Moles (Nevi)

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Overview

Moles, or nevi (singular: nevus), are the most common growths in humans. They can be present at birth or acquired throughout life. The incidence of nevi increases throughout childhood, peaks in adolescence, and typically wanes in older adulthood. Nevi evolve and change throughout childhood and during pregnancy.

Moles can appear anywhere on the skin in various sizes and shapes. They are made up of melanocytes, skin cells that produce melanin (dark pigment).

Moles typically evolve and grow as we do. They generally begin as flat brown spots, similar to a freckle, that, over time, may grow larger, become elevated, and grow hairs.

Certain types of moles carry a risk for developing malignant melanoma, a serious form of skin cancer. Sunburns, particularly in childhood, can increase the risk.

Some moles are present at birth. Congenital nevi are seen on over 1 percent of newborns. They can be small, or they can cover most of the skin surface. Large nevi are at highest risk for malignant changes.

One relatively common mole is the dysplastic nevus. It is broader and larger than an ordinary mole and tends to be irregular in color and shape. People with dysplastic moles have a greater than average chance of developing melanoma.

While most changes in moles are not cancerous, it is important to consult a dermatologist with concerns about moles, especially if unusual changes in them can be observed. The dermatologist may recommend that a biopsy be taken. This involves removal of part or all of the mole for evaluation.

FAQs

Q: My mole has hair over it. Can the hairs be removed?
A: There are many options for removing the hairs, including clipping or shaving, tweezing or waxing, electrolysis, and laser hair removal. Moles with hairs can be cosmetically undesirable. Evidence shows that irritation of the mole, such as that caused by shaving, will not cause it to become cancerous.

Q: My child was born with a dime-sized mole on his thigh. Should I have it removed? If so, when?
A: Your child has what is called a congenital nevus. Most dermatologists agree that small congenital nevi have little or no increased risk above an acquired mole for becoming cancerous. Nevertheless, malignant melanoma can occur. In small congenital nevi, this risk increases at puberty. It is therefore recommended that the mole be surgically removed prior to that time. Not all congenital moles need to be removed, and you should consult with your dermatologist to determine what is best for your child.

Q: I am 40 years old and I am still getting new moles. Is something wrong?
A: Most moles are acquired in childhood and adolescence, but it is normal to develop new moles throughout one's life.

Q: Recently I developed white rings around two moles. Will this spread to the rest of my body?
A: What you have are called halo nevi (singular: halo nevus). This is a relatively common phenomenon, especially in adolescents. Over the next months or years the moles will gradually disappear, as will, typically, the white area. However, some people with halo nevi are predisposed to vitiligo, a loss of pigment in various areas of the skin. You should have a dermatologist evaluate the mole for you, because the halo phenomenon can, in rare instances, be seen with malignant melanoma.

Q: I have a lot of moles and I'm worried about melanoma. Should I have them all removed?
A: There is no evidence that removing all of one's moles will prevent melanoma from occurring. Furthermore, this will result in numerous scars. Instead, you should examine yourself and your moles in front of a full-length mirror regularly, such as once a month. Becoming familiar with your moles will enable you to evaluate them regularly and detect any changes. You also can visit your dermatologist yearly—more frequently if he or she recommends it—for a more thorough examination. The dermatologist may identify any suspicious-looking lesions and may want to remove them at that time.

Q: Can I have all my moles removed by laser without leaving scars?
A: No. Laser treatment is not recommended at this time for removing moles.

Q: What are my options for removing an unsightly mole?
A: Moles can be surgically excised (cut out). When this is done, the entire area around the mole is removed and stitches are placed to close the wound. There is little or no chance of recurrence and the resulting scar is usually a fine white line.

Moles with an elevated surface typically are removed cosmetically by a process called shave excision. This involves numbing the area around the mole and removing the top portion of it so it is flush with the surrounding skin. A small scar usually results, which is usually cosmetically acceptable. If the mole had hair or was dark in color, these likely would remain. There is a chance that after this procedure the mole could regrow.

Moles (Nevi), Overview, FAQs reprinted with permission from dermatologychannel.net
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