Most people will develop small brown moles that are harmless. They may be flat, dome shaped or bumpy looking. These moles usually will appear throughout their childhood, but some new moles may appear in adulthood or after pregnancy.
Most of the times, these moles appear due to our genetic predisposition. However, sun exposure can also trigger new moles. We pay special attention to moles because sometimes these can change and melanoma (a dangerous type of skin cancer) may arise from an existing mole.
If you have >50 moles on your body, you may be at a higher risk of developing melanoma. If you have a family history of melanoma, you should also be more vigilant and undertake annual skin checks.
Hope this clarifies!
Hi Yuk Hwee,
If you notice a changing mole, you should ALWAYS see a dermatologist who can assess your mole and determine if it is just a normal changing mole or if the mole is developing suspicious features.
While it is normal that some moles may become larger, darker or lighter over time in a harmless manner, it is still safer to leave such an assessment to a trained professional.
As a trained dermatologist who has worked in the UK as well as Asian countries, I have performed numerous skin checks on different skin types using magnifying devices to look out for suspicious features.
I am usually on the lookout for any unusual pigment network, different colours, shapes and patterns, or non-healing ulcerated or bleeding lesions. If a mole is deemed suspicious, a simple and quick biopsy can be performed to send a sample to the lab for formal testing.
It is difficult to give you a definite answer on whether such creams are effective because it ultimately depends on what are the ingredients present in the cream. In my opinion, the safest and most effective way to removal moles would be either by surgical or laser mole removal.
Surgical mole removal refers to removing the mole by cutting it out under local anaesthetic. Don't worry, it sounds a lot scarier than it really is! First, a quick numbing injection is given and the mole removed surgically and a few stitches are applied to close the wound. This is a simple procedure that typically takes 5-10 minutes for most small moles.
The advantage of this method is that moles are completely removed from the deep layers of the skin and recurrence is extremely rare. Also if the mole appears suspicious, it can be sent off for analysis to confirm that it is harmless. I'd admit that scarring will most likely be obvious initially, but most patients barely notice it after 6-12 months. This is my preferred method for removing raised moles.
Laser mole removal is most useful for small flat moles. A numbing cream is applied and a highly effective pigment laser is used to “burn off” the pigmentation from the mole. The procedure can be done in less than 5 minutes and patients are left with a small wound that will scab up over 1 week and then fall off, leaving a small brown area.
Most flat moles will disappear after 1 treatment. Sometimes a few sessions are required if the mole is a little raised or if the pigment cells are deeper. I always counsel patients that there is a risk the lasered moles may recur over time, but the same procedure can be easily repeated.
In Asian skin, all pink pimples will heal leaving a brown mark known as post inflammatory hyperpigmentation. This is due to the higher melanin content in our skin being disturbed during the inflammatory process.
The good news is, these brown patches will usually fade in 2-3 months, and medical grade lightening creams or a light laser can help it fade faster. Just remember to stay out of the sun to help it along as well.
Hi Yang Wei,
It is excellent that you are taking steps to examine your own skin. This is what I'd always recommend all my patients to do in between their annual skin checks with me. The main abnormalities to look out for can be remembered as the ABCDE of abnormal moles:
In addition, I also ask patients to look out for bleeding non-healing moles, and the “ugly duckling”. A mole that stands looks different from the rest should always be checked by a trained dermatologist.
A melanoma may develop from a normal mole which then changes over time. A melanoma normally changes in shape, size and colour, sometimes slowly or sometimes very quickly.
If a mole becomes very black, bleeds or have irregular borders and different colours within, do speed-dial your dermatologist office for an appointment.
Yes apart from the most dangerous melanoma, there are 2 other types of skin cancer.
Skin cancer can be broadly divided into non-melanoma skin cancer or the more dangerous melanoma. Non-melanoma skin cancer includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
BCCs account for vast majority of skin cancers and are most often found on sun exposed areas of people who spend a lot of time outdoors. BCCs are generally not life threatening as they rarely spread to the rest of the body. However, if left untreated, they continue to grow and can destroy surrounding tissues.
This is a particular problem on the face and can require major reconstructive surgery for complete removal. BCCs often appear as a pink pearly spot or lump with obvious blood vessels in Caucasians. However in Asians, they can look very different, appearing as a darkly pigmented lump. They can sometimes have a bloody, crusted surface.
SCC is the second most common skin cancer. SCCs may be related to chronic sun exposure, longstanding sores or wounds, or appear on sites previously exposed to X rays or certain chemicals such as arsenic. Conditions that suppress the immune system over a long period of time can also contribute to the development of SCCs.
Early pre-cancerous skin changes can appear as solar keratosis, often noticed as just a rough patch of skin on the forehead or scalp. Early SCCs may appear as Bowen’s disease, a persistent red scaly patch also usually found on sun exposed areas.
Regardless of appearance, any new skin growth, change in skin growth or non-healing lesion should prompt an early visit to a dermatologist.
During your skin check with your dermatologist, you will often be asked some questions and examined to assess your risk for development of skin cancers.
This may include:
If you answer yes to any of these, you are at a slightly higher risk of developing skin cancer.
Hi Shan Shan,
The most important step everyone can take to minimize their risk of skin cancer would be to take sun protection seriously. Wearing a hat, regular sunscreen, avoiding mid-day sun and never ever going under a sun bed would be a good start.
Routinely checking your own moles for any change and visiting a dermatologist every year for a skin check can also ensure that any abnormal skin changes can be picked up early.
If your dermatologist finds an abnormal mole or growth that appears suspicious, then a simple test known as a biopsy needs to be done. It is a quick test that takes 5-10 minutes and a small skin sample is removed after a quick numbing injection. 1-2 stitches are usually applied to close the wound and this will heal in 1-2 weeks.
The skin is then sent to a specialised lab to be examined under the microscope by another dermatologist. Typically, the final report that tells you whether the mole is a skin cancer or not will be available after a week.
Hi Wei Chiang,
Sorry to hear that your father has been given such bad news. The next steps will depend on how deep the melanoma is.
For shallow melanomas, surgical removal with good margins may be adequate. For deeper melanomas, he will require surgical removal of the melanoma and referral to an oncologist for further staging. This refers to investigations to check if there is a spread to the neighbouring lymph nodes or other organs.
In advanced cases, immunotherapy or targeted therapy may be required.
Hi Peng Yuan,
Very sorry to hear that your mother has been diagnosed with melanoma. The treatment options should be discussed with you by your dermatologist. The next steps depend on how deep the melanoma is.
For shallow melanomas less than 0.8mm thick with no ulceration, surgical removal with good margins may be adequate. For deeper melanomas with ulceration, she will require surgical removal of the melanoma and referral to an oncologist for further staging. This refers to investigations to check if there is a spread to the neighbouring lymph nodes or other organs.
In advanced cases, immunotherapy or targeted therapy may be required, and these will be carried out by her oncologist.
Hi Wei Chiang,
In general, the cost depends on whether surgery or further treatment with immunotherapy or targeted therapy is needed. Whether a patient seeks treatment in the public or private sector also reflects a difference in cost, with the private sector often charging double or more of what the public rates might be.