Moles: When to Worry and When to Relax

Hemorrhoid issues?

Hello, Doctor.
I visited a dermatologist today because I had a small black spot on my chest that was a mole.
I showed it to the doctor, and it seemed a bit raised.
When I slightly squeezed it, it appeared that there was a pimple nearby, and although it didn't bleed, there was a small wound.
The dermatologist confirmed it was a mole, and the area I noticed had a pimple right next to it.
I squeezed it, causing some bleeding, but the doctor said it was fine as long as I applied medication to prevent infection.

I also have another spot on my abdomen near my waist that looks slightly coffee-colored and a bit raised.
The doctor referred to it as a pigmented lesion, but it also seems to be a mole.
He mentioned that if it looks unsightly, I could consider laser treatment, but there’s no need to worry about it.

I’m concerned about whether these moles are problematic.
The doctor said that since I’ve had them for about 2-3 years, it’s likely fine, and I just need to monitor them without needing a biopsy unless there are significant changes.
The mole on my chest appeared suddenly about three months ago, but its size has remained stable, and there are no signs of asymmetry or significant growth.
The doctor suggested I just return for a follow-up and not to overthink it, as he has many moles himself.
I would like to ask if it’s common for people to develop new moles as they age, and whether the color or slight elevation of moles is normal.
Is it true that there’s no need for a biopsy unless there are changes, and that I should just check them every one to two months? I hope you can help me assess the two photos, even though I have already seen a doctor who said they are normal moles.

Additionally, I previously consulted a traditional Chinese medicine practitioner who mentioned something about "internal heat" and toxins in the body.
Is there any validity to that theory? Thank you, and I apologize for disturbing your rest at night.

YK, 20~29 year old female. Ask Date: 2020/12/07

Dr. Hong Yuanbin reply Internal Medicine

Hello, based on the photos you provided, they do appear to be moles.
Moles are accumulations of melanocytes.
Even in adults, new moles can develop unless they suddenly grow large, have an irregular shape, or show any discharge, in which case one should be concerned about melanoma.
However, based on the photos you provided, the likelihood of that is very low.
I recommend continuing to monitor them.
Thank you for your inquiry.

Reply Date: 2020/12/07

More Info

When it comes to understanding moles, it's essential to differentiate between benign (non-cancerous) moles and those that may require further evaluation. Based on your description and the assessment from your dermatologist, it seems that the moles you have are likely benign, especially since they have not changed significantly over the past few years and do not exhibit concerning characteristics such as asymmetry, irregular borders, or color variation.

When to Worry About Moles
1. Changes in Appearance: If a mole changes in size, shape, or color, it may warrant further investigation. The "ABCDE" rule is a helpful guideline:
- Asymmetry: One half of the mole doesn't match the other.

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

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

- Diameter: Larger than 6mm (about the size of a pencil eraser).

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

2. Personal and Family History: If you have a personal or family history of skin cancer, you should be more vigilant about monitoring your moles.

3. New Moles: While it's common for new moles to appear during childhood and adolescence, adults can also develop new moles. However, any new mole that appears after the age of 30 should be evaluated by a dermatologist.

When to Relax
1. Stable Moles: If your moles have remained unchanged for several years, as your doctor indicated, they are likely benign. Regular monitoring is a good practice, but it doesn't necessarily mean you need to panic.

2. Dermatologist's Assessment: Trusting your dermatologist's expertise is crucial. If they have assessed your moles as normal and suggested observation rather than immediate biopsy, it’s a positive sign.

3. Color and Texture: Moles can vary in color and may be slightly raised. This is often normal, especially if they have been stable over time.

Monitoring Your Moles
Your dermatologist's recommendation to monitor the moles every one to two months is a reasonable approach. Keeping an eye on any changes will help you catch any potential issues early. If you notice any changes or new symptoms, you should return to your dermatologist for further evaluation.

Myths and Misconceptions
Regarding the idea that moles are related to "internal heat" or "toxins" in the body, these concepts are more aligned with traditional Chinese medicine and may not have a basis in Western medical science. Moles are generally understood to be clusters of pigmented cells (melanocytes) and can be influenced by genetic factors, sun exposure, and hormonal changes rather than internal toxins.

Conclusion
In summary, it sounds like your moles are being appropriately monitored by a healthcare professional. Continue to observe them as advised, and don’t hesitate to reach out to your dermatologist if you have any concerns or notice changes. Regular skin checks and being aware of your body are key components of maintaining skin health. If you have further questions or uncertainties, consider scheduling a follow-up appointment for peace of mind.

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