Moles (Nevi) and Sunspots (Lentigines)

Moles are benign tumors of the skin that are usually brown or black. Moles can appear anywhere on the skin. Most moles appear in early childhood and during the first 25 years of a person's life. As the years pass, moles usually change slowly, becoming raised and/or changing color. Sometimes, hairs develop within the mole. Some moles may not change at all, while others may slowly disappear over time. Moles occur when melanocyte cells (pigment makers) in the skin grow in a cluster instead of being spread throughout the skin. Moles may darken after exposure to the sun, during the teen years, and during pregnancy.

Types of moles:
◦ Congenital nevi are moles that are present at birth, and occur in about one in 100 people. These moles are slightly more likely to develop into melanoma than are moles that appear after birth. A mole or freckle should be checked if it has a diameter of more than a pencil eraser or any characteristics of the ABCDEs of melanoma (see below).
◦ Dysplastic nevi are moles that are generally larger than average (larger than a pencil eraser), are irregular in shape, or have uneven color with dark brown centers and lighter edges. People who have 10 or more dysplastic nevi have a 12 times higher chance of developing melanoma on any part of their body (not necessarily within these or other lesions).

Check your own skin (including all over the body, under the nails and scalp) can help you find melanoma early when it’s highly and easily treatable. When examining your skin, you want to look for the warning signs, which are called the ABCDEs of melanoma:
◦ Asymmetry, when one half of the lesion is different from the other half
◦ Border irregularity
◦ Colors: having multiple different colors (black, brown, blue, red, pink)
◦ Diameter: greater than that of a pencil eraser
◦ Evolution: evolving or changing lesion (this is likely the most important sign)

Sunspots (Lentigines)

The term ‘sunspots’ includes freckles, and larger tan lesions that occur as we get older, and are the result of sun exposure. These lesions are benign and do not have a risk of turning into skin cancer. However there is a type of melanoma that can look like a sunspot to the untrained eye. Therefore, always see a dermatologist if any new or suspicious lesions arise. A dermatologist can distinguish melanoma from lentigines, especially with a new device called a dermatoscope. This device shines light into the skin and allows the doctor to see into the lesion, and evaluate the pigment patterns and other structures in the skin.

Even though lentigines are benign, many people do not like having these on their skin. Thankfully, there are lasers that can remove these lesions. One such laser is a q-switched nd:YAG laser (Medlite laser). Most patients notice a resolution of the lesions with one treatment. Creams may be able to lighten the lesions but rarely can they completely remove them.

The best way to prevent lentigines is to stay out of the sun as much as possible, especially between the hours of 10 a.m. and 2 p.m. Use a broad-spectrum sunscreen with an SPF of 30 or higher when outdoors, and wear protective clothing, such as long-sleeved shirts, pants, and a wide-brimmed hat. Avoid using tanning beds.