Though warm weather makes it tempting to swap your winter coats for T-shirts, unprotected sun exposure can be harmful to your skin and lead to noticeable changes, such as the development of moles. TriHealth dermatology division director Dr. LeAnna Lane spoke with HealthScene Ohio about proper care and treatment of moles, and shared advice on how to safely enjoy the sunshine.
HealthScene Ohio: What are moles and how do they develop?
Dr. LeAnna Lane: Moles are clusters of melanocytes, which are the types of cells in our skin that make pigment. They are more numerous in lighter skin types, mole-prone families and areas of sun exposure.
HSO: What are the defining features of the different types of moles?
LL: There are three broad types:
Congenital moles: Moles people are born with. Can be larger than other types of moles. Usually brown, raised and often have hair.
Acquired moles: Usually first appear in childhood and become more numerous over time. May be flat or raised, and are usually brown or flesh-colored with even pigmentation and smooth borders.
Dysplastic moles: Tend to be larger moles with more haphazard pigment and fuzzy borders. Come in more variety of colors.
HSO: Which types of moles require professional treatment and which ones can be left alone?
LL: Most moles are normal growths on the skin. However, if a mole changes over time and becomes worrisome for melanoma, the mole should be removed. If a mole is bothersome because it is itchy or rubbed by clothing, for example, it can also be removed.
HSO: How often should an individual check himself or herself for moles, and how often should he or she consult a dermatologist for a general checkup?
LL: The American Academy of Dermatology (AAD) recommends, at a minimum, checking your birthday suit on your birthday. Many dermatologists will recommend patients perform a self-skin exam once monthly, often combined with a monthly self-breast exam. There are no formal guidelines from the AAD or the American Cancer Society on how often adults should be screened, although it is recommended as part of health maintenance. The frequency is often determined by personal risk factors. In general, those with lighter skin types, more numerous moles and family members with a history of melanoma should have more frequent checks.
HSO: When should patients seek medical consultation regarding concerns about a mole?
LL: The ABCDEs are a good guide:
Asymmetry: One half of a mole is unlike the other half
Border: Fuzzy borders or scooped borders
Color: Color changes from one area of the mole to another with multiple shades
Diameter: Most melanomas are greater than 6mm, or the size of a pencil eraser
Evolving: A mole or skin spot that looks different from the rest or is changing in size, shape, color
A mole that becomes tender or bleeds by itself can be another sign of a problem.
HSO: What should patients expect from the mole removal process?
LL: The skin around a mole is injected with a numbing medicine. The mole is then scooped or shaved from the skin with a small blade. This is the most common way, and it leaves behind a small circular wound that heals with a small circular scar. Larger moles may need to be excised, or cut out, in which case a deeper cut is made and stitches are usually required to bring the skin back together. This will leave a larger line type of scar.
HSO: How long does it normally take for skin to recover following the removal?
LL: Usually two to three weeks for healing.
HSO: How likely is it that a mole will grow back once it is removed?
LL: This often depends on the size of the mole and how it was removed. Moles that are excised are less likely to come back, but this tends to be a larger and more invasive procedure than shave removal.
HSO: What concerns, if any, would you share with someone who is looking to remove a benign mole for cosmetic purposes?
LL: There is no scar-free way to remove a mole; they cannot be frozen with liquid nitrogen or treated with a laser. Unfortunately, patients may be less happy with the scar than they were with the mole, and there is no way to put the mole back.
HSO: Do moles need to be covered with sunscreen? How should someone approach sun exposure?
LL: Moles should be covered with sunscreen, but no more so than the rest of the skin. Melanoma most often develops on new skin, not from an existing mole, so patients should take care to protect all of their skin. Patients just need to be smart about their skin when they are outside. Wearing sunscreen with at least an SPF 30 on all the areas not covered by clothing, wearing protective clothing and hats when possible, staying in the shade, going out in the morning or evening hours – these are all ways of protecting the skin and moles.
HSO: What are some other things readers can do to prevent the development or growth of moles?
LL: Moles most commonly develop in areas of sun exposure. For example, look at the number of moles on the outside versus the inside of your arm. So, protecting the skin from sun, starting early in life, is the best way to prevent the development and growth of moles. And never, ever use a tanning bed. But some moles are going to be part of our genetics and will develop in spite of sun protection.
Amanda Etchison is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
About the Expert
Dr. LeAnna Lane is the dermatology division director at TriHealth. A graduate of the University of Missouri-Columbia School of Medicine, Dr. Lane is a member of the Alpha Omega Alpha Honor Medical Society and is certified by the American Board of Dermatology. Dr. Lane’s practice focus is on general dermatology and skin cancer prevention and screening. Her research on public attitudes toward tanning and protection of skin from sun has been featured in journals such as Pediatric Annals and Pediatric Dermatology, and has also been presented at the American College of Sports Medicine’s annual conference.
