Moles: normal changes, warning signs of melanoma and removal

Moles are small, coloured spots on the skin. The NHS says most people have them. Most are harmless, and the NHS says they are usually darker on brown and black skin.

The NHS describes harmless moles as usually round or oval with a smooth edge, flat or raised, smooth or rough, and sometimes with hair growing from them.

Moles do not stay exactly the same all your life. The NHS says it is normal for babies to be born with moles, for new moles to appear, especially in children and teenagers, for moles to fade or disappear as you get older, and for moles to get slightly darker during pregnancy.

The key point is what is unusual for you. Cancer Research UK says to know what your skin looks like normally, to check it with a mirror or ask a partner or friend to check areas you cannot see, and to remember that a mole that looks very different from your others should be checked.

Some moles can be a sign of melanoma, a type of skin cancer. The NHS and Cancer Research UK describe the features that make a mole more likely to be a melanoma, which doctors summarise as the ABCDE checklist.

The NHS says people with black or brown skin have a lower chance of getting melanoma but can still get it, most often on the soles of the feet, palms of the hands or under a nail.

Cancer Research UK says melanoma in people with brown or black skin may be more difficult to see and may not show the ABCD signs. It may be symmetrical, broken and sore, a pink colour, under a finger or toe nail, or on the palm or sole. The NHS says to see a GP about a dark area under a nail that has not been caused by an injury.

Melanoma is easier to treat if found early, so any change is worth getting checked. The NHS says to see a GP if you have any of the following.

• A mole that has changed size, shape or colour.

• A mole that is painful or itchy.

• A mole that is inflamed, bleeding or crusty.

• A new or unusual mark on your skin that has not gone away after a few weeks, including on the palms of your hands or soles of your feet.

• A dark area under a nail that has not been caused by an injury.

The NHS says the GP will ask about your health, family medical history and symptoms, and will want to know if the mole has recently changed and whether you or a family member has had skin cancer. They will look at your mole and any other areas of affected skin, and may ask to take a photograph to send to a skin specialist (dermatologist), which is called teledermatology.

If the GP thinks it could be melanoma you will be referred to a specialist in hospital, and the NHS says you should get an appointment within 2 weeks. An urgent referral does not definitely mean you have cancer.

The NHS says moles only need treating if they are a sign of melanoma, and that the main treatment for melanoma is surgery to remove the mole.

Harmless moles are not usually removed on the NHS for cosmetic reasons. The NHS says you can pay a private clinic to remove a mole, but it may be expensive.

The NHS says UV light from the sun can increase the chance of a mole becoming cancerous, and that if you have lots of moles you need to be extra careful in the sun. It recommends checking your moles regularly for any changes.

• Stay in the shade between 11am and 3pm, when sunlight is strongest.

• Cover skin with clothes, and wear a hat and sunglasses if you have moles on your face.

• Regularly apply a high-factor sunscreen (minimum SPF30) and reapply after swimming.

• Do not use sunlamps or sunbeds, which use UV light.

The NHS says new moles are common in children and teenagers, and that babies can be born with moles. A new mole in a child is usually normal, but any mole that changes quickly, bleeds or looks very different from the others should be seen by a GP. The NHS says to make sure babies and children are protected from the sun because their skin is much more sensitive than adult skin.

Moles can get slightly darker during pregnancy, which the NHS lists as normal. Changes in size, shape or other signs of melanoma should still be checked.

On the NHS, a changing mole is assessed by a GP, who can refer you urgently to a skin cancer service. Teledermatology, where a photograph is sent to a specialist, may be used.

Private dermatology services can examine moles and offer dermoscopy and removal, often with shorter waits. Whichever route you choose, ask how and when you will get the result and who will arrange follow-up if the mole is found to be a melanoma.