questions to ask before mole changes

Overview

A mole is a small spot on the skin made of pigment-producing cells. Most moles are harmless, but sometimes a mole changes over time. This article helps you understand what questions to ask your doctor or dermatologist if you notice a mole changing.

Yes. Moles are very common, and noticing a change in a mole is also common. It does not mean you definitely have cancer. It simply means it is worth having it checked by a healthcare professional.

Anyone can have moles. They are more likely to appear on people with fair skin, but people with darker skin can also develop moles and skin cancer. Mole changes can happen at any age, but the risk of serious skin cancer increases with age.

Symptoms

Common symptoms

• A mole that gets bigger or changes shape
• A mole that changes colour or develops multiple colours
• A mole that becomes raised, lumpy, or dome-shaped
• A mole that itches, tingles, or feels sore
• A mole that bleeds or forms a crust
• A mole that looks different from all your other moles

Symptoms in children

• New moles often appear as children grow – this is usually normal.
• In rare cases, a mole may grow very quickly, bleed, or become painful; this should be checked.
• A mole that appears in a child but looks unusual compared with the child's other moles should be seen by a doctor.

Symptoms in older adults

• Older adults may develop new moles or existing moles may fade or disappear.
• Any mole that changes, or a new mole that appears after 60, should be checked by a doctor.
• Older skin is more likely to show sun damage, so regular skin awareness is important.

Causes

Main causes

• Moles form when pigment cells in the skin grow in clusters rather than spreading out evenly.
• Changes in a mole can happen because of sunlight exposure, which damages skin cells.
• Hormonal changes – for example during pregnancy – can make moles darker or larger.
• Aging can make existing moles change or fade.
• In some cases, a mole can change because it has become a skin cancer, most commonly melanoma.

Risk factors

• Fair skin, light-coloured eyes, and red or blonde hair
• A history of sunburn, especially blistering sunburn in childhood
• Many moles (more than 50) or multiple irregular-shaped moles
• A personal or family history of skin cancer
• Use of sunbeds or sun lamps
• Being over the age of 50

When to see a doctor

See a doctor urgently if:

• See a doctor as soon as possible if you notice any of the ABCDE signs: Asymmetry, irregular Border, uneven Colour, Diameter larger than 6 mm (about the size of a pencil eraser), or Evolving/changing.
• See a doctor as soon as possible if you have a new mole appearing after age 30.
• See a doctor as soon as possible if a mole is bleeding, itching, or getting larger.

Book a routine appointment if:

• Ask for a full skin examination as part of your routine health check if you have a family history of melanoma or many moles.
• Bring a list of questions to your appointment so you don’t forget anything.

Diagnosis

Your doctor will ask you about your mole’s history and your family history of skin cancer. They will then look at the mole and surrounding skin. Using a handheld device called a dermatoscope, they can see patterns in the mole that are not visible to the naked eye. If the mole looks suspicious, the doctor will suggest removing a sample for testing.

Tests that may be done

• Clinical skin examination, sometimes with a dermatoscope
• Photography to monitor changes over time
• Skin biopsy (removing the whole mole or a small part of it for lab analysis)

What to expect at your appointment

You may be asked to remove clothing above the area being checked. The doctor will inspect your mole and possibly your whole skin. A biopsy is done with a local anaesthetic, so you will feel a small sting before it goes numb. The sample is sent to a lab, and results usually come back in 1 to 3 weeks.

Treatment

Many moles need no treatment at all. If a mole is causing discomfort or has features that worry your doctor, removing it is a simple procedure. Your treatment will depend on the biopsy result. If the mole is non-cancerous, you may only need follow-up checks. If it is cancerous, your doctor will explain the next steps tailored to your situation.

Self-care at home

• Keep a photo log of your mole with a ruler next to it, and note the date.
• Do not pick, scratch, or try to shave off a mole. This can cause infection and bleeding.
• Protect your skin from the sun with clothing and a high-factor sunscreen.

Medical treatments

Removal of a mole is usually done with a surgical scalpel under local anaesthetic. The mole may be shaved off or fully cut out, depending on the type and depth. If a mole is found to be skin cancer, you may need a wider excision to remove a small area of healthy skin around the site. There are no specific medicines that you should take for a mole; treatment is based on the diagnosis from the biopsy.

When is surgery considered?

Surgery is the standard treatment for a mole that looks pre-cancerous or is a confirmed skin cancer. It is also used if a benign mole is large, irritated, or for cosmetic reasons.

Living with this condition

If you are watching a mole, check it once a month. Use the ABCDE rule and also look for any new mole, a sore that doesn’t heal, or a spot that feels different from your other spots. Take photos to compare over time.

Lifestyle tips

• Use sunscreen every day with high UVA and UVB protection.
• Wear a wide-brimmed hat, sunglasses, and protective clothing when outdoors.
• Avoid direct sun between 11am and 3pm.
• Do not use sunbeds.

Diet and exercise

A healthy diet and regular exercise build overall skin health. There is no evidence that any specific food or supplement prevents melanoma, but staying well-hydrated and eating plenty of vegetables and fruits supports your immune system.

Mental health and emotional wellbeing

Waiting for results after a mole removal can be a tense time. It is normal to feel anxious. Try to focus on the fact that you have taken a positive step. If worry becomes overwhelming, speak with your doctor about counselling or support services.

Prevention

You cannot prevent the appearance of normal moles, but you can reduce the chance of a mole turning into skin cancer by protecting your skin from UV rays. Avoid sunburns and sunbeds, and check your skin regularly.

Vaccines

Currently, there is no vaccine that prevents mole changes or skin cancer. The most effective prevention is sun protection and early detection.

Screening programmes

If you are at higher risk, your doctor may recommend regular skin screening. This means a professional examines your skin to look for unusual spots. You can also do monthly self-checks at home.

Complications

If left untreated

• A melanoma can grow deeper into the skin and spread to lymph nodes or other organs if it is not caught early.
• A mole that is repeatedly irritated may bleed and become infected.
• Some mole changes, such as an inflammatory reaction or an infection, can cause scarring if not managed.

Long-term outlook

The outlook is excellent for people who find and treat a suspicious mole early. Even when a mole is melanoma, it is usually curable if it has not grown deeply into the skin. Remember that the vast majority of moles that are checked are not cancer. Staying aware and acting quickly is the best way to keep your skin – and you – healthy.

Find support

International organisations

• Skin Cancer Foundation ↗

Local organisations

• NHS ↗ · United Kingdom

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