Irregular Moles: When to Worry and What to Do

Q: Irregular Moles: When to Worry and What to Do

Hello： The assessment of the benign or malignant nature of moles is based on five key principles： ABCDEA (Asymmetry)： The lesion is asymmetrical; B (Border irregularity)： The edges are irregular; C (Color variability)： The color is mottled or has recently changed; D (Diameter > 6

There are many irregularly shaped moles on my body that appear to have a greenish tint?

Hello, doctor.
I have many moles on my body, and I have been aware of a few larger moles since I was a student.
Recently, after reading an article about melanoma online, I started to closely observe my moles.
I have a mole on the sole of my foot that appeared about 10 years ago, measuring approximately 0.3 mm in diameter, flat, and asymptomatic.
I also have about four moles on my body that are around 0.5-0.6 mm in diameter, with irregular borders.
Two of these do not match the others.
Additionally, I have many smaller moles measuring 0.1-0.3 mm, which also have irregular borders, with colors mostly in light brown, and some are black.
This week, I had two of the larger moles biopsied at the dermatology department, and the report will be available next week.
My question is, if these two biopsied moles are benign, should I have the other larger moles or the smaller moles with irregular borders and uneven colors biopsied as well? Generally, do moles with irregular borders and mixed colors of black and brown have a high likelihood of being malignant, or is there a significant chance they could also be benign? Furthermore, I have many small, light-colored spots on my abdomen that look like freckles, which appeared later on.
Are these related to hormonal changes after pregnancy? They did not exist before.
Are these considered freckles or moles? Lastly, could you recommend a good dermatologist in Kaohsiung? Thank you for taking the time to respond!

Ms. Tsai, 30~39 year old female. Ask Date: 2013/06/25

Dr. Lin Xinpeng reply Dermatology

Hello: The assessment of the benign or malignant nature of moles is based on five key principles: ABCDEA (Asymmetry): The lesion is asymmetrical; B (Border irregularity): The edges are irregular; C (Color variability): The color is mottled or has recently changed; D (Diameter > 6 mm): The diameter is greater than 6 mm or has suddenly enlarged rapidly; E (Elevation, enlargement): There is sudden elevation or enlargement, or the surface shows ulceration.
Regarding your question, not every mole with irregular borders or mottled color requires a pathological biopsy.
In principle, only moles larger than 0.6 mm, those that have recently grown rapidly or enlarged, or those that have significantly changed color should be considered for biopsy.
Additionally, moles located on the hands and feet, regardless of size, should be advised for early excision if there are obvious irregular changes, due to the higher risk of acral melanoma in individuals of Asian descent.

Reply Date: 2013/06/25

More Info

When it comes to understanding irregular moles and when to worry about them, it's essential to consider several factors, including the characteristics of the moles, any changes over time, and your personal and family medical history.
From your description, it sounds like you have several moles with varying sizes and characteristics. The fact that you have been observing these moles closely, especially after reading about melanoma (skin cancer), is a prudent approach. Moles that are larger than 6mm, have irregular borders, multiple colors, or change in size, shape, or color over time can be concerning and warrant further evaluation by a dermatologist.

The moles you mentioned, particularly those that are larger and have irregular borders or uneven coloration, should be monitored closely. While not all irregular moles are cancerous, the characteristics you described can increase the risk of malignancy. It’s good that you have already taken the step to have two of the larger moles biopsied. The results from these biopsies will provide critical information about whether those specific moles are benign or malignant.

If the biopsy results come back negative (benign), it does not automatically mean that other moles are safe. It is advisable to have any moles that exhibit concerning features—such as irregular borders, varying colors, or changes over time—evaluated by a dermatologist. They may recommend a biopsy for those moles as well, especially if they exhibit characteristics that align with the ABCDE criteria for melanoma: Asymmetry, Border irregularity, Color variation, Diameter greater than 6mm, and Evolving changes.

Regarding the smaller, lighter moles that have appeared after pregnancy, hormonal changes can indeed influence the appearance of skin lesions. Pregnancy can lead to the development of new moles or changes in existing ones due to hormonal fluctuations. These lighter spots may be classified as nevi (moles) or could be benign skin changes such as lentigines (often referred to as age spots or liver spots). If these new spots are not changing in appearance and do not exhibit any concerning features, they may not require immediate attention, but it’s always best to consult with a dermatologist for peace of mind.

In terms of the likelihood of malignancy, while irregular borders and color variations can be indicators of potential issues, many moles with these characteristics can still be benign. It’s important to remember that the only definitive way to determine whether a mole is cancerous is through a biopsy.

As for recommendations for dermatologists in Kaohsiung, I cannot provide specific names or clinics. However, I suggest looking for board-certified dermatologists with good reviews and recommendations from other patients. You can also check with local hospitals or medical centers that have dermatology departments, as they often have experienced specialists.

In summary, continue to monitor your moles, follow up with your dermatologist regarding the biopsy results, and don’t hesitate to seek further evaluation for any moles that concern you. Early detection is key in managing skin health, especially when it comes to potential malignancies.

Similar Q&A

Understanding Moles: When to Worry About Changes and Skin Health

I visited a surgeon due to a finger injury, and before leaving, the doctor advised me to pay attention to a mole on my hand because its edges are irregular. He mentioned that if it becomes raised or undergoes any other changes, it would be advisable to have it removed. This has m...

Dr. Jiang Yujiao reply Dermatology
Hello! I apologize for not being able to respond to your question quickly due to being out on leave. Some individuals may indeed have a greater number of moles with irregular borders, and this can be more common in families. Generally, it is advisable to have regular follow-up ex...

Should You Be Concerned About an Irregular Mole on Your Skin?

Hello doctor, I have an irregular-looking mole on my back, as shown in the image (https://drive.google.com/file/d/1A3VNusRMc-X3u4AHUmKQ-5WFliufmZ8Z/view?usp=sharing). Last month, I showed it to a doctor who said it was a normal mole. Should I just monitor it, or should I see a do...

Dr. Wu Yuxin reply Dermatology
In addition to visual inspection, checking moles may also require the use of a dermatoscope and pathological examination; it is not possible to make a judgment based solely on photographs.

Understanding Moles: When to Worry and When to Relax

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 wa...

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...

Understanding Unusual Moles: When to Seek Dermatological Advice

I would like to ask: I have a mole located just below my chest that is approximately 0.3 centimeters in diameter. The color is not very uniform, with parts being brown and others black, and it looks different from my other moles. Additionally, since it is positioned right at the ...

Dr. Zheng Lizhen reply Dermatology
In addition to monitoring the color of moles, it is important to observe their size, whether their shape is symmetrical, and if there are any irregular protrusions. It is advisable to first seek a diagnosis from a dermatologist. If the mole is not malignant and you can perform re...