What are moles?
Moles – medically termed ‘nevi’ – are skin lesions appearing as small dark brown spots. Moles occur when pigment- or colour-producing cells called melanocytes grow in clusters. These are common in appearance and may be present at birth or develop later in life. Most people have 10 to 40 moles by adulthood, which mostly appear in childhood and usually until 30 years of age. Moles are usually round or oval but, over time, they can become flat or raised or can change colour, while some might slowly fade away. Moles tend to become darker with sun exposure or due to hormonal changes during the teenage years and pregnancy.
Changes in moles
The moles that are of medical concern are those with an appearance that has changed over time. This can include changes in colour, height, size, or shape or moles that bleed, itch, exhibit redness or swelling. Medical attention is required if you find any of the features that are described as the ABCDEs of melanomas: Asymmetry, irregular Borders, change in Colour, Diameter greater than a pencil eraser and Elevated or enlarged.
Types of moles
- Congenital nevi: are the moles developed at birth. These are more likely to become cancerous than the ones that develop later in life.
- Dysplastic nevi: are large moles (diameter larger than that of a pencil eraser) with irregular shapes that are found to be inherited. These are characterised by colour variations within the mole – typically dark brown centres and lighter, uneven borders. These moles are at a higher risk of developing into cancer.
A mole can be identified by your doctor on physical examination of the skin. A biopsy (sample of the tissue) is taken for lab examination, which may be performed if the mole is suspected to be cancerous.
Most moles do not require treatment. However, surgery is recommended if the mole is found to be or suspected to become cancerous. There are two methods for mole removal:
Excision (removal) of mole with stitches:
This procedure is performed under local anaesthesia. Your surgeon will remove the entire mole and the surrounding skin if the mole is suspected to be pre-cancerous or cancerous. The skin is then closed using stitches.
Excision without stitches:
During this type of excision – generally used for small moles – your surgeon utilises a surgical blade and shaves the mole off to the skin level or slightly below it. The bleeding caused during the procedure is stopped using an electrical instrument or a solution that will burn (cauterise) the area. After the procedure, a topical antibiotic is applied to the wound, which is then covered by a bandage. Care must be taken at home to keep the wound clean and covered until it heals completely.
Risks and Complications
As with any surgical procedure, mole excision can result in complications that include:
- Wound infection
- Temporary numbness or a burning sensation when knocked or hit
- Ensure the wound area is kept clean and dry.
- Clean the wound once or twice every day using water or diluted hydrogen peroxide.
- Once the wound is cleaned, apply a topical antibiotic cream and cover the wound using a bandage.
- Continue this routine until the wound heals completely.