Moles

Most people have moles on their skin. Young adults have plenty of pigmented moles that are dark or nearly black, but they become less noticeable in middle age. A pigmented mole may sometimes go through the feared transformation to a malignant pigment cell tumour called melanoma, but actually up to 80% of melanomas originate from normal-looking skin, from a single pigment cell, and not from a mole.

You should think twice about having a mole removed simply for cosmetic reasons, because scar tissue at the treatment site may turn out to be a bigger cosmetic problem than the mole itself. The way in which scar tissue develops cannot be predicted, so the scar can be an unpleasant surprise for those who have never previously undergone surgery. If the mole is to be removed, surgical removal is usually the safest option, as the entire mole is removed and a biopsy sample is taken to make sure the mole is benign. Laser mole removals should only be performed in rare cases.

Melanoma

Melanoma cases have increased among fair-skinned people during the last few decades in Finland and elsewhere. It’s likely that the increase is due partly to the fact that melanoma awareness has grown. As doctors and patients are now better able to suspect melanoma, it is detected earlier than before. Early detection has improved its prognosis. If treated early, melanoma can be cured in 90% of patients.

The risk of melanoma is greater in people with over 50 pigmented moles. The risk is also higher among those with fair skin that burns easily and tans poorly and/or is freckled, as well as among those with melanoma in their immediate family and moles with a diameter of over 7 mm. According to epidemiological studies, the development of melanoma is also affected by repeated sunburns, particularly at young age.

Contrary to general belief, abrasions or other skin injuries do not increase the risk of melanoma. However, smoking and malignant skin tumours are connected: although the risk of developing melanoma is no higher among smokers than non-smokers, smokers have more severe melanomas and poorer treatment outcomes. Smoking also slows down wound healing, so surgical scars are bigger in smokers than non-smokers.

Monitor your moles

You can monitor your moles and show them to the doctor, for example in conjunction with another appointment, if you’ve detected any of the following:

• The mole has grown bigger or you notice a sudden skin tumour.
• The mole has changed in size and appearance. This includes changes in colour from brown to black, bluish or reddish, or if the mole is oozing pus or blood. The changes often affect only part of the mole and are asymmetrical. A symmetrical mole can become asymmetrical as it grows.
• The mole is itchy, sore or tingly.
• The skin surrounding the mole is reddish.

When should you seek treatment?

• The size, colour and number of the moles usually change slowly over the years. Typically, a flat, brown mole starts becoming lighter in colour and slightly elevated. Over the years it may turn into a raised skin-coloured mole. If the changes are clear and happen faster, i.e. within weeks or usually within a few months, they should be taken seriously.
• If a mole is in a place where it cracks or ruptures, it can be removed even if it was unlikely to have developed into a melanoma.
• If you notice any changes in your moles or anything else about them that worries you, contact a healthcare professional to get an appointment for a mole check-up.

Information sources: The Finnish Medical Society Duodecim: Terveysportti, Lääkärin tietokanta database

FSHS General Practitioner / 24 February 2023

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