Scalp Nevi: When to Seek Medical Advice

Moles on the scalp?

Dear Dr.
Wu,
I would like to inquire about a growth commonly referred to as a mole on the right back of my scalp.
Since it is located on the back of my head, I have used a hand mirror to examine it and asked my mother to confirm.
The size is approximately 0.5 mm, flesh-colored with a slight reddish tint, raised, round in shape, and has a smooth, somewhat soft surface.
I would like to ask Dr.
Wu:
1.
Is this growth classified as a mole, or is it a type of skin proliferation such as a skin tag or lipoma?
2.
Is there a possibility of it becoming malignant?
3.
Should I proactively seek medical attention for removal, or is it sufficient to observe it conservatively for now?
4.
If I choose to observe it conservatively and only seek medical attention if it changes, will it be timely enough to address any potential issues?
Thank you for your time, Dr.
Wu.

Sincerely,
Ah Xiang

A-Xiang, 30~39 year old female. Ask Date: 2014/07/01

Dr. Wu Yuxin reply Dermatology

Moles are commonly referred to as intradermal nevi.
Generally, the risk of malignancy is low, but it cannot be said to be absolutely nonexistent.
It mainly depends on your mindset; if left unaddressed, most people tend to worry, constantly suspecting the worst and seeking opinions everywhere, yet still not obtaining the answers they truly desire.
However, please make an appointment for a consultation first, as we can discuss and provide recommendations after an examination.

Reply Date: 2014/07/01

More Info

When it comes to scalp nevi, or moles, understanding their characteristics and knowing when to seek medical advice is crucial for maintaining skin health. Based on your description of the lesion on your scalp, here are some insights and recommendations.

1. Characteristics of the Lesion
From your description, the lesion is approximately 0.5 mm in size, flesh-colored with a slight reddish hue, round, smooth, and soft. These characteristics suggest that it could be a benign nevus (mole) rather than a skin growth like a skin tag or a lipoma. Nevi are typically benign and can vary in color, shape, and size. However, the key is to monitor any changes over time.

2. Potential for Malignancy
While most nevi are benign, there is always a potential for changes that could indicate malignancy, particularly if the mole exhibits any of the following characteristics:
- Asymmetry: One half of the mole does not match the other.

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

- Color: Varied from one area to another (shades of tan, brown, black, or even red, white, or blue).

- Diameter: Larger than 6 mm (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.

Given that your mole is small and has not shown any concerning features, the immediate risk of malignancy may be low, but it is essential to remain vigilant.

3. When to Seek Medical Advice
It is advisable to consult a dermatologist if you notice any changes in the mole or if you have concerns about its appearance. Even if it appears benign, a professional evaluation can provide peace of mind. Dermatologists can perform a thorough examination and, if necessary, a biopsy to rule out any malignancy.

4. Conservative Observation vs. Proactive Removal
If the mole remains unchanged, a conservative approach of observation is reasonable. However, if you choose this route, it is crucial to regularly check the mole for any changes. If you notice any alterations in size, shape, color, or if it begins to itch or bleed, you should seek medical advice promptly.
In general, if there is any doubt or concern about a skin lesion, it is better to err on the side of caution and consult a healthcare professional. Early detection and intervention are key in managing potential skin cancers effectively.

Conclusion
In summary, while your scalp nevus appears to be benign based on your description, it is essential to monitor it closely. Regular self-examinations and awareness of any changes are vital. If you have any concerns or if the mole changes in any way, do not hesitate to seek medical advice. A dermatologist can provide a comprehensive evaluation and recommend the best course of action, whether it be observation or removal. Remember, your health and peace of mind are paramount, and proactive care is always beneficial.

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