WHAT ARE BIRTHMARKS?Moles are benign clusters of pigment-producing cells in the skin. They are a normal phenomenon; almost everyone gets multiple moles, an average of about 25 per person.
The official medical term for this benign mole is nevus naevocellularis (English: nevus, mole , birthmark ).
In addition to normal, benign moles, there are also dysplastic moles (dysplastic or atypical nevus) and malignant moles (melanomas).
These moles are benign, but can sometimes be precursors to melanoma. A melanoma can develop from a dysplastic mole and occasionally even from a normal mole, although the chance of a mole becoming malignant is less than 1 in a million. A melanoma can also develop spontaneously in previously normal skin.HOW DO BIRDS FORM?A birthmark is a harmless developmental disorder of the skin. Occasionally, a birthmark is visible at birth (known as a congenital birthmark). Most birthmarks develop between the ages of three and twenty. After the age of forty, the number of birthmarks can decrease again.
The number of birthmarks is determined by genetic factors and the amount of sunlight exposure the skin receives during life. (Excessive) sun exposure in the first 15 years of life is particularly important in the formation of birthmarks.WHAT ARE THE PHENOMENA?Moles are visible as brown or black spots, usually flat, but sometimes raised, distinctly convex, or bumpy. They can vary considerably in size, shape, and color. Characteristically, the shape and pigmentation are regular. Below are some different types of moles:
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| mole (nevus) |
mole (nevus) |
mole (nevus) |
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| junctional nevus |
dermal nevus |
compound nevus |
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| mole (nevus) |
nevus papillomatosus |
n. pigmentosus et pilosus |
WHEN SHOULD I WORRY ABOUT A BONEMARK?Most moles are benign, but they can become "restless" (meaning the mole begins to change in the direction of cancer).
A restless mole is more irregular in shape and pigmentation (i.e., different shades of brown to black next to each other in the same mole) and often also has a reddish discoloration.
A restless mole can be recognized by the following changes:
- growing larger
- changing color or color composition
- changing shape
- itching, stinging, or painful
- developing scabs
- bleeding.
In many cases, these symptoms will be due to harmless changes in the mole, but in such cases, it is always advisable to consult your doctor or dermatologist to determine if there is a malignant change in the mole.
A melanoma is usually larger than a regular mole, the shape is irregular and asymmetrical, and the pigmentation is often irregular. In addition to brown and black, the colors red, purple, blue, gray, white, or a combination of different colors can occur. The photos below are of melanomas: they are all non-symmetrical, they have all grown recently, and there are various color changes present:
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| brown, black, pink-white |
light and dark brown |
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| black, red |
black, white-pink, brown |
For more information about the difference between a normal mole and a malignant mole, see the leaflet on melanoma .HOW IS THE DIAGNOSIS MADE?Based on the external symptoms, an experienced physician can often confidently diagnose a common or restless mole, i.e., a benign mole. A dermatoscope, a magnifying glass that can magnify the skin several dozen times, can be helpful in this process.
In cases of doubt or when melanoma is clearly suspected, microscopic examination will always be necessary to eliminate any remaining doubt. For microscopic examination, the mole or melanoma must be removed under local anesthesia.WHAT IS THE TREATMENT?A benign mole is a normal phenomenon and not a pathological/abnormal condition, and therefore does not require treatment. Sometimes, patients want to have a mole removed for cosmetic reasons, or because it protrudes and keeps breaking. Removal can be done in several ways. Spherical moles are usually cut off at the skin level with a sharp knife (this is called a shave excision), after which the base is cauterized to stop bleeding (electrocoagulation). Moles that are somewhat deeper in the skin are cut out in the shape of an oval (excision), after which the wound is sutured. Burning alone or laser removal is also possible. If there is even the slightest suspicion of melanoma (malignant mole), the mole will be excised, leaving a small border around it, and examined microscopically.RISK FACTORS AND WHAT CAN YOU DO?The main risk factor for developing melanoma is genetic predisposition. The risk increases if more family members have melanoma.
A minor risk factor for developing melanoma is having many (more than 100) normal moles or three or more irregular moles. People with pale skin, freckles, or blond/red hair also have a slightly increased risk of melanoma. These are all factors that are fixed and cannot be influenced. The only known risk factor that can be influenced is exposure to excessive sunlight.
Sunburn at a young age increases the risk of developing melanoma. It is especially advisable to avoid excessive sunlight exposure, especially in young children. There are also indications that regular tanning bed use can increase the risk of melanoma.
It is crucial that melanoma is detected as early as possible. In the early stages, this form of skin cancer is usually highly curable. Later, metastases develop, posing a significant health risk, often with fatal consequences. It is therefore crucial to consult a doctor if you notice any changes to a mole, discover an unusual mole, or experience any symptoms related to a mole.
A small percentage of people have such a high risk of developing melanoma that regular checkups by a dermatologist are advisable. If you have dozens of conspicuous moles and/or two or more family members with melanoma, you may fall into this category. In that case, it is advisable to consult your doctor.
Congenital moles can also become malignant in rare cases. The risk depends on the size of these moles. For small congenital moles, the risk is very small.WHAT ARE THE OUTLOOK?Thanks to the attention paid to melanoma over the past few years through various information campaigns and media coverage, this form of skin cancer is being detected at increasingly earlier stages. People with suspicious symptoms are consulting their GP sooner than in the past. As a result, the outlook for people with melanoma has improved significantly over the past 30 years. The vast majority of melanoma patients today never experience recurrence of symptoms after removal. |
