Does Melanoma Always Start as an Atypical Mole?

Most moles are benign, meaning they’re not cancerous. But cancer loves to lurk inside moles and creates visible changes that alert you to a potential problem. In honor of Melanoma and Skin Cancer Awareness Month, Dr. Robert Topham and our Holladay Dermatology & Aesthetics team want to make sure you know how to spot the signs of skin cancer and what to do if you have an atypical mole.

What constitutes an atypical mole?

Almost everyone has moles, even children. By the time you’re an adult, you may have 10-40 moles in various places on your body. Don’t worry; this is normal. What’s not normal is having moles that change a lot. These are called atypical moles, and they warrant your attention and our expert evaluation.

Why? Because moles are clusters of skin cells, and cancer often begins in their midst. Medically known as dysplastic nevi, atypical moles have distinct characteristics that are easy to remember using the letters A, B, C, D, and E.

A stands for asymmetry, where the two halves of your mole don’t match. 

B stands for border and reminds you to check the edges of your moles. Smooth, even borders are normal; scalloped or jagged edges may cause concern.

C stands for color. Although normal moles come in various colors, they should be solid, and mottled or multicolored moles may indicate a problem.

D stands for diameter. You should have any moles checked that are larger than the diameter of a pencil eraser.

E stands for evolution, meaning that change is atypical. While it’s normal for a mole to get a little darker as you age or during pregnancy, extreme changes in color, size, or shape and any new symptoms like itching or bleeding warrant an examination.

What is melanoma?

To understand melanoma and other types of skin cancer, it helps to picture your skin as a bustling city with different neighborhoods. The happening uptown region is your epidermis — a prime spot for skin cancers to crash the party. 

Here are some other key players in the neighborhood:

1. Squamous cells: These are like the cool kids or the surfers of the skin, hanging out on the outer part of the epidermis. They're always on the move, making way for new buddies to join them.

2. Basal cells: The hardworking construction crew is located downtown in the basal cell layer. These fellas are constantly building new cells to replace the squamous cells that move on. As the basal cells head up to the surface, they go through a sleek makeover and transform into squamous cells.

3. Melanocytes: Consider melanocytes as the enigmatic artists giving your cityscape its unique color palette, creating shades of tan and brown with their melanin masterpieces. But beware — they have a dark side, with the potential to turn into the notorious melanoma.

Melanoma is a sneaky type of cancer that starts in melanocytes and often hangs out in dark black or brown tumors. But don’t be fooled by light-colored moles. Some melanomas switch off their melatonin production and masquerade as tan, pink, and even white moles — sneaky.

In our cityscape analogy, melanoma can infiltrate every part of the “city” but prefers certain hangouts like men’s chests and backs and women’s legs. That doesn’t mean you won’t find them lurking in other neighborhoods, though. Melanoma has been known to show up under fingernails, on foot soles, on palms, around the genitals, and even in the mouth and eyes. 

Although melanoma is less common than other types of skin cancer, like squamous and basal cell skin cancer, it’s more dangerous because it spreads more quickly and can infiltrate other parts of your body if you don’t catch and treat it early. 

The link between atypical moles and melanoma

Not only are most normal moles benign, but most atypical moles are also benign. However, having an atypical mole puts you at a higher risk of developing melanoma. Having more than one atypical mole increases your risk again, and having large moles, or more than 100 moles, ups the ante even higher.

The best way to know if your atypical mole is cancerous is to come in for an examination. Dr. Topham may recommend a biopsy to take a sample of the cells and check them for cancer. 

Meanwhile, you can do your part by keeping an eye on your moles and knowing the landscape of your skin. Perform regular self-checks and keep track of changes with photographs. There are also smartphone apps that help you monitor your moles. 

It’s Melanoma and Skin Cancer Awareness Month — a great time to take stock of your moles and schedule an appointment at Holladay Dermatology & Aesthetics in Holladay, Utah. If you have any suspicious characters in your skin’s neighborhood, call or click today.