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A mole is a collection of pigment cells forming a growth on the skin. The tendency to form moles is inherited, although in many cases sun exposure contributes to their appearance. They usually begin in childhood, increase in number and size at puberty and remain throughout life.
With the increased publicity about skin cancer, diligent checking of moles has become accepted as a method of early melanoma detection. However, it can be difficult for the average person to distinguish between a suspicious and an innocent mole.
Most moles are quite innocent, and do not have a tendency to develop into melanoma. Generally speaking, raised moles which are uniform in colour and outline are not serious, even if they enlarge. Moles which rub on clothing are not more likely to develop into melanoma and neither are those which become suddenly itchy. However, individuals with a large number of moles have an increased risk of developing melanoma, which will often appear as new moles.
Any two-tone freckle should be regarded suspiciously and preferably be removed. Melanoma begins as a flat, irregular mole or freckle with two colours, usually brown and black, spreading within the mole. It is only in the late stages that melanoma becomes raised, itchy and bleeds. In the early stages melanoma carries an excellent prognosis irrespective of treatment.
Wholesale removal of moles is a fruitless exercise, as it does not diminish the risk of melanoma. Only suspicious moles should be removed and these include:
- Any two-tone, irregular freckle (that is, a flat lesion with two colour pigments – brown-black, brown-red);
- Any mole which has recently changed colour or outline;
- Dark, hairy moles.
Although the tendency towards skin cancer is due to excessive sun exposure in early childhood, the development of melanoma in children is rare. It may occur in children with dark brown, hairy moles and is more likely to develop in children with dysplastic naevi. Dysplastic naevi are large, irregular, two-tone moles, which are often inherited. People with these moles have a high risk of melanoma and need to be checked regularly by a doctor.
Some common misconceptions about moles
There is a common belief that removal of an innocent mole can somehow cause a malignant change. This is not the case and many harmless moles can be safely removed for cosmetic reasons. Removal of a mole, however, does not mean a melanoma won’t develop elsewhere on your body. Other people believe that having all their moles removed will reduce their chances of developing melanoma. People who have many moles are more likely to develop a melanoma but removing innocent moles is of no advantage as melanoma can arise elsewhere.
Many people incorrectly fear that pulling hairs out of a mole will cause a melanoma. It is perfectly safe to remove hairs from a mole.
Dark, hairy moles
Dark, hairy moles are due to an accumulation of pigment cells which occurs during foetal life. Apart from their unsightly appearance, they have a higher risk of developing malignant melanoma. Where possible these moles should be removed but if they are large this can be difficult. Some can be removed using surgical tissue expanders. These enlarge the surrounding skin, so that when the mole is removed the skin can be pulled back over the depression. This is best done in childhood. Moles which cannot be removed must be watched carefully for any abnormal changes, as melanoma can occur in childhood.

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