The appearance of small brown spots on your skin isn’t necessarily a cause of concern. Dr Lisa Chan advises if, when and how you should take remedial action. Moles are a common complaint at the clinic, and are caused by clusters of pigmented cells that show up as a brown spot. Most people have 10 to 40 moles over their body, and hormonal fluctuations can cause them to grow larger and darker.
The appearance of a mole may change over time, but red flags that should prompt further testing can be remembered with the mnemonic ABCDE:
- A stands for Asymmetry, where a line drawn through the centre of the mole creates two halves that don’t match each other.
- B stands for Border. Normal moles are round or oval, and moles with uneven, ragged, crusty or scalloped edges are a cause for concern.
- C stands for Colour. A mole should be uniform in colour. If there are uneven shades of brown and black, red, pink, white or blue, further tests should be undertaken.
- D stands for Diameter. Most benign moles should be below 6mm in size.
- E stands for Evolution. If a mole has changed rapidly in size, shape, colour or other traits (eg. becoming itchy, painful, or bleeding), it’s a good idea to have it looked at by your doctor.
Monitoring a changing mole is important for the early detection of skin cancer. If the mole looks suspicious, make a timely appointment with your doctor. The mole may need to be surgically removed and sent for a histological diagnosis, along with a safe margin of surrounding skin. This procedure can be done under local anaesthesia on an outpatient basis. Sometimes patients want benign moles removed for cosmetic reasons, especially when they occur over prominent sites such as the eyelids and lips.
I like to use a combination of carbon dioxide laser and radio-frequency ablation to maintain precision and minimise the chances of scarring. After treatment, there will be a wound approximately the size of the original mole, and this will take two to three weeks to heal.
The most important things to do during this period include keeping the wound clean and moist, and avoiding exposure to sunlight. Hydrocolloid bandages can achieve both of the above. In most cases, the healed site becomes barely noticeable from the surrounding skin. If the original mole was large or deep, a second procedure may be needed. Pigmented spots come in all shapes and sizes, and not all of them are a cause for concern.
Become familiar with the size, shape and location of the moles over your body, especially if you have large, unusual or more than 50 moles. Wearing sunscreen and long-sleeved clothing will also help limit moles development and the chances of malignant transformation. Most moles are harmless, but always speak with your doctor if you have any worries.
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