have them checked regularly and prevent skin cancer
They can occur on any part of the body, take on different shapes and colours and are different in size: the small, mostly brown, spots and elevations on the skin are colloquially referred to as moles or liver spots.
As a rule they are completely harmless but may affect the patient’s aesthetic appearance. This article will provide you in a nutshell with information on why moles should be checked periodically, how dangerous they actually are, and what removal options you can consider.
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Moles can occur at birth or later in life. Causative factors are hereditary, extent and intensity of sun exposure and skin type. It is a collection of pigment-forming nevus cells which rise from deeper skin layers and multiply in the higher skin layers.
They are usually not dangerous, yet they can lead to skin changes, degeneration, develop melanoma or trigger other skin cancers.
That is why periodic examinations, which I carry out in my practice in Vienna, are so important for early diagnosis. Book an appointment.
Their emergence is not due to a single factor. If they are present in large quantities in the direct family (parents, grandparents), the probability of occurrence increases.
There is also a dependency on the skin type: generally speaking, the lighter the skin, the higher the number of moles. In people with dark skin, they usually occur in a smaller number.
Melanin is an important factor in the development of moles and contributes significantly to the dark colouring of the skin.
One associates moles with skin cancer. Currently, the number of people suffering from skin cancer is increasing in Austria. Recognised early, skin cancer is well curable. As the disease can also affect younger patients, periodic mole control or skin cancer screening is also recommended for this group. There are certain danger signs that should be observed. For the first self-examination, you can follow the ABCDE rule:
- Asymmetric changes
- Boundaries that are irregular
- Colour, not uniform pigmentation
- Diameter more than 5 mm
The above is used as an initial tool to identify suspicious moles. A medical consultation is required if at least two of the five points apply.
The examination take place in my Viennese practice. Depending on the indication, different methods are used:
- In the first step, I will carry out a microscopic examination. The early detection of skin changes (melanoma, tumours) is possible and even the smallest changes to a birthmark or mole can be identified with this instrument. The examination is painless and non-invasive and can quickly distinguished between harmless and suspicious changes.
- If necessary, the moles identified as conspicuous can be photographically recorded and stored. In the case of video photographic microscopy with the FotoFinder® system, one or more overview images are taken of the skin site with the atypical birthmark using a high-resolution special camera. The camera zooms in on the the birthmark and images are stored digitally. Once captured, images can be compared with new ones again and again. Every change becomes immediately visible and can be diagnosed early. Based on your individual mole status, I recommend a tailor-made control schedule. Usually yearly controls are recommended. In some cases - especially in the case of cancer aftercare - 3 month follow-ups are required. With the help of the computer-assisted follow-up images produced during the check-ups, moles that have changed can be diagnosed early and reliably.
As long as a birthmark is not conspicuous, treatment is not required. If it is not clear in the course of an examination whether it is benign or malignant then it should be removed and examined histologically to be sure. Most moles are however removed for aesthetic reasons, especially if they are on the face or other visible areas.
Moles occur in different forms. It is good to know these in order to respond to changes in a timely manner. The classic forms are:
- Congenital moles (congenital nevus): they are, as the name says, already present at birth. They come in different shapes, sizes, and colours, and usually become visible in the first year of life. For them, the risk is slightly higher than for the moles which appears later in life. Hairy moles should be watched closely. Statistically there is an increased risk when the mole is larger than one centimetre in diameter.
- Common birthmark (nevus) are single coloured and regularly limited. Almost all people have these moles. In Northern Europe an average person has about 30 to 40.
- Elevated mole (papillomatous nevus): This type of mole looks rather scary, sometimes hair grows out of it. It is single-colored and represents a rather cosmetic problem because of the rough, somewhat raised surface and the hair.
- Unusual birthmark (atypical or dysplastic nevus): The appearance is close to the malignant melanoma. It has a diameter of more than 5 mm, has different colours with a frayed edge, flat or raised. When such moles occur, a dermatologist should be consulted urgently as the risk of getting melanoma is higher.
- Blue birthmark (blue nevus): The birthmark is gray-blue in colour, flat or elevated. The colour is created by refraction. The actual birthmark is located in deeper skin layers. This type of birthmark can change and should be kept under observation.
Do not take any risks
If you notice unusual moles; especially those that grow fast, an examination is strongly recommended. You are welcome to make an appointment at my practice. Book an appointment.
Whether the removal of a mole is recommended and how it should be done, will be discussed with you after a thorough examination. All removed moles are examined histologically by a Pathologist (this may take several weeks) to exclude any risk. The surgical removal itself is done under local anaesthesia and is painless. What is important to me is the cosmetically demanding removal of all skin lesions and the avoidance of unsightly scarring. In certain moles (for example, papillomatomatous nevi or fibroids), removal can be gentle with the high-efficiency erbium laser or cautery (electricity).
Cancers of the skin are grouped under the name "skin cancer". Two types can be distinguished:
• White skin cancer (basal cell carcinoma, squamous cell carcinoma, actinic keratosis): they form virtually no metastases.
• Black skin cancer (malignant melanoma): metastasises already in the early phase and changes can hardly be detected by visual observation alone.
It should be pointed out again that intensive sun exposure and insufficient sun protection contribute to the development of moles and white and black skin cancer.
Actinic keratoses are white skin cancer precursors and develop after chronic light damage. Treatment is important because the precursors can develop over a period of months or years to skin cancer. In my practice, I can remove these precursors with the latest high-efficiency precision laser, the Erbium laser. Other options to treat these precursors include liquid nitrogen or curettage. Another option is the daylight PDT in which a medical cream, combined with sunshine, triggers a chemical reaction which leads to the rejection of altered cells. With this therapy larger areas can be treated effectively and painlessly.
Regular mole / skin cancer screening is especially important. The earlier a disease is detected, the better the chances of recovery.
My range of services for skin cancer screening and mole control includes:
- Information and advice on skin type and personal sunscreen needs.
- Clinical examination with state-of-the-art instruments: dermatoscope, digital dermatoscope, Foto-Finder® (documentation in chronological order)
- Removal of moles and other benign or malignant lesions by gentle laser or cosmetic surgery.
- Surface treatment of skin cancer precursors using Daylight PDT and laser.
You are welcome to make an appointment for a first consultation in my practice in Vienna. Book an appointment.
Learn more - SUN PROTECTION AND SKINCANCER: INTERVIEW DR. BISSCHOFF (German)
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