Mole Patrol: Spotting the Early Signs of Melanoma

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Summer is the time for picnics, BBQs, family reunions and graduation parties. With kids enjoying summer break and daylight getting longer, many people take time off for vacation and spend more time outdoors under the hot sun. However, to safely enjoy those long hours outdoors, now is a good time to remind ourselves of ways to prevent skin cancer, particularly melanoma.

Melanoma is a serious form of skin cancer that begins in cells known as melanocytes. While it is less common than basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), melanoma is more dangerous because of its ability to spread to other organs more rapidly if it is not treated at an early stage. The first signs and symptoms of melanoma often are a change in an existing mole, though it can also occur on otherwise normal-appearing skin.

What is a mole?

Moles are growths on the skin that are usually brown or black. Moles can appear anywhere on the skin, alone or in groups.

Most moles appear in early childhood and during the first 25 years of a person’s life. It is normal to have between 10-40 moles by adulthood.

As the years pass, moles usually change slowly, becoming raised and/or changing color. Sometimes, hairs develop in the mole. Some moles may not change at all, while others may slowly disappear over time.

Do moles increase my risk for melanoma?

Most moles will never cause any problems, but someone who has many moles is more likely to develop melanoma. One study suggests that the presence of 11 or more moles on your right arm could signal a greater risk of melanoma. This doesn’t mean you will definitely get melanoma if you have lots of moles. But it does mean you should be very careful about exposing yourself to the sun. And you should keep an eye on all your moles.

People who have lots of unusually shaped or large moles have a higher risk of melanoma than the general population. A large mole is one greater than 5 millimeters in diameter, which is about the size of a pencil eraser.

What warning signs should I look for?

A simple way to remember the warning signs is to remember the A-B-C-D-Es of melanoma— a useful tool to keep an eye on your skin and catch the early signs of melanoma. Please note that this is just a guide and melanoma may present with different features. This is why regular skin checks from a health care provider are so important. Be sure to seek advice from your primary care provider if you notice any of the following:

• A is for Asymmetry. Most melanomas are asymmetrical. Asymmetrical means that they are not a specific shape, for example like with the shape of a fried egg or an amoeba. Also, with melanoma, the border of the mole can be less sharp compared to what we see in a healthy mole. Normal healthy moles are usually round or oval with both sides of the mole being the same shape. Therefore, if you draw a line through the middle of a mole and the two sides don’t match, then the mole may be asymmetrical. If you have an asymmetrical mole please see your doctor right away.
• B is for Border. Melanoma borders tend to be uneven and may have scalloped (cut out) or notched edges. Healthy moles usually have smooth, even borders.
• C is for Color. Multiple colors in a mole are a warning sign that it may be melanoma. While healthy (also known as benign) moles are usually a single shade of brown, a melanoma may have different shades of brown, tan or black. As a melanoma grows, the colors red, white or blue may also appear.
• D is for Diameter or Dark. While it’s best to catch a melanoma when it is small, it’s a warning sign if a mole the size of a pencil eraser (about 5 mm, or ¼ inch across) or larger.
• E is for Evolving. Evolving is another word for changing. Any mole that is changing in size, shape or color is a warning sign for melanoma. Also, any raised spot on your skin, or if your skin has any new symptom such as bleeding, itching or has crust forming, this may also be a warning sign of melanoma.

How do I protect myself from skin cancer and melanoma?

While some sunlight can be good for our health, it’s important to limit sun exposure and protect yourself all year long, not just during the summer or at the beach. UV rays from the sun can reach you on cloudy and hazy days, not just on bright and sunny days and can be harmful to your skin and cause melanoma. UV rays also reflect off of surfaces like water, cement, sand and snow. Indoor tanning (using a tanning bed, booth ,or sunlamp to get tan) also exposes us to UV radiation and can be harmful to your skin. You can protect your skin from melanoma and other skin damage by wearing sunscreen to block UV rays.

Protect the Skin You’re In

To reduce your risk of skin cancer, the Skin Cancer Foundation recommends these tips:

• Seek the shade on sunny days, especially between 10 a.m. and 4 p.m.
• Don’t get sunburned.
• Avoid tanning, and never use UV tanning beds.
• Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
• Use a good quality (UVA/UVB) sunscreen every day (please read the label and find one with an SPF of 15 or higher.) For long periods of time outdoors or with water activities, use a water-resistant sunscreen with an SPF of 30 or higher.
• Apply one ounce (two tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours or after swimming or if you are sweating a lot.
• Keep newborn babies out of the sun. Use sunscreen on babies over the age of six months.
• Check your skin from head-to-toe every month.
• See a dermatologist (skin doctor) at least once every year for an overall skin check to look for unhealthy moles and other skin problems.

Sources: Skin Cancer Foundation, Mayo Clinic, Centers for Disease Control and Prevention (CDC)

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