Should All Moles Be Removed?

Moles are associated with melanoma, the deadliest form of skin cancer. Therefore, why not remove all moles? The answer is simple: It would not be practical or possible to remove all moles.

One or more of the following factors must be present before the decision to remove a mole is made:

  1. The individual with the mole thinks it looks unattractive or feels the mole is in an area of trauma, where clothing can irritate it.
  2. The physician thinks the mole looks suspicious or unusual.
  3. There is a history of change in the mole.
    1. “Change” is the important word. Any change in size, shape, color, persistent itching, ulceration or bleeding constitutes a change. In addition, if a mole first appears when a person is past twenty, it should be checked. These changes or “warning signs” are commonly described as the ABCDE’s:
      1. A-Asymmetry-if you cut the mole in half, the two sides of the mole do not
      2. B-Border-the border or edges of the mole are ragged, blurred or irregular.
      3. C-Color-the mole has a variety of shades and colors.
      4. D-Diameter- the diameter of the mole is larger than 1/4 inch (the size of a pencil
      5. E-Evolving-any change in size, shape, or color.

As a melanoma develops, the asymmetry, irregularity, and other changes are recognized more easily. Our goal is to find the melanoma in its early stage when it can be cured by simple excision.

Some individuals are at higher risk for developing melanoma. Individuals with a higher risk have one or more of the following risk factors:

  1. a large number of moles (greater than 75-100 moles).  Individuals with that many moles are at a greater risk for melanoma than people who have few moles or than people who tan, rather than burn, after sun exposure.
  2. a strong family history of blood relatives who now have or have had melanoma.
  3. a family history of “atypical” or “dysplastic” moles.

Individuals, with one or more of these risk factors, should have any change in a mole evaluated by a dermatologist.

As a guide, remember the following:

  1. A “normal” mole should not exceed the size of a pencil eraser.  If it is larger than an eraser, it should be evaluated by a dermatologist.
  2. New moles in people over 20 also require evaluation, as they are uncommon.
  3. Change of any kind in a mole should be considered a potential sign of trouble.
  4. Suspicious pigmented lesions should be evaluated in order to be removed for testing.

Most moles cause no problems. Your dermatologist can determine if a mole is dangerous. Removal of a mole is painless and simple. And most importantly, the early removal of dangerous moles can save lives.

I advise my patients to have at least 2 family members learn the ABCDE’s of Melanoma, so that someone is capable of telling Mom “I got your back!”


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