Moles & Melanoma

What is a mole?
A mole is a growth on or in the skin. Another name for a mole is a “nevus,” the plural of which is “nevi.” Moles develop when melanocytes – the cells that make melanin, a brown pigment in your skin – grow in clusters or nests. Some moles may be present at birth, but most moles tend to appear later in childhood. Most people may continue to make new moles until around the age of 40. In fact, it is not uncommon for most adults to have between 10 and 40 moles - all totally healthy! Some moles even tend to fade away with the passing of time.

Some signs that a mole may be clinically worrisome (“atypical”) and should be seen by your St. Luke’s board certified dermatologist include the following:

• A new mole that develops in adulthood
• A mole that changes color
• A mole that changes shape or texture or height
• A mole that starts to itch or hurt
• A mole that starts to bleed or ooze
• A mole becomes hard or starts to feel lumpy
• The skin overlying a mole turns dry or scaly or develops what looks like a wound overtop of it (“ulceration”)

What is melanoma?
Melanoma is a specific type of skin cancer that begins in melanocytes, the cells that make your skin’s pigment. Most melanocytes are in our skin. Additionally, melanoma can also develop in the eye, the digestive tract, and other areas of the body. In women, melanoma most commonly develops on the back or lower legs. In men, melanoma is more often found on the head, neck, or back. Patients with darker skin are less likely to develop melanoma than people with fair skin; when it does develop in people with dark skin, melanoma is more often found on the palms of the hands, under the fingernails, under the toenails, and on the bottoms of the feet.

People with the following known risk factors have an increased chance of melanoma:

• Having multpiple “dysplastic” moles
• Having more than 50 moles
• Having a history of severe, blistering sunburns
• Having a personal history of melanoma (if you have had one melanoma, then you may be at greater risk of developing another melanoma)
• Having skin that burns easily (having fair or pale skin, red or blond hair, blue or gray eyes, and many freckles may raise your risk of developing melanoma)
• Certain medical conditions (having certain types of cancer or genetic conditions, for example, may raise your risk of developing melanoma)
• Certain medications (medicines that lower your immune system, for example, may raise your risk of developing melanoma)
• Having a family history of melanoma (if a close relative has had melanoma, then you may be at greater risk of developing melanoma yourself)

Melanoma is a potentially dangerous form of skin cancer because left untreated it is likely to invade nearby tissue and spread to other parts of the body (“metastasize”), such as the lung, liver, bone, or brain. Melanoma causes the most deaths from skin cancer each year. The good news is that the earlier melanoma is detected and removed, the more likely that overall treatment will be successful.

The first sign of a melanoma may simply be a change in the shape, size, or color of a mole. Sometimes, however, melanomas may also appear as a brand new mole. Distinguishing between a good mole and melanoma may be very difficult; consequently, your St. Luke’s board certified dermatologist should examine you on a regular basis and more urgently if you notice any worrisome changes.

Your St. Luke’s board certified dermatologist diagnoses melanoma by, first, doing a thorough skin exam. This may involve the use of a dermatoscope, a special instrument that gives your St. Luke’s dermatologist a magnified view of your moles. Next, if your St. Luke’s dermatologist is concerned, he or she will ask your permission to have the abnormal-appearing skin lesion sampled surgically (i.e., a “skin biopsy”). Usually, this minor surgical procedure takes only a few minutes and can be done in the clinic. The skin tissue sample is then sent to a lab where it gets processed so that a skin-focused pathologist can examine the sample under a microscope, checking it for melanoma cancer cells.

You can start protecting your skin today by limiting your sun exposure and avoiding sunlamps and tanning booths. Having a “suntan” or “sunburn” means that your skin has already been damaged: The more damage you do to your skin, the greater the chance of developing melanoma. Ask your St. Luke’s board certified dermatologist to perform a thorough skin exam on you and teach you how to check yourself regularly for early signs of melanoma.