Congenital Nevi: When to Monitor or Remove? - Dermatology

More Info

---

Understanding congenital nevi, or congenital moles, is crucial for parents and individuals who have them. Congenital nevi are moles that are present at birth and can vary significantly in size, shape, and color. Here, I will address your questions based on medical knowledge and experience.

Q1: Are congenital nevi that have been present since birth and have not changed over the years considered normal, even if they do not meet the ABCDE criteria for acquired moles?
Yes, congenital nevi that have been stable over time and do not exhibit any of the concerning features outlined in the ABCDE criteria (Asymmetry, Border irregularity, Color variation, Diameter greater than 6mm, and Evolving) are generally considered normal. The ABCDE criteria are primarily used for assessing acquired moles, which can change over time and may indicate potential malignancy. In contrast, congenital nevi are typically benign and stable. However, it is essential to monitor them for any changes, as even congenital nevi can occasionally undergo transformation.

Q2: Should congenital nevi that have been stable for years be removed as a preventive measure, or is it sufficient to continue monitoring them?
In most cases, if a congenital nevus has been stable for many years and shows no signs of change, it is usually safe to continue monitoring it rather than opting for preventive removal. The decision to remove a congenital nevus often depends on several factors, including its size, location, and any potential for cosmetic concerns or irritation. For instance, larger congenital nevi (especially those greater than 20 cm) may have a higher risk of developing into melanoma, and in such cases, dermatologists may recommend removal.

It is also important to consider the psychological and emotional aspects of having a congenital nevus. If the nevus is in a location that causes distress or embarrassment, removal may be a valid option, even if it is not medically necessary.
Regular dermatological check-ups are advisable, especially during childhood, as skin changes can occur with growth and development. If any changes are noted—such as an increase in size, changes in color, or the appearance of symptoms like itching or bleeding—prompt evaluation by a dermatologist is essential.

In summary, congenital nevi that are stable and do not exhibit concerning features are typically normal and can be monitored rather than removed. However, individual circumstances vary, and it is always best to consult with a healthcare professional for personalized advice. Regular skin checks and open communication with your dermatologist can help ensure that any potential issues are addressed promptly, providing peace of mind for you and your family.