Mole – Causes, Recognition and Treatment
A mole is a benign pigmented skin lesion caused by a local accumulation of melanocytes. Most moles are harmless but should be monitored regularly for any changes.
Things worth knowing about "Mole"
A mole is a benign pigmented skin lesion caused by a local accumulation of melanocytes. Most moles are harmless but should be monitored regularly for any changes.
What Is a Mole?
A mole (medically known as a naevus or melanocytic naevus) is a benign skin lesion formed by a local cluster of pigment-producing cells called melanocytes. Moles can be present at birth or develop over the course of a lifetime. They are among the most common benign skin lesions in humans and are in the vast majority of cases completely harmless.
Causes and Development
The exact causes of mole formation are not yet fully understood. However, several contributing factors have been identified:
- Genetic predisposition: A family history of numerous or atypical moles increases the likelihood of developing them.
- UV radiation: Prolonged sun exposure can stimulate the formation of new moles and darken existing ones.
- Hormonal changes: Puberty, pregnancy, and the use of hormonal contraceptives can trigger the appearance of new moles or cause changes in existing ones.
- Congenital factors: Some moles are present at birth and are referred to as congenital naevi.
Appearance and Types
Moles vary widely in size, shape, colour, and surface texture. The main types include:
- Junctional naevus: Located at the dermal-epidermal junction; typically flat and evenly pigmented.
- Dermal naevus: Located within the dermis; often raised and may have hair growing from it.
- Compound naevus: A combination of junctional and dermal components.
- Dysplastic naevus: A mole with irregular shape or colour that requires close monitoring.
- Congenital naevus: A mole present at birth; larger congenital naevi carry a somewhat higher risk of malignant transformation.
When Can a Mole Be Dangerous?
The vast majority of moles are benign. In rare cases, however, a mole can develop into a melanoma (malignant skin cancer). Regular self-examination using the ABCDE rule is recommended for early detection:
- A – Asymmetry: Is one half of the mole different from the other?
- B – Border: Are the edges irregular, ragged, or blurred?
- C – Colour: Is the colour uneven or does it contain multiple shades?
- D – Diameter: Is the mole larger than 5 mm?
- E – Evolution: Has the mole changed in size, shape, or colour?
If one or more of these warning signs are present, a dermatologist should be consulted without delay.
Diagnosis
Moles are primarily diagnosed through a clinical skin examination by a dermatologist. The following methods are commonly used:
- Dermatoscopy: A handheld magnifying device that allows detailed assessment of the pigment structure of the mole.
- Photographic documentation: Regular photographs help track changes over time.
- Histological examination: If malignancy is suspected, the mole is surgically removed and examined under a microscope.
Treatment and Removal
Benign moles generally do not require treatment. Removal may be advisable or necessary in the following situations:
- When malignant transformation (melanoma) is suspected
- When the patient requests removal for cosmetic reasons
- When the mole is subject to repeated mechanical irritation from clothing or shaving
The main removal methods include:
- Surgical excision: The standard approach, in which the mole is cut out with a safety margin and submitted for histological analysis.
- Laser treatment: Suitable for flat, benign moles; histological examination is not possible with this method.
- Cryotherapy: Freezing of small, superficial moles.
Prevention and Recommendations
Dermatologists recommend the following to reduce the risk of malignant transformation and to enable early detection:
- Regular skin cancer screenings with a dermatologist
- Consistent sun protection through the use of sunscreen, protective clothing, and avoiding peak sun hours
- Monthly self-examination of all moles using the ABCDE rule
References
- Garbe C. et al. - Diagnosis and treatment of melanoma. European consensus-based interdisciplinary guideline. European Journal of Cancer, 2022.
- WHO – Ultraviolet radiation and health. World Health Organization, Geneva (2023). Available at: https://www.who.int/news-room/fact-sheets/detail/ultraviolet-radiation-and-health
- Elder D.E. et al. - WHO Classification of Skin Tumours, 4th edition. IARC Press, Lyon (2018).
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