Moles: When to Monitor and When to Remove

The evaluation of moles?

Hello, doctor.
I have come across many articles online that mention certain moles on the body require special attention, such as those located in the armpits, mucous membranes, soles of the feet, and areas of friction, suggesting they should be removed.
I have several moles that have been on my body for over ten years in these so-called "danger zones," and they have not changed at all.
I would like to ask the doctor if the approach to moles should be to observe them for any changes, and if there are no changes, then self-monitoring is sufficient? We can't just remove all moles for peace of mind as suggested online, right? Thank you.

Ayu, 30~39 year old female. Ask Date: 2020/12/06

Dr. Wu Yuxin reply Dermatology

Your perspective is correct; stay vigilant and seek medical attention immediately if you have any concerns.

Reply Date: 2020/12/06

More Info

When it comes to monitoring moles (or nevi), it is essential to understand the characteristics that may indicate a need for further evaluation or removal. The general guideline is to observe moles for any changes in size, shape, color, or texture. The ABCDE rule is a helpful tool for assessing moles:
- Asymmetry: If one half of the mole does not match the other half.

- Border: Irregular, scalloped, or poorly defined edges.

- Color: A variety of colors (brown, black, tan, red, white, or blue) within the same mole.

- Diameter: Moles larger than 6mm (about the size of a pencil eraser) should be examined.

- Evolving: Any change in size, shape, color, or elevation, or any new symptom such as bleeding, itching, or crusting.

Moles located in areas prone to friction, such as the armpits, groin, or soles of the feet, may be at a higher risk for changes due to constant irritation. Additionally, moles on mucosal surfaces (like inside the mouth or genital area) should be monitored closely, as they can sometimes develop into skin cancers more readily than those in less exposed areas.

For moles that have been stable for over ten years without any changes, it is generally acceptable to continue self-monitoring. However, it is crucial to have regular skin examinations by a dermatologist, especially if you have a family history of skin cancer or if you have numerous moles. Dermatologists can provide a thorough evaluation and may recommend removing moles that exhibit any concerning features or are located in high-risk areas.

The decision to remove a mole should not be taken lightly, as unnecessary excision can lead to scarring and other complications. Instead, focus on regular monitoring and consult a healthcare professional if you notice any changes or if you have concerns about specific moles.
In summary, while it is essential to be vigilant about changes in moles, not all moles require removal, especially if they have remained stable over the years. Regular check-ups with a dermatologist can provide peace of mind and ensure that any potentially harmful changes are caught early. If you have any specific moles that you are concerned about, it is always best to seek professional advice tailored to your individual situation.

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