Most people
have moles and most moles cause no problems. However, some moles are
cause for concern and should be checked by a health care provider.
So, how do you know if a mole should be checked? And why?
To begin, some
skin cancers look like moles. Melanoma
skin cancer can be fatal if not caught and treated early.
Anyone can get melanoma, but people who don’t tan well or who
burn easily are at the greatest risk.
Sunburns early in life and having more than 50 moles are also
increased risk factors. There
is evidence that ultraviolet radiation used in indoor tanning
equipment may also cause melanoma.
How do you
know which moles to have checked? The answer to this is easily found
in the beginning letters of the alphabet, ABCD—and sometimes E:
A
stands for Asymmetry. If
one half of the mole doesn’t look like the other half, you should
have it checked.
B
is for Border. If the
edge or border of the mole is uneven or indistinct, you should have it
checked.
C
is for Color. If the
mole is more than one color throughout or mottled, you should have it
checked.
D
is for Diameter. If
the mole is larger than 6mm, you should have it checked.
If any of the
above is true, or if you can’t see the mole or moles because they
are located in hard to see areas, or if you’re not sure it even is
a mole, you should have it checked.
E
is for Elevated. In addition to concerns regarding cancers, a mole
could be an atypical nevus. Simply
put, an atypical nevus is a mole that meets one or more of the ABCD
criteria and is usually raised above the skin’s surface, or elevated
(thus, ABCD—and sometimes E.) These moles can be found anywhere on
the body, usually begin to appear at puberty, and are often more
common in areas of the skin that have had exposure to the sun.
The person
checking your mole or moles will likely ask questions such as: How
long have you had the mole? Were
you born with it? Did it
appear after your 20th birthday? Has it changed in
appearance lately or has it always looked like this?
Does it bleed or itch? Is it painful?
You can also
expect to answer questions about your history of sun exposure or
tanning as well as the history of skin cancer in your family.
Some people
want moles removed for cosmetic reasons. For others, a mole is
irritated by clothing, shaving or other activity.
If hair grows from your mole, you might not like the way it
looks. It is considered safe to shave over a mole or have hair removed
from a mole by electrolysis or by snipping it with scissors.
So, what
happens if your health care provider thinks a mole is suspicious?
First, she or he will need to get a sample of it to be examined
under a microscope to determine if it is cancerous. This can be done
in a variety of ways. You may wish to have a small piece of it removed
or you may want the entire mole removed.
Sometimes, even if the entire mole is removed and found to be
cancerous, you may need another surgery to be sure the margins are
clear and thus reduce the chance of a recurrence.
Whether you
have a mole removed because it is suspicious for cancer or you simply
don’t like the way it looks, removal can usually be done as an
office procedure. This may involve stitches.
Any mole that is removed will be sent to a pathologist to be
evaluated for cancer. Since removal usually leaves a scar, be sure to have a clear
understanding with your provider to determine whether the mole is
suspicious or being removed for cosmetic reasons.
Sometimes the scar left behind is less attractive than the
mole.
If you are
uncertain about whether you should have a mole looked at, remember:
ABCD—and sometimes E. And, if there’s any doubt, have it checked!
Billie
Bergstrom is a PAC at Alaska Family Wellness Center.
Her practice includes skin problems, primary care, obesity, and
bioidentical hormones.
You can make an appointment to see her at (907)561-9444.
