Moles come in all shapes and sizes; some raised and some flat. Almost every adult has moles; on average, we grow about 10 to 40 moles in our lifetimes. Those with lighter skin tend to have more moles. While moles are nothing much to worry about, you should know that: 

  • Melanoma, a type of skin cancer that develops from pigment-producing cells also known as melanocytes, can grow near or in a mole 
  • The first sign of melanoma appearing can be a change to a mole over time or even a new mole on your skin 
  • When caught and treated early, melanoma can be cured 
  • One way to catch melanoma early is by examining your skin regularly. I will teach you how to do so in this article.

Is it a mole or melanoma?

Moles can appear anywhere on our bodies, from our scalp, palms, toes and even under our nails. They may not look alike and can differ in colour, size or shape. However, they often have these traits: 

  • Uniform in colour — moles are often brown, but they can be black, red, tan, pink or blue 
  • Round in shape 
  • Can be flat or raised with hair sticking out. Note that raised moles aren’t always determining factors of skin cancers 
  • Looks the same; does not change in appearance 

Melanoma, on the other hand, is slightly different. Moles with melanoma are often irregularly shaped, larger than the size of say a pencil eraser and contain many colours. We usually refer to the ABCDEs when examining moles or skin growths to check for signs of melanoma. 

Asymmetry
When your mole is asymmetrical, it means one half does not match the other. Normal moles are always symmetrical. To check for asymmetry, you may use a ruler or just draw an imaginary line through the middle of the mole. Compare the two halves — do they look the same or match up in terms of shape? If it doesn’t, have the mole checked by a dermatologist. 

Border
Regular moles have well-defined borders, meaning the moles resemble complete circles. Irregular moles have borders or edges that are ragged or blurred — think scattered and looking somewhat like a blurry paint splat. 

Colour
Irregular moles do not have the same colour throughout and usually contain shades of red, tan, brown, black, blue or white. If you have a mole of many shades or a mole that has lightened or darkened over time, you should get it checked by a doctor. 

Diameter
A mole is suspicious if it’s larger than 6mm or the size of a pencil eraser. 

Evolving
If a mole that wasn’t once raised is now raised, you should have it checked out by a doctor. The same goes for moles that shrink, change colour, itch or bleed. Essentially, moles that change in appearance over time are usually warning signs.

Are raised moles dangerous?

Raised moles may appear large and unsightly, but they are not always dangerous. As aforementioned in this article, raised moles are not necessarily signs of skin cancer. I would be worried if: 

  • The particular mole was not raised in the past or elevated over time 
  • The raised mole has surrounding melanin with irregular borders or colours (refer to ABCDEs above)

Is it possible to remove moles safely?

Regardless of whether your mole is cancerous or not, yes, it can be removed safely. This includes raised moles which require slightly more work — but still achievable nonetheless. 

In Singapore, there are three ways for mole removal:

Surgical excision

Surgical excision is recommended for raised moles. This method requires cutting the mole out of the skin using a surgical instrument like a scalpel, electrocautery or an ablative laser. While surgical excision sounds intimidating, it is a simple procedure where the mole is removed through free-hand cutting or a special device. There will be a linear scar, but with good surgical skills and microsurgical techniques, scarring can be minimised.

Surgical shaving

Surgical shaving requires shaving the mole off the surface of the skin. This method is better for flat moles or protruding moles that don’t grow too deep. Some textural change or discolouration is inevitable.

Laser

There are two types of laser treatments available: ablative and non-ablative pigment laser. Some common ablative lasers are the Erbium-Yag and CO2 laser, which are well-liked among patients and doctors due to their ability to remove moles precisely without damaging other skin layers. Ablative lasers are often recommended for raised moles; I suggest using an ultrapulse CO2 laser first to flatten or remove the protruding mole, and then a pigment laser to get rid of any residual pigment. A few sessions may be required, but removing the raised portion of the mole usually requires just one session. 

For flat moles, non-ablative pigment lasers may be a better option as ablative lasers can cause a scar or dent.

To sum up

I hope this article gave you a better insight on moles. Remember to pay special attention to your moles, especially during pregnancy or menopause, when your hormones may be surging.

References

  1. Hamilton, S. A., Kirk, J., & Morris, A. M. (2001). Long-term results of surgical excision and skin grafting for a giant hairy naevus of the face: time for a return to conventional wisdom?. British journal of plastic surgery, 54(6), 543–545. https://doi.org/10.1054/bjps.2001.3661
  2. Rastrelli, M., Tropea, S., Rossi, C. R., & Alaibac, M. (2014). Melanoma: epidemiology, risk factors, pathogenesis, diagnosis and classification. In vivo (Athens, Greece), 28(6), 1005–1011.https://pubmed.ncbi.nlm.nih.gov/25398793/