Mole removal is almost always done when a mole appears to be at high risk of developing into skin cancer, though moles can also be removed for cosmetic reasons if they are causing distress to the patient. Everyone has moles, and the overwhelming majority of them never amount to anything dangerous. In fact, the typical adult has somewhere between 10 and 40 moles, with that number holding steady once an adult is in their mid-30s. But though most moles are completely benign, they must be checked regularly for signs that they may be developing into something more. If a healthcare provider is concerned about a patient’s mole, they have several removal methods available, all of which are easy to perform and cause minimal discomfort.
When to be concerned about a mole
Everyone is born with some moles, and everyone develops more as they age, but not all moles are the same. Therefore, it’s important that adults know how to classify their moles and when to schedule an examination with their healthcare provider. There are many categories under which moles can be sorted, and some of them include:
1. Acquired melanocytic nevus – Also referred to as common moles, an acquired melanocytic nevus is one that appears after birth. They usually develop in response to frequent and extended exposure to sunlight, and therefore are often seen when young children spend their time playing outside a lot. However, they can emerge well into adulthood, though they rarely appear after someone has turned 35. Any common mole that does appear after this time is worth further examination.
Common moles are further classified by their location in the skin. A junctional mole is one located in the epidermis, while an intradermal mole is one found in the dermis. It’s also possible for a common mole to develop in both the dermis and epidermis – a condition known as a compound mole.
2. Congenital melanocytic nevus – A congenital nevus is one that is present at birth, and is the result of genetics. Everyone is genetically programmed to develop a certain number of moles, and they usually present with the exact same appearance as an acquired common mole.
A congenital melanocytic nevus is medically notable in that large congenital moles are a known risk factor for melanoma. In this instance, a large congenital mole refers to one that is at 20 centimeters in diameter.
Both acquired and congenital common moles present with the same features. Those include distinct borders around the mole, a dome-like surface and even pigmentation.
3. Atypical nevus – An atypical nevus is one that, like the term suggests, does not present like a common mole. Atypical moles can only be diagnosed as such through physical examination through histological methods (looking at a sample of the mole under a microscope), so they merit examination by a physician.
An atypical nevus is defined as one that has one or more unusual features. For example, an atypical nevus may have indistinct borders, may have varying pigmentation, are often larger than common moles and may develop both flat and raised areas.
Most atypical moles, like most common moles, are benign in nature and will never develop into anything concerning. However, a patient with a large number of atypical moles is considered to be at a greater risk of skin cancer, and the more atypical a mole is, the more likely it is to develop into cancer.
Whether or not someone appears to be at risk of skin cancer, it is important for people to perform self-examination frequently. During a self-examination, people have to use their better judgment to determine if a mole needs. When in doubt, get it checked out.
During self-examination, there are several warning signs to look for in checking for a possible melanoma. Referred to as the ABCDE method, it includes:
- A (Asymmetry) – If one half of the mole appears different than the other half, then it is said to be asymmetrical. In most cases, an asymmetrical mole is obviously asymmetrical.
- B (Borders) – If the mole’s borders are not clearly defined or are uneven in texture, then further examination is warranted.
- C (Color) – If the mole presents with several colors, or if the mole changes color with time, then that is a concern. Most moles are brown, black or tan, though it’s not unusual for a mole to be red or pink, but the color should not change.
- D (Diameter) – If the mole’s diameter, or distance across, is longer than the width of a pencil eraser, then additional examination is needed. This comes out to about 6mm in diameter.
- E (Evolution) – Moles should not change in size, color, texture or shape. If a mole does do that, it’s time to see a healthcare provider.
If, after examining a mole, a physician believes a mole should be removed to minimize the risk of cancer, there are a few ways the physician can go about it.
Removing the mole
Moles are removed using the same methods that physicians use with similar skin conditions, like skin tags or warts. There are three primary approaches to this procedure:
- Cutting – Moles can be surgically removed from the skin, either by shaving the mole until it is even with the surrounding skin, or by excising it if the mole is located deep within the skin.
- Freezing – Moles can be frozen with the use of liquid nitrogen, applied with a spray or swab. The liquid nitrogen destroys the tissue it comes in contact with, allowing the physician to remove the mole without the need for a cut. A blister may develop where the mole was located, but this will rapidly heal and go away.
- Burning – Alternatively, a physician can apply heat to the mole with the use of a wire and electrical current. With precise application of heat, the top layers of the mole can be burned off with precision. This approach may take more than a single application, but it minimizes the likelihood of bleeding.
All three procedures can be done by a primary care physician, and done as a quick outpatient procedure. Full recovery with little pain is expected within a day or two, and once the mole is removed in this fashion, it usually stays gone.
Moles are part of who we are, and though they are usually benign, they aren’t always. If there is any concern about a particular mole, seek the advice of a healthcare professional.