¬ What is Mole?

Skin is the largest organ of our body and has many functions. It serves like a barrier to the outer world to avoid cold,hot exposure  and minor traumas. Also, it prevents from dehyrdration, keeps away microrganisms to enter into our body, synthesize vitamins and functions as a sense organ. In our daily life concerning  this crucial organ we may come up against many risks including many good or bad lesions.This essay  is intended to be written to help you understand more about moles.

Moles (nevus) are small brownish lesions that can be noticed on every individual’s body especially emerge between ages  10-20. They may be flat or raised on the skin. Often they have circular or oval shapeswith smooth edges. Most of them come up due to sun exposure. Depending on their location on the skin moles or nevuses can be defined and called as intradermal, junctional or compound nevuses. Moles namely nevuses are commonly seen  lesions anywhere on the skin and can appear at any age. Junctional nevuses get bigger at maturity stage and become compound nevuses. As to intradermal nevuses, they are called as moles. They can be seen in any part of the body.They can be flat or raised, brownish or  skin coloured, circular or oval shaped  and they are mostly smaller than 6mm.

Are moles required to be removed?

Usually moles are removed for cosmetic reasons. Besides they can be excised surgically to prevent traumas that are caused by excessive contact to undergarments or irritation while shaving . Depending on the moles thay may be removed surgically or with laser.

Which moles are required to be removed?

Atypic mole (dysplastic nevus) It usually emerges later which is benign (harmless) mole that imitates skin cancer called as melanoma. Its colour may vary from black to pinky and it has flat and irregular edges. Also, size of these lesion typically ranges from 5-10mm.Even it is benign, patient has a greater chance to develop melanoma than others. As the number of atypic mole increases the risk of melanoma increases. Distinguishing an atypic  moles is a major issue  because it may seem like melanoma. That’s why, it requires a close follow up and removal if it poses risk. Also, remaining ones should be followed carefully. Thus, it is crucial that patient should check her/ himself. In case a change in the colour, size, shape occurs or itching starts immediately patient should be examined by a plastic surgeon or dermatolog with a dermatoscope. 

Congenital melanocytic nevus (giant hairy nevus) It is congenital and dark in colour. It is present at birth and it may also appear a year followed by birth. The main reason for not recognizing at birth is that the mole has flesh/skin colour. In the years ahead it is detectable as it gets darker colour when melanin /pigment production increases .

It is assumed that the mole is grown between the 5th and 24th week of embryonic stage.İt appears randomly and independently from family. It may also be inherited. The colur varies from dar kor light brown to blue. Generally, it has regular smooth edges and may be in several shapes like circular, oval. Mostly if diameter is less than 1.5 cm and it is diagnosed as small congenital hairy nevus. The one which is bigger than 20 cmis diagnosed as giant hairy nevus. Malignite which means the risk that it may turn into a bad illness changes between %0-%5. In some resources the ratios may differ.

That is why small congenital mole should be followed up oftenly and giant ones require surgical removal besides dermatoscopic follow ups.

Can moles develop cancer?

Malign melanoma is the most dangerous cancer type. Due to uncontrolled sun exposure, tanning and sunburn relating to genetic harm on the skin cells , the cells emerge as a result of infinite proliferaton and cause tumor.These tumors take root from the melanocytes which produce pigments to skin.They may resemble melanoma moles and sometimes moles can develop melanoma. While most of the melanomas are black or brown they may be pink, red,skin colour, blue, purple or even white. Malign melanoma strictly necessitates surgical treatment.

How should moles be cured? When should they be removed? 

If conditions stated below develop patient must see a plastic surgeon or dermatologist. The changes are abbreviated as ABCDE. ABCDE is highly important for the follow up of moles. 

Asymmetry: If you draw a line in the middle of the existing mole the parts are even and have it checked if it is not.

Border:In the early phase, the mole has irregular edges or borders and also has notches and umbos.

Colour:Moles have often one colour while melanoma has more than one colour.Black, dark brown or diffrent brown tones can be observed. At the same time the colour of melanoma can be red even blue. 

Diameter: Melonomas are bigger than an eraser (6mm).Sometimes they may be smaller.Typically they are smaller than 6mm.

Evolving: Diameter, shape, colour and height should bring up doubt.Other than these signs and symptoms including itching, bleeding and crusting should be considered carefully.

Does the mole removal cause cancer?

Surgical removal does not cause cancer. Conversely,when totally removed it is a preventive treatment that abducts the risky tissue from the body.

How is surgical removal done?

Moles that are considered to be removed are marked as diamond pieced shape.The surrounding is numbed locally with anesthetic injection. After this step you won’t feel any pain. Next step, the mole is excised and removed surgically with its root. By using fine stitches / sutures the closure is done. Medical dressing is placed. Immediately after te procedure you may resume your daily life.

Is mole removal painful?

Mole removal is performed under local anesthesia.During injection with very fine needle for local anesthesia you may feel little discomfort.But after this step you won’t feel pain just in case  a simple pain killer will help you manage the mild pain. 

Prof. Dr. Muhitdin Eski