Concerns About a Long-Standing Mole: When to Seek Dermatological Advice

Inquiry Consultation

Dear Dr.
Wu,
First of all, I wish you a Happy Lunar New Year! I have a concern regarding a lesion on my right thigh.
It appears to be a compound nevus, slightly raised, black in color, and measures approximately 0.1 to 0.2 centimeters.
This nevus has been present for several decades.
Since this compound nevus grows hair, I occasionally shave the hair off with a razor.
However, today (January 21), upon closer inspection, I noticed that the nevus seems to be missing a small corner, but there is no bleeding.
I am unsure if the nevus originally had this appearance or if I accidentally shaved off a portion of the nevus while removing the hair.
I would like to ask Dr.
Wu the following questions:
Q1: If it is indeed the case that I accidentally shaved off a small part of the compound nevus while removing the hair, do you believe this action could lead to any adverse effects or malignancy of the nevus?
Q2: Following up on the previous question, the compound nevus currently shows no symptoms (such as pain, itching, inflammation, or bleeding).
What would you recommend as the best course of action for this nevus? Should I continue to observe it, or is it necessary to seek medical evaluation immediately?
Thank you, Dr.
Wu.

Axiang, 40~49 year old female. Ask Date: 2023/01/21

Dr. Wu Yuxin reply Dermatology

1.
No.
2.
Just observe.

Reply Date: 2023/01/21

More Info

When it comes to concerns about a longstanding mole, especially one that has changed in appearance, it is essential to approach the situation with caution and awareness of the potential implications for skin health.

Understanding Moles and Their Changes
Moles, or nevi, are common skin growths that can vary in color, size, and shape. They can be flat or raised and may have hair growing from them. A compound nevus, like the one you described on your thigh, is typically benign, but any changes in its appearance can warrant further investigation.

Q1: Potential Risks of Shaving the Mole
If you accidentally shaved a small portion of the mole while removing hair, it is unlikely to cause any immediate adverse effects or malignancy. However, any trauma to a mole can potentially lead to changes in its characteristics. This includes the risk of irritation, inflammation, or even infection. While the act of shaving itself does not inherently increase the risk of the mole becoming cancerous, it is crucial to monitor the area for any changes.
If the mole begins to exhibit signs such as increased asymmetry, irregular borders, multiple colors, or changes in size, these could be indicators of a more serious condition, such as melanoma. The "ABCDE" rule is a helpful guideline for assessing moles:
- Asymmetry: One half does not match the other.

- Border: Edges are irregular, ragged, or blurred.

- Color: Color is not uniform and may include shades of brown, black, or even red, white, or blue.

- Diameter: The mole is larger than 6mm (about the size of a pencil eraser).

- Evolving: The mole is changing in size, shape, or color.

Q2: Current Management of the Mole
Given that your mole has been stable for many years and has only recently shown a minor change, it is advisable to adopt a watchful waiting approach. However, since you noticed a change, it would be prudent to schedule a dermatological appointment for a professional evaluation. A dermatologist can perform a thorough examination and may recommend a biopsy if there are any concerns regarding the mole's appearance.

In the meantime, here are some steps you can take:
1. Avoid Further Irritation: Refrain from shaving or irritating the area until you have consulted with a dermatologist.

2. Monitor Changes: Keep an eye on the mole for any new changes in color, size, or texture. Document any changes with photographs if possible.

3. Sun Protection: Protect the area from sun exposure by applying sunscreen with a high SPF, as UV exposure can exacerbate skin changes and increase the risk of skin cancer.

4. Consult a Dermatologist: Given the recent change, it is wise to seek professional advice sooner rather than later. A dermatologist can provide a definitive diagnosis and recommend appropriate management.

Conclusion
In summary, while minor changes in a longstanding mole may not be cause for alarm, they should not be ignored. Monitoring the mole and seeking dermatological advice is the best course of action. Early detection and intervention are key in managing skin health, particularly when it comes to moles that have been stable for years but show signs of change. Always prioritize your health and consult with a healthcare professional when in doubt.

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