Dangerous and non-dangerous mole changes

Why should you know what dangerous and harmless changes in moles look like? Because most people have moles (melanocytic nevi), moles come in several types and can change, and some of them increase the risk of developing a type of skin cancer called superficial or nodular melanoma, which is caused by abnormal proliferation of melanocytes, the cells that produce the skin pigment melanin.

Can a mole become cancerous?

Today, when asked whether a mole can become cancerous, experts answer in the affirmative.

Moreover, there is a syndrome of dysplastic (atypical) nevi or familial melanoma syndrome, which develops with multiple nevi (the presence of more than fifty moles on the skin). Studies have found that this is associated with an autosomal dominant mutation in the CDKN2A cancer cell growth suppressor gene, which is involved – in addition to malignant melanoma – in the development of pancreatic cancer.

It is believed that only an atypical mole can become malignant, so those who have more than five atypical moles, as well as a history of melanoma in a first-degree relative (parents, siblings or children), should be especially vigilant about the transformation of moles. People with a hereditary disease called xeroderma pigmentosum, in which skin cells are unable to repair damage to their DNA, also have a higher risk of developing skin cancer.

There is a dermatological ABCDE scale for checking changes in moles, which includes the following parameters:

• A – Asymmetry: a mole should be symmetrical, and if one half of the mole is very different from the other, this may be a pathology.
• B – Border: a normal mole has smooth edges and clear outlines, otherwise this should alert you.
• C – Color: as a rule, a normal mole is uniformly colored, so inclusions of pink, white or dark brown spots may indicate dangerous changes in the structure of its tissue.
• D – diameter: if the mole is more than 6 mm in diameter, this is a bad sign, as such moles can become even larger over time.
• E – evolution, that is, changes in all or any one of the listed parameters.

It is clear that dangerous and harmless changes in moles should be diagnosed by a specialist after dermoscopy of pigmented lesions with suspicious features.

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Change in the number or size of moles

The change in the number of moles can be either towards their increase or (much less frequently) towards their decrease. If a pregnant woman has many moles, this means changes in the synthesis of not only estrogen, but also melanocortins - hormones that stimulate the formation of melanocytes, and the enzyme of their membranes tyrosine. After pregnancy, such moles may remain, but they may also disappear.

In men over 55-60 years of age and in women during menopause, senile nevoid papillomas or horny keratomas (acrochordons), which are characterized by hyperpigmentation and fairly rapid growth, are often mistaken for moles.

The number of moles increases in most fair-skinned people who spend a lot of time in the sun or in tanning beds, and excess UV radiation is associated with an increased risk of melanoma.

In all other cases, an increase in the number of moles on the body over a relatively short period of time should make a person seriously think about their health and go to see a dermatologist. But if there are fewer moles, then doctors consider this to be a harmless change.

A change in the size of a mole may also be observed. And when you notice that your mole has begun to grow, you should worry in a timely manner. After all, if a mole has become larger than its previous size, it means that the melanin-containing cells are actively multiplying, and this process may be malignant.

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Other dangerous changes in moles

In addition, the fact that a common melanocytic nevus has become dysplastic may be indicated by:

• change in the shape of a mole;
• change in color of a mole;
• subjective symptoms accompanying changes in moles.

Changes in the shape of a mole and its texture that need to be paid special attention to include the loss of its rounded symmetrical shape, its spreading into a spot with jagged edges (if these changes occurred with a normal mole, and not a new borderline pigmented nevus or lentigo, which initially had the appearance of a spot, formed).

A dermatologist consultation is needed:

• if the mole has become convex (that is, previously existing flat moles have become convex over the entire surface or only in the central part, as doctors say, in the form of a fried egg);
• when a mole becomes rough, and its surface becomes covered with very small cracks and, in addition, the mole (and, possibly, the area of skin on which it is located) begins to peel, which may be accompanied by itching;
• when the mole becomes hard to the touch;
• if a flat mole has become hanging, that is, more loose, with a bumpy surface;
• in the case when a mole becomes shiny after injury.

In the case of hair loss that grows from a nevus, specialists have suspicions about its atypicality, but when hair begins to grow from a mole, this is considered a sign of its benignity. And when a mole becomes flat, this also does not cause any particular concern among specialists.

At the same time, dermatologists consider a change in the color of a mole to be an unfavorable factor, that is, if:

• the mole became spotty (specks of a different color appeared on its surface);
• in the presence of light-colored congenital nevi, some moles suddenly become darker, for example, if instead of beige, a mole becomes brown;
• a mole, either flat or raised above the surface of the skin, has become black - entirely or partially, or the color of the mole has not changed, but an almost black border has appeared around it (that is, certain shifts have occurred in the structure of melanocytes);
• a convex mole has become red (bright red) or a mole has become purple, which indicates its vascularization, and this, in turn, indicates the activation of metabolism in its tissues.

Pathological processes can also be discussed when a mole becomes lighter or a mole becomes white.

The most common subjective symptoms accompanying changes in moles, which in clinical dermatology and oncology are considered potentially dangerous:

• the appearance of itching of varying intensity, that is, the mole began to itch;
• a burning sensation at the site of the problematic melanocytic nevus;
• a feeling of discomfort (this is when a person feels the presence of a mole, which should not normally happen);
• the mole started to hurt.

Atypical or dysplastic moles can appear on any part of the body, on the head or neck; however, such moles rarely appear on the face. By the way, changes in moles are also recorded on areas of the skin that are not exposed to the sun.

Most of these nevi remain stable for a long time. Researchers at the American Academy of Dermatology estimate that the likelihood of developing melanoma from a modified mole is about ten times greater if there are five or more dysplastic nevi. Men are most likely to develop melanoma on the head, neck, and back, while women are most likely to develop this type of skin cancer on the back or lower legs.

Experts say the vast majority of moles are benign, and data on the potential for a mole to transform into skin cancer is controversial, but it turns out that about 10% of malignant melanomas have dangerous changes in moles as a precursor.