When it’s more than just a mole

Normal moles are common, small (less than 5mm) spots/growths on the skin that appear at birth or during the later years of childhood. They can be either flat or elevated and are generally round and regularly shaped.¹ Common moles usually have a pink, brown, or tan color, but tend to have a darker appearance for people with dark skin or hair.¹

Many are commonly found on parts of the skin that are exposed to the sun.² Most moles are harmless, but they can become cancerous. Monitoring moles and other pigmented patches is an important step in detecting skin cancer, especially malignant melanoma.

Melanoma is one of the deadliest forms of skin cancer. Moles that are melanoma may often appear as asymmetrical, irregularly bordered, multi-colored or tan/brown, or as a growth that continues to increase in size over time. These moles may begin as a flat spot and become more elevated. In rare instances, the moles may be amelanotic, in other words, the mole does not have any type of skin pigment (melanin). In these cases, the mole may be pink, red, or normal skin color, making it harder to recognize as a melanoma.³

Sometimes it can be hard to tell the difference between an atypical mole and an early melanoma. This ABCDE guide can help you determine if a mole or a spot may indicate melanoma or other skin cancers:^3,4

• Asymmetry: Unlike common moles, atypical moles are often asymmetrical—A line drawn through the middle would not create matching halves.
• Border: While common moles usually have regular, sharp, well-defined borders, the borders of atypical moles tend to be uneven or unclear.
• Color: Common moles are most often uniformly tan, brown or flesh-colored, but atypical moles have varied, irregular color with subtle, haphazard areas of tan, brown, dark brown, red, blue, white or black.
• Diameter: Atypical moles are generally larger than 6 mm (¼ inch) in diameter, the size of a pencil eraser, but may be smaller.
• Evolving: Enlargement of or any other notable change of symptoms in a previously stable mole such as bleeding, itching or crusting, or the appearance of a new mole after age 40, should raise suspicion.

The degree of atypical features in the mole can help determine whether it is harmless, or at moderate or high risk of becoming a melanoma. Dermatologists examine such moles with a dermoscope, a handheld magnifying device that allows visualization of internal skin structures and colors not seen by the naked eye.⁵ The dermatologist may also opt to remove the entire mole or a portion of it for examination in a lab.

Certain factors can be clear warning signs that an atypical mole is actually a melanoma or in danger of becoming a melanoma. If you or a loved one has any of the following, consult a dermatologist immediately:

• Itching
• pain
• elevation
• bleeding
• crusting
• oozing
• swelling
• persisting open sores
• bluish-black color
• and other features.

Watch for changes

Become familiar with the location and pattern of your moles. Regularly examine your skin to look for changes and warning signs, especially if you have a family history of melanoma. With the help of mirrors, do a head-to-toe check, including your scalp, palms and fingernails, armpits, chest, legs, and feet, including the soles and the spaces between the toes. Also check your genital area and between your buttocks.

Protect your skin

Take measures to protect your skin from ultraviolet (UV) radiation, such as from the sun or tanning beds. UV radiation has been linked to increased melanoma risk. Children who haven’t been protected from sun exposure tend to develop more moles. Avoid peak sun times between 10 a.m. and 4 p.m. Use a broad spectrum sunscreen (at least SPF 15) year-round and re-apply as indicated.⁶ Cover up and get in the habit of wearing UV-blocking sunglasses, broad-brimmed hats, long sleeves and other protective clothing that can help you avoid damaging UV rays.⁶

Talk with your doctor about your risk factors for melanoma and whether you need a professional skin exam on a routine basis.

Disclaimer:

The information featured in this site is general in nature. The site provides health information designed to complement your personal health management. It does not provide medical advice or health services and is not meant to replace professional advice or imply coverage of specific clinical services or products. The inclusion of links to other web sites does not imply any endorsement of the material on such websites.

1. Common Moles, Dysplastic Nevi, and Risk of Melanoma. National Cancer Institute. https://www.cancer.gov/types/skin/moles-fact-sheet. Revised November 17, 2022. Accessed May 1, 2023.
2. Are moles determined by genetics? https://medlineplus.gov/genetics/understanding/traits/moles. Last updated July 8, 2022. Accessed May 18, 2023.
3. Skin Cancer Foundation. Amelanotic Melanoma: It Doesn’t Look Like Other Melanomas. https://www.skincancer.org/blog/amelanotic-melanoma-it-doesnt-look-like-other-melanomas. Published March 31, 2021. Accessed May 1, 2023.
4. Skin Cancer Foundation. Atypical Moles & Your Skin. https://www.skincancer.org/risk-factors/atypical-moles. Revised January 2021. Accessed May 1, 2023.
5. American Osteopathic College of Dermatology. Dermascopy. https://www.aocd.org/page/dermoscopy. Accessed May 1, 2023.
6. Spend Time Outside and Stay Sun-safe. American Cancer Society. https://www.cancer.org/latest-news/stay-sun-safe-this-summer.html. Published April 15, 2020. Accessed May 1, 2023.