How to Recognize Dangerous Moles: A Guide for Early Detection

Everyone has at least a few moles on their skin. While most moles are harmless, some can develop into melanoma—a serious and aggressive form of skin cancer. Melanoma can affect people of all ages, including children. Although it accounts for less than 10% of all skin cancer cases, it causes nearly 80% of skin cancer-related deaths.

This guide will help you understand how to recognize potentially dangerous moles and when to schedule a skin check with your doctor.

What Are Moles and Why Do They Appear?

Moles, or nevi, are benign skin growths typically black or brown in color. They can appear on any part of the body and are comprised of melanocytes, the cells that give skin its natural color.

Interesting Fact. Moles form during intrauterine development and can manifest at various ages, though they more commonly appear before the age of 40.

The number of moles a person has depends on several factors.

• Genetics (hereditary factors)

• Hormonal changes (puberty, pregnancy, breastfeeding)

• Sun exposure, especially sunburns in childhood

While harmless moles are formed from melanocytes, these same cells can also develop into dangerous melanomas. However, scientists have yet to determine what specifically triggers this cellular transformation. There is no definitive standard that classifies a mole as 'bad' or 'good.' Each case requires a thorough diagnosis. The goal of a preventive mole examination is not only to detect suspicious or malignant growths but also to identify individuals at risk for developing melanoma, who will then require ongoing medical monitoring.

What Do Normal Moles Look Like?

• Even color (brown, black, red, or purple)

• Defined border that separates the mole from the surrounding skin

• Small size, typically less than 6 mm (about the size of a pencil eraser)

• Slow growth or stability in size over time

• May be flat or raised, and can resemble warts or skin tags

Moles That May Look Unusual but Are Often Benign

Moles can look different. Even the same person may have different types of moles. Some are potentially more dangerous and can be a marker of health problems.

Blue Nevus

A blue nevus is a 0.4-inch (up to 1 cm) spot, nodule, or node that is dark blue, black, or gray in color. The color is due to the large number of cells with melanin in the dermis. These moles have a dense consistency and are located more often in the scalp, on the back of the hands and feet. Blue nevus usually appear in early childhood, more often in girls, grow slowly.

Spitz's Nevus

Spitz's nevus is a reddish-pink or yellow nodule, more often located on the face and extremities in children. It increases in size rapidly. Can be a sign of poor diet, GI problems. Removal is usually required.

Nevus Halo

Nevus halo appears in people with reduced immunity and severe autoimmune diseases. A white rim appears at the site of the mole. It occurs more often in childhood and adolescence.

Spotted Nevus

A spotted nevus is a light brown spot type measuring 0.4 to 6 inches (1 to 15 cm). It has a background of small dark brown spots or nodules 2 to 3 mm (2 to 3 mm) in size. The foci usually develop before the onset of puberty. The cause is a failure of the structure of pigment cells containing melanin.

Nevus of Ota

Nevus of Ota is a gray or blue spot around the eye caused by genetic neurological factors. It can be subtle or brightly colored. It is mainly found in Asian people.

Flaming Nevus

Flaming (wine) nevus looks like a red or purple irregularly shaped spot. Occurs from birth, formed from dilated capillaries. As the child grows, it enlarges and becomes lumpy, never resorbs on its own. The exception is Unna's nevus. Red spot (sometimes called "stork bite" or "angel's kiss") is located on the back of the neck, sometimes on the eyelids and bridge of the nose. In a third of newborns, such a nevus, disappears by 3-5 years of age.

Anemic Nevus

Anemic nevus - white spots with irregularly shaped edges on the chest or back. It occurs due to a violation of the development of blood vessels in a certain area of the skin. In infants, it is almost invisible, more vividly manifested at school age.

What Increases the Risk of Melanoma?

Melanoma does not always arise from a nevus. It can develop in places where there have never been moles before. But you need to know what can trigger the development of the dangerous disease.

High Exposure to Sun

Ultraviolet radiation is the most studied risk factor for melanoma. It can affect and damage the DNA of melanocytes. Normally, other skin cells die when exposed to high levels of radiation, but melanocytes are protected and can survive by accumulating breaks in their genes. This can lead to malignant skin neoplasm.

Note to self. Five or more sunburns double the risk of developing melanoma, especially if the burns were received in childhood.

Use of Tanning Beds

Artificial UV radiation (such as tanning beds) increases the risk of developing melanoma. A large review of various studies found that people who use tanning beds before age 35 have a 59% higher risk of developing melanoma of the skin than those who do not use tanning beds. 

As a general rule, experts recommend not tanning at all. Use SPF protection, closed clothing, and sunglasses if you vacation to hot countries or live in sunny states. 

Having More Than 50 Moles

The risk of developing skin melanoma increases more than 7 times among people with a large number of nevi (100+) compared to people with a small number of moles (0-15).

Atypical Moles

Potentially dangerous moles are called atypical nevi. Atypical nevi are benign skin growths that should be closely monitored. Such moles have an increased risk of transforming into melanoma.

Typically, atypical nevi are larger than 5 mm in diameter, with fuzzy edges and a multicolored surface. Doctors recommend checking them yourself every month. So you will quickly notice the signs of change in moles and can timely contact a doctor.

Melanoma Cases in the Family

Up to 10% of patients with melanoma of the skin have a hereditary form of the disease. If your close relatives have had cases of melanoma, this is a reason to have periodic skin examinations by a doctor. 

The risk of melanoma recurrence is higher in patients who have already experienced the disease.

Related to Moles Formations

The closest "relatives" of moles are benign warts or spines. These are growths on the skin associated with human papillomavirus (HPV) infection. The virus can be contracted in the home or through unprotected sex.

When Should I Have My Moles Checked?

It depends on how many nevi you have and what type they are. We have already mentioned that dysplastic neoplasms are more likely to develop into melanoma. 

What Types of Moles Are Dangerous?

It is necessary to independently monitor moles and monitor their size, shape, and color changes. You should always look out for unusual moles; the ABCDE self-diagnosis algorithm can help.

A. Asymmetry

A healthy mole is typically round, as it grows uniformly. Asymmetry occurs when one half of the mole does not match the other. If unsure about a mole's symmetry, consult a dermatologist for a professional evaluation.

B. Border

Healthy moles have smooth, well-defined borders and are usually round. In contrast, melanomas often feature irregular or blurred edges.

C. Color

Typical moles are generally uniform in color. Melanomas, however, may display uneven coloring and multiple colors. Pay close attention to moles that begin to darken, as this can be an indicator of malignancy.

D. Diameter

Melanomas typically measure more than 6 mm in diameter, similar to the size of a pencil eraser, although some may be smaller. A mole's large size is a reason to watch it closely, but remember that even larger moles can be benign, and smaller ones can be malignant.

E. Elevation or Enlargement

Melanoma may change in size, shape, and color and elevate above the skin's surface. Inflammation or swelling near a mole is a concerning sign. Sometimes, the mole may not change, but the surrounding area might become swollen.

Ugly Duckling Syndrome

A simple strategy for identifying dangerous skin neoplasms with self-diagnosis. Most moles on the body look similar to each other. However, when a mole develops into melanoma, it stands out significantly from other spots on the body. These are irregularities and abnormalities, areas on the skin that appear irregular. This sign is individualized because an ugly mole in one patient may appear perfectly normal in another.

When Should Changes in Moles Concern You?

In pregnant women, it's common for moles to change in color and size; this is generally not a cause for concern. Moles can also change slightly with age.

However, if a mole changes within six months to a year, it's advisable to seek a medical evaluation. Such changes could be indicative of potential health issues and warrant professional advice.

What is the Risk of Melanoma for People with Dark Skin?

People with dark skin are less likely to get melanoma. Their skin is dominated by Eumelanin (a type of melanin.  It absorbs some of the ultraviolet (UV) rays that hit the skin, giving a small amount of protection from dangerous radiation. But the darkest skin tone provides only the equivalent of SPF 13. That's too little to safely be in the sun and fully protect yourself from UV rays.

The five-year melanoma survival rate for Black patients is approximately 70 percent, compared to 94 percent for White patients. Among Africans and Asians, melanoma most commonly appears on less exposed areas such as the soles of the feet, palms of the hands, or underneath the fingernails.

How to Do a Proper Self-skin Examination

At home, you can try to check a mole using algorithms for neural networks. Various apps can evaluate a mole to see if it is dangerous.

• UMSkinCheck
• Miiskin
• MoleScope
• SkinVision

Remember that today, no app can replace the consultation of a competent specialist. The algorithm of applications is configured so that, with the slightest doubt, it makes a conclusion for the worse. So that you do not miss dangerous neoplasms on the skin.

How to Self-Examine Moles?

Self-examination of the skin is best done after a shower or bath in a well-lit room in front of a full-length mirror. For hard-to-reach areas (such as the back of the thighs), you can use a hand-held mirror. 

You can also get help from people close to you, especially when examining the back and head. During the first examination, be especially careful to note the location and texture of moles, spots, freckles and other skin growths so that you can note any changes later on.

Moles Self-Examination Guide

• Face and Upper Body: Stand in front of a mirror. Examine your face, ears, neck, chest, and abdomen. Women should lift their breasts to check the skin underneath.
• Arms and Hands: Inspect the underarm area, and assess your arms (including shoulders and forearms) from all sides. Look at the backs of your hands, palms, areas between your fingers, and under your fingernails.
• Legs and Feet: While sitting, check the fronts of your thighs, shins, and the backs of your feet. Examine the areas between your toes and under the toenails.
• Using a Hand Mirror: Review the back of your thighs, calves, and soles of your feet. Check each leg in turn. Then examine your buttocks, genitals, lower and upper back, the back of your neck, and your ears with the hand mirror.
• Scalp: Use a hairbrush or hairdryer to part your hair and examine all areas of the scalp.
• Back: View your back in a wall mirror to check areas that are difficult to see.

When Should I See a Doctor?

• A mole looks unusual or is noticeably different from others.

• You develop a new mole after the age of 40.

• A mole changes in color, size, or shape within 6 months.

• A mole starts to itch, bleed, or ooze.

Should Moles be Removed?

There are medical and cosmetic indications for mole removal. Cosmetic reasons include all moles that cause aesthetic discomfort to the patient. If a person does not like the mole, they can remove it. Remember that before removing any mole, it is necessary to consult with a dermatologist.

Modern doctors have found a golden mean in deciding whether it is necessary to operate on the removal of moles. You can see the dropout zone through a dermatoscope (a special device for diagnosing moles). It includes tiny formations around the mole, similar to its structure and appearance. The presence of such clusters of cells indicates that the mole is growing and spreading to neighboring areas. With a high probability, it will soon turn into a dangerous tumor, so the mole should be removed. Also, the following moles should be removed for medical reasons.

• Moles are constantly traumatized (for example, they are constantly rubbed with clothes, or they are on the feet, palms).
• Damaged moles (cut, inflamed, etc.).
• Large single moles.
• Moles with changes in size, shape, and color that fit the ABCDE classification.

Important! You should not remove a mole yourself, even if it is small. There are many risks involved in removing a mole at home. Using Amazon creams and lotions may seem like the easiest way to solve the problem. But these products can increase the risk of developing colloidal scars. These are large, bulging scars.

When you remove a mole at home, an infection can get into the wound. The biggest danger is that you can't know exactly what you're dealing with. It is quite possible that the mole could be malignant. 

What to Do if Your Doctor Says You are at Risk of Melanoma

Don't be alarmed by this warning. It is important information that will help keep you healthy. You should know that not every potentially dangerous mole becomes a melanoma. A doctor can advise a tactic to monitor or remove such a mole.

For patients with an increased risk of melanoma and multiple, similarly pigmented moles on the skin, if possible, the doctor recommends a "skin passport," or "mapping."  These are photographs of all moles using a dermatoscope, made according to a special algorithm. "Skin passport" will allow the doctor to evaluate all of the patient's moles using a special computer program and monitor their changes over time.

Final Takeaway

Skin checks are a simple but powerful tool in preventing skin cancer. Knowing what’s normal—and what’s not—can save your life. If you're unsure about a mole, don’t wait. Schedule an appointment with your doctor to have it evaluated.

Need a mole checked? Contact our office today to schedule a skin exam.