More people come to dermatology services at this time of year with changing moles, probably because generally warmer weather should mean shorter sleeves and skirts and more skin, (and therefore moles), is on view.
(I say ‘should’; I am currently wearing a sweatshirt and jeans and a gale is blowing up outside…)
What to look out for
Most patients ask what features they should look out for in a worrisome mole.
Now, dermatologists assess moles based on the history of the mole.
For example, a longstanding mole that has not changed in any way is not going to be as worrying as a new mole that has changed size, shape or colour recently.
Saying that, new moles can develop up to around your mid-30’s, but a new mole in anyone aged over 40 years should be regarded with suspicion.
Assessing a mole
Moles are assessed broadly with the ABCD criteria. This stands for:
A – asymmetry (if the two halves of the mole do not look the same)
B – border (if the edge of the mole doesn’t look smooth and regular but jagged or blurred)
C – colour (if there is more than one colour or the mole looks uneven)
D – diameter (a mole that is increasing in size)
Moles all look different too, even the benign ones. Moles can be flat and brown, raised and brown or raised and skin coloured and the vast majority will remain harmless for life. However, if there is any change in size, colour or shape over a period of weeks or months, you must seek medical advice.
Also, any change in a mole, freckle, flat brown patch of skin or even normal skin that occurs quickly over a period of weeks or months warrants a review by your doctor.
Skin cancer and melanoma
The skin cancer that everyone worries about is called a melanoma. This is a type of skin cancer that can spread to internal organs and can kill if left too late. Contrary to popular belief, most melanomas do not develop from a mole but from previously normal skin.
Melanomas commonly occur on the leg in women (probably from wearing shorts or short skirts in the summer), the back in men (probably from taking their tops off whilst in the garden, working outside or on the beach) and on the face in the elderly.
That is why it is so important to apply sunscreen all over, not just on moles that you are worried about.
Other signs of skin cancer include: a new growth that never heals up, a new spot or sore that itches or hurts, a growth that bleeds, crusts or scabs over.
What increases the risk of skin cancer?
The type of sun exposure that particularly increases the risk of melanoma is when someone goes on holiday for several weeks, every year and has multiple episodes of sunburn as a result.
Also, the amount sun exposure during your childhood is linked to the development of melanoma, as is the number of sunburn episodes in a person’s life.
Using sunbeds is also linked to the development of melanoma.
Each year more than 900 people aged 15-34 years in the UK are diagnosed with melanoma. This is the 2nd most common cancer in this age group and we are increasingly seeing younger patients with a melanoma.
Everyone has a different skin type or colour but those most at risk are those with fair skin, fair hair, many moles and a family history of skin cancer.
Treatment for melanoma
The treatment for melanoma is surgery, ie the skin cancer is cut out of the skin.
The outlook is vastly improved if the melanoma is caught and removed early. It is therefore important that, whatever your skin type, you are cautious in the sun.
Check your skin regularly
If you are the ‘moley’ type you should monitor your skin and if you are at all worried that you have developed a new mole or that one of your existing moles has changed, you should seek medical advice.
For more information visit Cancer Research UK’s SunSmart website www.sunsmart.org.uk
For more about cancer visit www.cancerhelp.org.uk
Dr Sandy Flann, Consultant Dermatologist