Everything you need to know about identifying moles and preventing melanoma

While noticing an increase in moles on your body and face as you age is perfectly normal, it can come with questions and concerns. How can you tell if a pigmented legion is actually a mole, and not a freckle or skin tag? When is a mole potentially cancerous? Does your mole ‘profile’ make you prone to melanomas?

“It is important to monitor your moles throughout the year,” Dr Derrick Phillips, a London-based consultant dermatologist, tells us—however now is an ideal time. “Having a professional mole check in spring provides the opportunity for any abnormal moles or skin growths to be identified and treated ahead of the summer period, when they may be exposed to more harmful UV rays.”

To identify how to correctly monitor moles yourself, know where best to check them professionally, and bust some myths around common issues that moles present, we posed your questions to Dr Marko Lens, an internationally renowned authority in the field of skin ageing and skin cancer, and Dr Paul Banwell, a skin cancer expert and the founder and former head of the Melanoma and Skin Cancer Unit (MASCU) in East Grinstead, which is one of the UK’s largest skin cancer units.

When is a freckle actually a mole?

“Any dark spot on the body is called a pigmented legion,” says Dr Lens. Generally speaking, for a non-medical person it’s not easy to distinguish a ‘mole’ from a ‘freckle’, and that’s why a regular check with a dermatologist is advisable because often when we think something is a freckle, it’s actually a mole—and moles should be properly monitored.”

“Freckles occur as a result of genetics or sun exposure, whereas moles appear after skin cells develop into a cluster instead of spreading out,” explains Dr Banwell. “In themselves, freckles are quite harmless and rarely develop into cancer.” While freckles themselves aren’t an immediate cause for concern, “they can mean that your skin has been exposed to UV light which can cause premature ageing so it’s important to try and protect skin from this using a high factor SPF,” he adds.

How should you self-monitor moles?

Dr Lens says that the main reason we check moles is to avoid melanoma, which is the worst type of skin cancer. So a proper self-inspection is very useful. “Follow the ‘ABCDE’ method to identify signs that may indicate a melanoma, and therefore require professional intervention as soon as possible.”

A for Asymmetry

Has the shape of your mole changed? Or do the two halves differ in shape?

B for border

Have the edges of your mole become irregular or blurry? Do they look ‘ragged’?

C for colour and change

Are there multiple colours in your moles, or is the colour uneven? Have you noticed a change in colour? Has there been itchiness or bleeding?

D for diameter

Has your mole changed size? Has it become more raised? Anything above 6mm in diameter might be suspicious.

E for evolution

What is happening to the mole over time? Changes in any aspect can be a sign that a mole needs to be checked as soon as possible by a professional.

“Detection starts with self-examination, something everyone should be doing regularly regardless of their number of moles or sun-exposure history,” Dr Lens adds.

When should you seek professional advice for a mole?

“If you are worried about an area of your skin, or something has changed, please seek professional advice,” says Dr Banwell. “If skin cancer is caught early, it can be easily treated.”

There are different types of skin cancer, he explains; non-melanoma skin cancers and malignant melanomas. “Non-melanoma skin cancer, the most common types, refers to a group of cancers that slowly develop in the upper layers of the skin.” Here, “common symptoms of skin cancer include a sore area of skin that doesn’t heal within four weeks, looks unusual or hurts, is itchy, bleeds, crusts, or scabs for more than four weeks.”

Dr Banwell adds that the less common type of skin cancer is known as melanoma, which can be more serious. “Melanoma is a type of skin cancer that can spread to other organs,” he says. The most common sign of melanoma is the appearance of a new mole or a change to an existing mole.

“For melanoma, any pigmented mole that changes colour, size, outline, or moles that bleed, become raised, or crusty should be checked professionally, especially if there are pre-existing multiple moles, a family history of skin cancer, sunburn history and sunbed use.”

How often should you check your moles?

Dr Banwell advises using an approved system for checking for moles; “this can be done with the help of a partner or by using a phone to take pictures and monitor changes.” He adds that “it’s important to regularly check your whole body for any signs of melanoma including places that are often missed and hard-to-reach such as on the buttocks and back, as well as on the scalp.”

“If you are concerned, you should make a professional appointment for a full-body assessment—not for just one mole. People should check their own moles every three to four months and aim for a professional check once a year.”

Dr Lens agrees that professional mole checks are advisable once a year, post the age of 25. “It is common to develop more moles as you get older, but if you start noticing them develop and you’re younger than this you should seek advice.”

Are there any times in your life when you might expect the mole to change?

“Moles can change at any time and any point—or never; they’re very unpredictable. When we know they might change in appearance—from size to colour—is during pregnancy, due to hormonal changes. That’s why we always recommend that expectant mothers regularly check moles just to avoid a melanoma diagnosis during pregnancy. There are no other times in your life that you can expect changes unless you have often and frequent sunburns. These can be a strong triggering factor of the changing of the moles and the development of melanoma.”

Aside from monitoring your moles, what is the best way to avoid the development of melanoma?

Dr Lens says, “Avoid sun exposure as much as you can, and if you do go in the sun make sure you’re wearing broad spectrum SPF and reapply it every two hours. If you sweat excessively, go in water, or rub the skin with a towel, then you should reapply the sunscreen regardless of the two-hour guidance. Of course, physical avoidance of the sun is the best prevention of skin cancer and changes in moles. We know that so-called ‘recreational’ sun exposure is the biggest risk factor in the development of melanoma.”

Dr Banwell adds, “I cannot emphasise enough the importance of selecting a broad spectrum sunscreen, which will protect against UVB and UVA rays. UVB rays cause redness and sunburn as well as skin cancer while UVA rays can also cause cancer as well as ageing of the skin.”

While SPF formulas are more advanced than ever before, “people continue to apply it too sparingly and not often enough,” Dr Banwell notes. “The NHS recommends an SPF of at least 30 to protect yourself. Personally, I would use SPF 50.” He feels it’s also essential that a greater emphasis is placed on the importance of regular SPF application, “even when it’s not sunny”.

If you’re prone to moles, can that indicate that you could be prone to skin cancer?

“It’s believed that people with 11 or more moles on their arm are more likely to have over 100 moles on their body—a known risk factor for the melanoma type of skin cancer,” explains Dr Banwell.

“This can be described as ‘atypical mole syndrome’, which means you have a lot of moles and some are atypical. This can mean you are at a higher risk of developing skin cancer.”

If you’re not prone to moles and suddenly develop them, can that indicate a skin cancer risk?

“No, there are no rules. Some people develop moles at any later stage in life,” says Dr Lens.

“Most are benign and can occur due to factors such as age, or medication, sunburn, or genetics,” adds Dr Banwell. “If a mole appears and looks unusual, it is a cause for concern and should be checked.”

Is there any reason to remove non-cancerous moles except for cosmetic reasons?

“Not unless they are changing. I am against mole removal other than for a reasonable aesthetic request. Removing the mole just to save yourself from having a melanoma is not really necessary, and I recommend that people don’t do that,” says Dr Lens.

Dr Banwell adds that “it is important to note that not all moles need to be removed, and in some cases, removal may not be recommended—therefore, it is crucial to consult with a qualified professional before undergoing any cosmetic procedure”.

If you’ve had a mole removed, do you need to treat this healed skin with special care?

Dr Lens says, “Usually if you have a mole removed that area can be more sensitive and prone to sun damage. There is often pigmentation and sometimes also a scar. Therefore, again, you should avoid the sun, or protect it with SPF like everywhere else. Otherwise, no special treatment is required.”

He adds that “if you have had a mole removed by laser, sometimes you get a return of the pigmentation”. To inexperienced eyes, it can look like melanoma, but it’s not; it’s so-called ‘pseudo melanoma’—which is just pigmentation. “However, you’d want to get that confirmed by a professional.”

Are skin tags related to moles, and a cause for concern?

“They’re not; they’re a simple growth of excessive skin and are completely benign,” explains Dr Lens. “Sometimes skin tags can be pigmented, and because they are pigmented they look darker than the rest of the skin, but they are not dangerous and can be easily removed. It’s a minor procedure and nothing to worry about.”

However, there’s an important thing to note about skin tags—in Dr Lens’ clinical experience, “People see an aesthetician to have what they think is a skin tag removal, and often it was actually a mole (a mole can be non-pigmented, so it can look like a skin tag). And sometimes it can actually be a skin cancer, called a basal cell carcinoma. So again, it’s best to see a dermatologist to confirm for proper diagnosis and treatment.”

What should you do if you accidentally remove a raised mole?

Dr Banwell says this can happen quite often, especially around the bra and waistband areas. “It will be quite painful and can bleed, but it shouldn’t require medical treatment unless it continues to bleed—as a growth on the skin that continually bleeds is a warning sign of skin cancer.”

This piece originally appeared in Harper’s Bazaar UK. 

Also Read: Why you should include malachite crystal in your skincare routine

Also Read: 10 things you should know about freezing your eggs