Moles and Other Benign Skin Growths

Most moles are benign and don’t need treatment. You can have moles removed if you don’t like the way they look or feel. But moles may become a problem if they appear after you are 30. Or if they change in certain ways. These moles may turn into melanoma, a type of skin cancer. Melanoma is one of the fastest growing cancers in the U.S. It is often curable if caught early. But this disease can be life-threatening, particularly when not diagnosed early. Your risk for melanoma is higher if you:

• Have a lot of moles.

• Have had more lifetime exposure to the sun.

• Have had severe blistering sunburns.

• Use tanning beds.

• Have a personal or family history of skin cancer.

To manage your risk, it’s smart to check your moles for changes and ask your healthcare provider to do a thorough skin exam when you have a physical exam. To do this, you first need to learn where your moles are. Then check your moles each month.

Skin changes as you grow older and are exposed to sunlight, health conditions, trauma, and other environmental changes. Most people have some skin marks, such as freckles and moles. These may multiply or darken over time. Benign means they are not cancer.

Dermatofibromas

• Characteristics: Small round brownish to red-purple bumps caused by a buildup of fibroblasts (soft tissue cells under the skin). They often occur on the legs and may itch. They are more common in women.

• Treatment: Dermatofibromas can be surgically removed if they become painful or itchy.

Dermoid cyst

• Characteristics: A benign tumor which is made up of hairs, sweat glands, and sebaceous (oil) glands. Some internal dermoid tumors may even contain cartilage, bone fragments, and teeth.

• Treatment:  Dermoid cysts may be removed surgically for cosmetic reasons.

Freckles

• Characteristics: Darkened, flat spots that typically appear only on sun-exposed areas of the skin. Freckles are common in people with blond or red hair.

• Treatment: No treatment is needed for freckles.

Keloids

• Characteristics: Smooth, firm, raised, fibrous scars on the skin that form in wound sites. Keloids are more common in people with dark skin.

• Treatment: Keloids respond poorly to most treatment approaches. Injections of corticosteroid drugs may help to flatten the keloids. Other treatment approaches may include surgery, radiation, laser, or silicone patches to further flatten the keloids.

Lipomas

• Characteristics: Round or oval, easily movable lumps under the skin caused by fatty deposits. Lipomas tend to appear on the forearms, torso, and back of the neck.

• Treatment: Lipomas are generally harmless. But if the lipoma changes shape or you have symptoms, your healthcare provider may do a biopsy. Treatment may include surgical removal.

Moles (nevi)

• Characteristics: Small skin marks caused by pigment-producing cells in the skin. Moles can be flat or raised, smooth or rough, and some contain hair. Most moles are dark brown or black, but some are skin-colored or yellowish. Moles can change over time and often respond to hormonal changes.

• Treatment: Most moles are benign and no treatment is needed. Some benign moles may develop into skin cancer (melanoma). See below for signs.

Atypical moles (dysplastic nevi)

• Characteristics: Larger than normal moles (more than a half inch across), atypical moles are not always round. Atypical moles can be tan to dark brown, on a pink background. These types of moles may occur anywhere on the body.

• Treatment: May include removal of any atypical mole that changes in color, shape or diameter. In addition, people with atypical moles should avoid sun exposure, since sunlight may accelerate changes in atypical moles. People with atypical moles should see a doctor for any changes that may indicate skin cancer.

Pyogenic granulomas

• Characteristics: Red oozing and bleeding bump caused by excessive growth of capillaries (small blood vessels) and swelling. Pyogenic granulomas usually form after an injury to the skin and bleed easily.

• Treatment: Some pyogenic granulomas disappear without treatment. Sometimes, a biopsy is needed to rule out cancer. Treatment may include surgical removal and electrodessication of the base.

Seborrheic keratoses

• Characteristics: Flesh-colored, brown, or black wart-like spots. More common in middle-aged and older people, seborrheic keratoses may be round or oval and look like they are stuck on the skin.

• Treatment: Usually, no treatment is needed. If the spots are irritated, or the person wants them removed for cosmetic reasons, treatment may include freezing the area with liquid nitrogen or surgery.

Skin tags

• Characteristics: Soft, small, flesh-colored skin flaps on the neck, armpits, or groin. They are very common. They may be linked to metabolic syndrome and increased risk of heart disease.

• Treatment: If the skin tags are irritated, or the person wants them removed for cosmetic reasons, treatment may include freezing the tags with liquid nitrogen, electrodesiccation, or surgery by cutting them off.

Certain moles are at higher risk for changing into cancerous growths such as malignant melanoma, a form of skin cancer. Moles that are present at birth and atypical moles have a greater chance of becoming cancerous. Finding cancerous skin growths early is important because that’s when treatment is most likely to be effective. Use this ABCDE chart below to help you see changes in your moles at the earliest stages. The warning signs include:

• Asymmetry: the sides of the mole or growth don’t match.

• Border: the edges are ragged, notched, or blurred.

• Color: the color within the mole or growth varies.

• Diameter: the mole or growth is larger than 6 millimeters (size of a pencil eraser).

• Evolving: the size, shape, or color of a mole or growth is changing (evolving is not shown in the images below).

Anyone can get skin cancer. You are at greater risk if you have:

• Fair skin, light-colored hair, or light-colored eyes.
• Many moles or abnormal moles on your skin.
• A history of sunburns from sunlight or tanning beds.
• A family history of skin cancer.
• A history of exposure to radiation or chemicals.
• A weakened immune system.

If you have had skin cancer in the past, you are at risk for recurring skin cancer.

Skin exams are important for everyone. Talk with your healthcare provider about how often you need a skin exam. You may need one more often if you have an increased risk of skin cancer. You have an increased risk if you have had skin cancer before, have a family history of skin cancer, or have a weak immune system.

Your healthcare provider can check you for signs of skin cancer as part of your regular health exams. Or you can see a dermatologist. This is a doctor who specializes in skin diseases.

Skin self-exams are very important if you’re at risk for skin cancer. Get to know the pattern of moles, blemishes, freckles, and other marks on your skin. Any new moles or changes in existing moles should be checked by your healthcare provider right away.

The best time to do a skin self-exam is after a shower or bath. It’s important to look for changes when you do the self-exam. Do the exam the same way each time. This is so you don’t miss any part of your body. If needed, ask someone for help when checking your skin. This can help with hard-to-see areas like your back and scalp.

1. Check your skin in a room with a lot of light. Use both a full-length mirror and a hand-held mirror, so that you can see your whole body.

2. Look at the front and back of your body in the mirror.

3. Raise your arms and look at your left and right sides. Women should look under their breasts.

4. Examine the back and front of your legs. Also look between your buttocks and at your genital area.

5. Check the fronts and backs of your hands and forearms carefully. This includes between the fingers and under the fingernails.

6. Sit down and closely examine your feet. This includes the soles and the spaces between your toes. Also examine the nail bed of each toe.

7. Look at your face, neck, and scalp. You may want to use a comb or blow-dryer to move your hair as you look, so you can see your scalp more clearly.

See your healthcare provider if your moles hurt, itch, ooze, bleed, thicken, become crusty, or show other changes. Also call your healthcare provider if your moles show any of these signs of melanoma:

• A change in size, shape, color, or height.

• The sides don’t match (asymmetry).

• Ragged, notched, or blurred borders.

• Different colors within the same mole.

• Size is larger than 5–6 millimeters in diameter (the size of a pencil eraser).