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November 15, 2011 at 9:39 PMComments: 1 Faves: 0

When Should You Worry About a Mole or Skin Growth?

By Jeffrey VanWingen M.D. More Blogs by This Author

Growths on our skin are very common. As our barrier to the environment, our skin comes up against numerous conditions that work to change it. Indeed, change is an ongoing process in the skin, as it continually turns over and renews.

Genetics and age itself also bring change in the make-up of the skin. Often times, patients of mine question whether or not to be concerned with a new or changing growth on the skin. I'd like to take a moment to highlight some common and important skin findings.

Seborrheic Keratosis

Identifying: Patients are often concerned about these growths because they come up fast, are dark and are raised.These skin lesions grow atop the underlying skin layers and do not replace the skin. Seborrheic keratoses are distinguished by their waxy "pegs," or white spots in the body of the growth.

Causes: These lesions tend to run in families and have a genetic component.

Treatment: In general, they are not removed unless they are bothersome or cosmetically undesirable.

Actinic Keratosis

Identifying: Commonly, AK's are small, rough, and raised areas found on the face, scalp, or arms.

Causes: These skin lesions are due to sun damage. Actinic keratosis (AK) is common, affecting one in six Americans.

Basal Cell Cancer

Identifying: They are present on highly exposed areas of the skin. Basal cell lesions are characterized by appearing "dome-like" with a pearly sheen and neovascularization (new growth of blood vessels).

Causes: Basal cell skin cancers are caused by excessive sun exposure.

Treatment: It's highly unusual for basal cell skin cancers to metastasize, so they are not considered life-threatening. They will, however, continue to grow and erode until they are removed completely. Once every cell of the basal cell lesion is removed, it is cured. If on an expansive area of the skin, a basal cell can be removed in an office with the cut-out specimen sent to pathology to determine that it was completely removed. If the lesion is on a tricky area like the nose or an ear, the Moh's microsurgical procedure will be performed. This procedure involves removing the growth methodically to get the abnormal tissue and preserve as much normal tissue as possible. More advanced suturing technique is used to bring the skin together for good effect.

Squamous Cell Skin Cancer

Identifying: They are present on highly exposed areas of the skin. quamous cell lesions appear as an excessive, focal irritation or as a sore that will not heal.

Causes: Squamous cell skin cancers are also caused by excessive sun exposure.

Treatment: Like basal cell cancers, it is highly unusual for squamous cell skin cancers to metastasize, and they are not considered life-threatening. They are removed in total so that they do not spread and continue to cause damage. Squamous cell skin lesions are removed in the same fashion as basal cell lesions.

Moles and Melanoma

Moles, in general, are focal discolorations and changes in the skin. The most worrisome mole is melanoma, a malignant transformation of the skin that afflicts around 60,000 Americans each year. Melanoma has the potential to metastasize to other areas of the body and is life threatening. Excessive sun exposure is the main cause of melanoma. Besides prevention with sunscreen and avoidance of the sun, early detection is important in minimizing harm.

The following is simple acronym tool to use in evaluating a mole:

The ABCD Skin Exam

Asymmetry - more concerning moles are not regular and symmetric (like a circle).
Border - more concerning moles have a jagged or irregular border.
Color change - more concerning moles have more than one color and lack uniformity.
Diameter - more concerning moles are greater than 5 mm (or the size of a pencil eraser).

Any level of concern for melanoma warrants a skin biopsy. If melanoma is discovered, a wide removal is performed and chemotherapy may be required as further therapy.

Remember, if there is any uncertainty or concern, see your doctor for further evaluation. While we cannot undo what has been done in the past to our skin, we can work to prevent further damage with sunscreen and sun avoidance.

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1 Comment

  • thanks Jeff for the shared knowledge, what do you think about the "black salve" would you recommend it for the removal of moles? Can it hurt?

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