate. Early assessment leads to excellent outcomes if any treatment is needed.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.