Moles: Should You Worry About Friction and Surgery?

Moles on the body

Hello Doctor: I have quite a few moles on my body, most of which are small black moles about 1mm in size.
I read online that frequent friction can lead to malignant transformation, and even amputation! This makes me very anxious (I have three on my palms and three on the soles of my feet).
However, after reading several articles about moles, I found responses stating that the idea of friction causing malignancy is unfounded.
I have seen two dermatologists; one advised me to continue monitoring, while the other said the moles are benign and discharged me.
However, there are many articles online about melanoma that are quite alarming.
Should I consider having surgery to remove the moles in areas that experience frequent friction?

Mr. Zhang, 20~29 year old female. Ask Date: 2012/07/09

Dr. Yang Zhiya reply Dermatology

Hello, changes in moles are generally suspected when they are larger than 6mm, have irregular borders, asymmetrical shapes, or are continuously changing.
If you do not have these characteristics but are still concerned about changes, it is recommended that you take photographs every three months.
When taking the photos, place a ruler next to the mole, and then compare them with previous photos later.

Reply Date: 2012/07/09

More Info

When it comes to moles, or nevi, it's understandable to have concerns, especially with the information available online that often exaggerates risks. Let's break down your concerns regarding friction, potential malignancy, and the necessity of surgical intervention.

Firstly, it is important to clarify that while friction can cause irritation to moles, there is no substantial scientific evidence to support the claim that friction alone can lead to the transformation of benign moles into malignant melanoma. Melanoma is a type of skin cancer that arises from melanocytes, the cells that produce pigment in the skin. The exact causes of melanoma are not fully understood, but factors such as UV exposure, genetic predisposition, and certain skin types play a more significant role than friction.

You mentioned that you have several small black moles, primarily on your palms and soles. These areas are indeed subject to friction, especially with activities like walking or gripping objects. However, the presence of friction does not inherently mean that these moles will become cancerous. The key is to monitor any changes in the moles, such as changes in size, shape, color, or if they become itchy or bleed. The ABCDE rule is a helpful guideline for monitoring moles:
- Asymmetry: One half of the mole doesn't match the other.

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

- Color: The color is not uniform and may include shades of brown or black, or even patches of pink, 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.

If your moles do not exhibit these characteristics, they are likely benign. The dermatologists you consulted provided differing opinions, which can happen in medical practice. One may have a more conservative approach, suggesting observation, while another may lean towards removal for peace of mind, especially if there is a history of skin cancer in your family or if the moles are in high-friction areas.

Regarding surgical removal, it is a common procedure for moles that are suspicious or bothersome. If you feel that the moles are at risk of being irritated or if they cause you anxiety, discussing surgical options with a dermatologist is reasonable. They can perform a simple excisional biopsy, which not only removes the mole but also allows for histopathological examination to rule out any malignancy.

In summary, while friction is a valid concern, it is not a direct cause of melanoma. Regular monitoring and consultation with a dermatologist are essential. If you are still worried about the moles, especially those in high-friction areas, consider discussing the option of removal with your dermatologist. They can provide you with the best advice tailored to your specific situation, taking into account your medical history and the characteristics of your moles. Remember, proactive skin care and awareness are key to maintaining skin health.

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