Moles

Moles, also called nevi, are clusters of pigment-producing cells known as melanocytes. These cells give skin its color. When melanocytes grow in a concentrated group instead of spreading evenly throughout the skin, a mole forms. Moles can appear anywhere on the body, including the face, scalp, trunk, arms, legs, and even under the nails.

Most moles are brown, but they can also be tan, black, pink, red, or flesh-colored. Their appearance varies widely. Some are flat and blend into the surrounding skin, while others are raised and may feel smooth, rough, or slightly bumpy. Certain moles develop hair growing from them, which is typically normal.

Moles can be present at birth, known as congenital moles, or they may develop later in childhood or adulthood. It is common for new moles to appear through the teenage years and into early adulthood. By middle age, most people have between 10 and 40 moles on their body.

Most moles do not cause symptoms. They are typically painless and stable in appearance. However, certain warning signs may suggest that a mole needs professional evaluation.

A key tool used to assess moles is the ABCDE guideline. These features help patients recognize potentially abnormal changes.

• A stands for asymmetry. If one half of a mole does not match the other half in shape, it may be concerning.
• B refers to border. Benign moles usually have smooth, even borders, while irregular, notched, or blurred edges can signal a problem.
• C stands for color. A mole that contains multiple colors, such as shades of brown, black, red, white, or blue, should be examined.
• D represents diameter. Moles larger than about six millimeters, roughly the size of a pencil eraser, warrant closer attention, although melanomas can be smaller.
• E stands for evolving. Any mole that changes in size, shape, color, or texture over time should be evaluated promptly.

Other symptoms to watch for include itching, bleeding, crusting, tenderness, or a mole that looks distinctly different from others on the body. Dermatologists sometimes refer to this as the “ugly duckling” sign, meaning a mole that stands out from the rest.

It is important to understand that not all atypical moles are cancerous. Many irregular-looking moles are benign. However, melanoma can develop within an existing mole or appear as a new spot on previously normal skin. Early detection significantly improves outcomes.

Evaluation begins with a thorough skin examination. During an appointment, Dr. Richey carefully inspects the skin from head to toe, looking for patterns, irregularities, and any suspicious lesions. Patients are encouraged to mention new or changing spots, as well as any personal or family history of skin cancer.

A dermatoscope may be used during the exam. This handheld device provides magnification and specialized lighting, allowing the dermatologist to see structures beneath the surface of the skin that are not visible to the naked eye. Dermoscopy improves diagnostic accuracy and helps determine whether a mole appears benign or requires biopsy.

If a mole raises concern, a biopsy is performed. If melanoma or another skin cancer is diagnosed, treatment is tailored to the specific type and stage. As a Mohs surgeon, Dr. Richey specializes in precise surgical techniques that remove cancerous tissue while preserving as much healthy skin as possible. Early-stage melanomas and atypical moles that show concerning changes are often treated successfully when identified promptly.

For patients with numerous moles or a history of atypical nevi, regular skin checks are essential. Some individuals benefit from total body photography or digital mole mapping, which documents the appearance of moles over time and makes subtle changes easier to detect.

Patients should schedule an evaluation if they notice a new mole after age 30, a mole that is changing, or any lesion that bleeds, itches, or does not heal. Individuals with a personal or family history of melanoma, fair skin, significant sun exposure, or numerous moles should consider routine annual skin exams.

Moles are common and, in most cases, harmless. However, skin cancer can develop silently, and early detection remains critical. Regular self-examinations combined with professional skin evaluations provide the strongest defense against advanced disease. Careful monitoring, sun protection, and timely evaluation of suspicious changes help protect long-term skin health.