Moles, medically termed nevi, are skin lesions appearing as small dark brown spots. Moles occur when pigment or color producing cells called melanocytes grow in clusters. These are common in appearance and may be present at birth or develop later in life.
Most people have 10 to 40 moles by adulthood, which mostly appear in childhood and usually until 30 years of age. Moles are usually round or oval but over years, they can become flat or raised or can change color or some of them may slowly fade away. Moles tend to become darker on sun exposure or due to hormonal changes during the teen age years and pregnancy.
The moles that are of medical concern are those with the appearance that has changed over time. This can include changes in color, height, size, or shape or the ones with bleeding, itching, redness or swelling. Medical attention is required if you find any of the features that are described as ABCDEs of melanomas: Asymmetry, irregular Borders, change in Color, Diameter greater than a pencil eraser and Elevated or enlarged.
Types of moles
- Congenital nevi – are the moles developed at birth. These are more likely to become cancerous than the ones that develop later in life.
- Dysplastic nevi - are large moles (diameter larger than that of a pencil eraser) with irregular shapes that are found to be inherited. These are characterized by color variation within the mole, typically dark brown centers and lighter, uneven borders. These moles are at a higher risk of developing into cancer.
A mole can be identified by your doctor on physical examination of the skin. A biopsy (sample of the tissue is taken for lab examination) may be performed if the mole is suspected to be cancerous.
Most moles do not require treatment. However, surgery is recommended if the mole is found to be or suspected to become cancerous. There are two methods for mole removal:
Excision (removal) of mole with stitches:
This procedure is performed under local anesthesia. Your surgeon utilizes a scalpel and cuts out the entire mole and also the surrounding skin if the mole is suspected to be precancerous or cancerous. The skin is then closed using stitches.
Excision without stitches:
During this type of excision that is generally used for small moles, your surgeon utilizes a surgical blade and shaves the mole off to the skin level or slightly below it. The bleeding caused during the procedure is stopped using an electrical instrument or a solution that will burn (cauterize) the area.
After the procedure, a topical antibiotic is applied on the wound and it is covered using a bandage. Care must be taken at home to keep the wound clean and covered until it heals completely.
Risks and Complications
Like any surgical procedure, mole excision too may result in complications that include:
- Wound infection
- Injury to the surface nerves causing temporary numbness or burning sensation
- You need to keep the wound area clean and dry
- You should clean the wound once or twice every day using water or diluted hydrogen peroxide
- Once wound is cleaned, you need to apply a topical antibiotic cream and cover the wound using a bandage.
- You must clean the wound until it heals completely