Atypical Moles/Dysplactic Nevi
This mole looks irregular, should I be concerned?
Atypical moles, or dysplastic nevi, are very common and affect many people. In fact, about one out of every ten people are believed to have at least one atypical mole. Atypical moles are moles than have an abnormal appearance. They can vary in color (many shades of brown, pink or red), can have irregular borders and can be asymmetrical. Clinically they can look like and resemble melanoma - a bad type of skin cancer. Atypical moles are NOT cancerous moles. They are not even pre-cancerous moles. Patients that have atypical moles do not always develop melanoma. However, patients with many atypical moles have a greater risk of developing melanoma over their lifetime, so I always encourage these patients to frequently examine their skin and come in regularly for their skin exams.
During our examination if I suspect a mole may be abnormal I will most likely recommend to remove the mole (or moles) and have a biopsy done on the mole(s). The process to remove a mole is very simple, and can be done very quickly during your office visit.
How is a mole removed?
- The easiest way to remove a mole is by what we call a shave removal. The mole is numbed with a local numbing agent by injection, and once the area is prepped I shave off the mole flat to the skin. The mole is then placed in a specimen jar and sent for evaluation by a dermatopathologist (a special trained doctor who will examine the mole and tell me if the mole is healthy or not and if any further treatment is needed). Check out the Procedure Care section to see how to take care of a mole after it is removed.
Once the mole is removed it is sent for a biopsy. When the results return, I will determine based on the report what treatment is needed next. Atypical moles or dysplastic nevi are often given a "stage" or "degree" of atypical cells within that particular mole.
- Mild Atypia: These are very low grade changes within a mole. They often do not require much treatment. They can be observed and watched for future changes.
- Moderate Atypia: These moles are more atypical than mild atypical moles, but they are still not very concerning. Depending on some other factors in the biopsy report, these can sometimes be left alone and monitored clinically. Sometimes these moles need to be removed further and a small procedure is done to completely remove the mole. A minor excision is performed in the office to remove the mole and stitches will be put in place. Check out the Procedure Care section to see how to take care of a mole after it is removed by excision.
- Severe Atypia: Moles with severe atypia are more concerning. They have many atypical and abnormal changes in the mole and are always removed further. These will always be excised to ensure that no further abnormal cells are left behind and to also make sure we examine all the skin around the mole to be sure it is nothing more than an atypical mole. Check out the Procedure Care section to see how to take care of a mole after it is excised.
For patients that have many moles, or more importantly, many irregularly looking moles, remaining diligent in your skin health is essential. Frequent skin exams at home and regular visits to your dermatologist is very important for early detection of abnormal moles.
When examining your own skin I always try to stress to my patients to always be on the lookout for any mole or growth that is new or changing in any way. Not all new growths or lesions that change are bad, but some are and the earlier these are identified the better. The "ugly duckling" rule is one method that should be applied when examining your skin. Look for anything that stands out differently from the rest of the growths or moles that you see on your skin. I often refer to a simple guide for evaluating your moles.
ABCDE's of moles.
- A: Asymmetry - Most benign moles are symmetric - meaning that if you fold the mole in half onto itself each side should match. Many atypical moles appear to be asymmetric and do not have a consistent shape.
- B: Border - The borders or edges tend to be irregular and jagged in cancerous or abnormal moles. Many benign growths have very smooth borders and edges.
- C: Color - Most benign moles are made up of one color (usually a shade of brown). When a mole or growth appears to have many different colors in shades of brown and black it could be a warning sign that something is wrong with that mole.
- D: Diameter - Most benign moles tend to be smaller than malignant ones. Malignant or abnormal moles are usually larger than the size of a pencil eraser. However, when detected early they may be smaller than this size.
- E: Evolving - Most benign moles remain stable and unchanged over time. But when a mole or growth begins to evolve or change you should have it evaluated. Any change that occurs should be a warning sign to have the growth checked. Look for change in size, color, elevation, texture, or other traits such as itching or bleeding.
Some important tips to keep your moles healthy:
- Apply a broad-spectrum sunscreen of SPF 30 or higher 20-30 minutes before sun exposure.
- Re-apply sunscreen every 60-90 minutes while in the sun.
- Avoid peak hours of the sun between 10am and 2pm.
- Wear sun protective clothing.
- Do not burn!
- Avoid indoor tanning.
- Examine your skin once a month for new or changing spots.
- Have a yearly skin examination to ensure your skin is in good health.