Moles or nevi are very common growths on the skin. Most people have moles and can either be present at birth (congenital) or acquired in childhood and adolescence. Moles can be different colors ranging from no color to brown or black and typically 3 to 5 millimeters in diameter. An easy guideline is the size of a pencil eraser or less.
Moles are caused by clusters of the pigmented cell melanocytes that group together within the epidermal and dermal layers of the skin. Moles can be flat or raised have round symmetry be irregular in shape. Moles can appear on your nail beds, mucous membranes in addition to the face and body.
What to Watch For
The good news is moles have a lower incidence of becoming cancerous but it’s a good idea to get familiar with your own moles characteristics. Other considerations are any family history of skin cancer, particularly melanoma and your sun exposure. Skin cancer screenings are the best way to get an accurate baseline of what your normal is followed by yearly screenings.
For adults, it’s important to watch for any mole that has changed in size or a new mole. Other changes besides growth are borders that are irregular, itching, and bleeding. When in doubt it’s always good to schedule an appointment. Cancerous moles such as melanoma found early are highly treatable.
Most moles do not need to be removed but are done so because the patient finds the mole unattractive or is in a place that is bothersome. Suspicious moles should always be evaluated and removed.
Diagnosis and Treatment
Once you’ve determined it’s time to schedule your appointment you can expect the following:
Diagnosis: Dermatologists in their specialty have a trained eye to spot moles that need further evaluation. Dr. Michalak, Emily Nardiello PA-C, Elizabeth Wood, PA-C, or Debbie Gauthier, NP use a dermatoscope as part of this process. This hand-held device enables visualization of moles providing filters to better see the features of each mole. If it’s determined the mole needs further evaluation, then a biopsy is performed.
Biopsies: Biopsies are done by taking a sample of the mole by shave or punch biopsy. Punch biopsies require a small stitch in the skin. Results are then read through pathology and the patient is called to review the findings.
Treatment: If found to be atypical a second appointment will be recommended. Dr. Michalak will review the findings from the biopsy with you and provide a comprehensive treatment plan. Atypical moles can require surgical excision and is a common method of removal. Atypical moles are not skin cancer but can increase your chance of developing melanoma especially if you have more than one.
Cosmetic Mole Removal
If you elect to remove a mole for cosmetic reasons, the procedure is similar. Mole removals can either be done by shave or surgical excision. The location and depth of the mole will determine how it’s removed and discussed in your appointment. Cosmetic removal is normally not covered by insurance because it’s an elective procedure. We will provide the fees prior to your procedure.
Self-examination is the best precaution you can take besides routine sunscreen protection and yearly skin exams. The first five letters of the alphabet ABCDE can be used as a general guideline for what to look for in early detection of melanoma:
• Asymmetry- most melanomas are irregular in shape vs. round or oval
• Border irregularity-look for scalloped edges vs. smooth borders
• Color-Multiple colors, especially black or colors like red or white is a warning sign and should be evaluated
• Diameter-anything larger than the size of a pencil eraser should be watched more carefully
• Evolving- changes in size, color, elevation or that bleeds, crusts or itches
When to See A Dermatologist
Anytime you are concerned you should schedule an appointment. Early detection is key when it comes to treating melanoma which can be deadly if not caught early. Skin cancer can grow quickly so it’s best to have peace of mind and be evaluated. We recommend yearly skin exams as part of your normal health care routine.
Scheduling Your Appointment
Patients can usually be seen within a week of calling for an appointment or sooner. Cosmetic Surgery & Dermatology takes most insurance plans including Medicare. The office is an all-inclusive clinic and AAAHC accredited surgery center.