Can You Tell if Your Mole is Cancerous?

By Paul J. Weber, M.D., P.A. | Moles can be good or bad, sometimes even experts have difficulty agreeing about which moles are good and bad. However, knowledge of moles is important because, among other reasons at least one out of every three melanoma skin cancers arises in a mole. Because melanoma is lethal if untreated, improved public knowledge of moles and melanoma can and will save lives. The chances that an American will develop melanoma are rapidly rising. If current trends continue, one in every one hundred Americans born today will eventually develop melanoma. One in every five patients who develop melanoma will die from it.

The terms mole and nevus (plural: moles and nevi) mean the same thing and can be used interchangeably. In this article we will use lots of parentheses to indicate that these words that can mean the same thing. Even the experts in the field of dermatology do not agree on the use of all of these terms.

Melanoma tends to occur in adults in the prime of their family and professional lives. Traits and factors associated with melanoma include having many typical (normal) moles, any atypical moles, familial atypical mole syndrome, familial melanoma syndrome, disorders of DNA repair, excessive sun exposure (for your genetic background), freckling, history of severe sunburn, ease of burning, inability to tan, blue eyes and light hair.

Nevi (moles) can look like beauty marks (e.g., Cindy Crawford) or they can protrude like a bump on a witch’s chin (common nevus). Most people have between 10 and 40 moles. Darker skinned persons frequently have darker colored moles. Moles can range in color from pink to tan to brown to black to blue to normal skin tone. Nevi are made of cells called nevo-melanocytes. Nevo-melanocytes, as the name suggests, are cells that exist along the spectrum between nevus (mole) cells and melanocytes. These nevo-melanocyte cells can be totally benign in nature (common nevus cells) or they may become or appear more abnormal, resulting in atypical (dysplastic) moles and even melanoma.

The true behavior of a nevo-melanocytic mole is usually best determined by biopsying (cutting a sample of) the mole and examining the biopsy specimen under the microscope. The website author believes that a microscopic result is more important than the doctor’s clinical naked-eye diagnosis.

However, the dermatologist’s clinical examination by eye is also important because it sets up the biopsy in which the true nature of the mole can be discovered. The medical importance of nevi (how they can affect our health) rests in knowing that some nevi can signal or develop into melanoma, a deadly from of skin cancer. Knowing the A, B, C, Ds of pigmented lesions can help save a life by finding and curing a melanoma.

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Fortunately, the A, B, C, Ds have made teaching patients about “bad moles” and melanoma inspection easier, but the A, B, C, Ds are not foolproof or even “expert proof.” They may not be as simple as they sound, or maybe not enough doctors understand them. For example, it has been well shown by many studies and quizzes given to doctors of all specialties using a biopsy-proven, obvious, everyday smattering of important pigmented skin lesions (good and bad moles and melanomas) that most non-dermatologists have a high failure rate at correct diagnosis.

All removed moles, even benign-looking ones, should be sent to pathology for microscopic examination, just in case. The microscopic examination helps to tell us whether the mole is harmless. Sometimes moles that are textbook examples of benign or “good” moles turn out to be serious melanoma, discovered incidentally on a 1 of 1000 chance. If a typical doctor’s practice sees several thousand such patients every 3 to 5 years, that may be a chance save a life.

10% of melanomas may not fit the classic dermatologists’ rules for malignancy. Since early detection and removal is the best way to cure melanoma, the patient can participate actively in his/her own care by self-examination. Signs of concern include a mole’s recent change in appearance, size, shape or color, irregularity in color, loss of a uniform border, asymmetry, bleeding and notching of a border. Moles with any of these signs should be brought immediately to the attention of a dermatologist for close scrutiny of the lesion.

Paul J. Weber, M.D., P.A.
5353 North Federal Highway, Suite 400
Fort Lauderdale, FL 33308
Tel: 954-489-9800 | Fax: 954-489-0401

What is a skin tag?

A skin tag is a common, acquired benign skin growth that looks like a small piece of hanging skin. Skin tags are often described as bits of skin- or flesh-colored tissue that projects from the surrounding skin from a small, narrow stalk. They typically occur in characteristic locations including the neck, underarms, eyelids, and under the breasts (especially where underwire bras rub directly beneath the breasts). Although skin tags may vary somewhat in appearance, they are usually smooth or slightly wrinkled and irregular, flesh-colored or slightly more brown, and hang from the skin by a small stalk. Early or beginning skin tags may be as small as a flattened pinpoint-sized bump around the neck. Some skin tags may be as large as a big grape.

Where do skin tags occur?

Skin tags can occur almost anywhere there is skin. However, favorite areas for tags are the eyelids, neck, armpits, upper chest (particularly under the female breasts), and groin folds. Tags are typically thought to occur in characteristic locations where skin rubs against skin or clothing.

Who tends to get skin tags?

Nearly half of the population is reported to have skin tags at some time. Although tags are generally acquired (not present at birth) and may occur in anyone, more often they arise in adulthood. They are much more common in middle age and they tend to increase in prevalence up to age 60. Children and toddlers may also develop skin tags in the underarm and neck areas. Since they are thought to arise more readily in areas of skin friction or rubbing, tags are also more common in overweight people.

Picture of skin tags

Hormone elevations, such as those seen during pregnancy, may cause an increase in the formation of skin tags, as skin tags are more frequent in pregnant women. Tags may be easily removed during or after pregnancy.

Skin tags are a benign condition and not directly associated with any other major medical conditions, since tags are commonly found on healthy people.

Is a skin tag a tumor?

Skin tags are a type of growth or tumor, albeit a completely benign and harmless one. Tags are not cancerous (malignant) and not found to have potential to become cancerous if left untreated.

What does a skin tag look like under a microscope?

The outer layer of the skin (the epidermis) shows overgrowth (hyperplasia), and it encloses an underlying layer of skin (the dermis) in which the normally-present collagen fibers appear abnormally loose and swollen. Usually there are no hairs, moles, or other skin structures present in skin tags.

What problems do skin tags cause?

These tiny skin growths generally cause no symptoms unless they are repeatedly irritated as, for example, by the collar or in the groin. Cosmetic removal for unsightly appearance is perhaps the most common reason they are removed. Occasionally, a tag may require removal because it has become irritated and red from bleeding (hemorrhage) or black from twisting and dying of the skin tissue (necrosis). Sometimes they may become snagged by clothing, jewelry, pets, or seatbelts, causing pain or discomfort. Overall these are very benign growths that have no cancer (malignant) potential.

Occasionally a tag may spontaneously fall off without any pain or discomfort. This may occur after the tag has twisted on itself at the stalk base, interrupting the blood flow to the tag.