Moles are common and frequent skin growths, but itchy moles can be a sign of skin cancer. This article explains how to differentiate them.
Moles can form in any part of your body, although they are particularly frequent in sun-exposed areas. Some persons have more than 40 moles, and in most cases, this is perfectly normal and does not pose a health threat. However, a minority of those moles can turn out to be cancerous.
Melanoma is a type of skin cancer that very much resembles a normal mole. However, specific characteristics and warning signs of melanoma should prompt you to go to the doctor to get that mole checked out.
Please keep reading to know more about melanoma and its warning signs. Remember, the sooner you catch it, the better the prognosis.
Melanoma is not the only kind of skin cancer, nor the most frequent. Only about 1% of skin cancers are melanoma; other types such as squamous cell carcinoma and basal cell carcinoma are far more frequent.
However, likely, you have never heard of squamous cell carcinoma until now, but you have listened to plenty about melanoma.
This situation has a straightforward explanation; squamous cell carcinoma is rarely fatal. In most cases, it is straightforward to treat. The survival rate is over 90%.
Melanoma, on the other hand, is a very aggressive cancer with a high mortality rate. Even though melanoma only represents 1% of all skin cancer, it is responsible for the vast majority of skin cancer deaths. Still, when caught early, it can be easily treated.
Keep reading to learn everything you need to know about itchy moles and melanoma.
What is a mole?
Moles are a common type of skin growth. They are small brown spots that usually appear in sun-exposed areas like the face, the scalp, the soles of the feet, the back, and the hands’ palms.
Although most moles are brown or black, some of them can be red, pink, or blue. A mole is a cluster of a certain kind of skin cell called a melanocyte on a microscopic level.
Melanocytes are the cells responsible for producing a pigment called melanin, which gives color to the skin and protects the skin from harmful UV radiation.
Most people have around 10 to 15 moles in different parts of their bodies; these moles can change in shape and color over time. Some might even completely disappear or fade away.
Most moles are normal and harmless, but some of them might turn cancerous. Signs like itching, crusting, and bleeding could be signs of melanoma, so it is essential to keep an eye on both your old and new moles to note any mole changes early.
What are the different types of moles?
Medically speaking, there are three different types of moles, categorized by appearance time, aspect, and their risk of becoming cancerous.
The three main types of moles are:
- Congenital mole (birthmarks): Congenital moles are present at birth and vary widely in shape, size, and color. About 2 percent of infants are born with a congenital mole in the United States. These moles are usually not dangerous in any way, although some patients may desire treatment for cosmetic reasons. However, large congenital moles have a 4% risk of becoming cancerous at some point.
- Acquired Mole (common mole): Acquired moles are noncancerous moles that appear on the skin after birth. People usually have between 10 and 40 common moles throughout their bodies. These moles are typically round or oval, small, unchanging, and only have one color. Many common moles also have hairs on their surface. Those with darker skin also tend to have darker moles than those with fair skin. Importantly, people with more than 50 common moles are at higher risk of developing skin cancer than the rest of the population.
- Atypical mole (dysplastic nevi): Atypical moles are moles with the potential to turn into melanoma. Studies show that about 1 in every 10.000 atypical moles actually becomes cancerous. Atypical moles look the same way as cancerous moles do. They are usually big, pebbled in texture, irregularly shaped, and mixed in color. Atypical moles can appear anywhere in the body, but they are rare on the face.
What are the signs that a mole might be cancerous?
The signs that a mole might be melanoma can be summarized using the ABCDE abbreviation; each letter stands for a different characteristic.
- A is for asymmetry; most moles are perfectly round or oval. If you drew a line across a normal mole, you would have two halves. When the two halves of the mole are uneven, it might be time to worry.
- B is for Borders; cancerous moles usually have irregular or ragged borders.
- C stands for color; a normal, benign mole is usually of only one color; malignant melanoma moles can have two or more different colors. Some authors describe melanoma moles with classic red, white, and blue appearance.
- D stands for diameter; a common mole is usually smaller than one-quarter of an inch across (approximately the same diameter as a pencil eraser). In melanoma skin cancer, moles are generally more significant than that.
- E is for evolving; the mole is changing size, shape, or color or is raised over the skin’s edge. Those are signs of a cancerous mole.
Some authors also add the letter F. The letter F stands for funny looking. It is a subjective measure that means that malignant moles simply look weird or somewhat different from normal moles. So, go with your gut. If you see a mole that, for whatever reason, doesn’t look right to you, go to the doctor immediately.
Why do moles get itchy?
Not every itchy mole represents cancer. Most of the time, itchy moles result from irritation (due to the mole continually rubbing against your clothes, for example).
Applying new colognes, aftershaves, or other personal care products can also cause your mole to itch. Washing your clothes with new detergents or fabric softeners can also cause irritation and itching.
However, in a minority of cases, itching is a consequence of skin cancer, mainly when it occurs in a funny-looking mole or a mole with one or more of the ABCD warning signs listed above.
Other signs that your more might be cancerous include:
- Bleeding after scratching, due to an increased number of blood vessels.
- Crusting over it
Is a melanoma raised or flat?
In most cases, melanoma lesions are raised rather than flat.
Can scratching a mole make it cancerous?
No, scratching a mole does not make them cancerous. It is the other way around. Some skin cancers cause itchy moles, and itchy moles cause scratching. Therefore, cancer is what causes the scratching, no the scratching that causes cancer.
Do melanoma moles appear suddenly?
New moles appear when melanocytes proliferate or duplicate excessively in one place. Melanocytes contain the pigment that gives moles their distinctive colors.
Some factors make it easier for this to happen; factors such as:
- Exposure to ultraviolet radiation (too much sun exposure)
- Having fair skin
- Genetics, some people are more likely to grow moles than others.
- Having a weakened immune system
Most moles appear during childhood and adolescence, and in women, new moles are common during pregnancy due to hormonal imbalances.
New moles in nonpregnant women are somewhat rare, but this does not mean having a new mole as an adult equals cancer. Although most moles that appear during adulthood are benign, every new mole in majority should always be checked by a doctor.
What are the symptoms of melanoma besides moles?
When melanoma produces symptoms different form mole appearance, it means that cancer has spread to other body parts.
Ulceration is a breakdown of the skin on top of the mole, which causes an ulcer. Ulcerated tumors are more dangerous because they have a higher risk of spreading to other parts of the body.
When melanoma spreads beyond the skin, the first place it goes to is the nearby lymph nodes. When cancer reaches the lymph nodes, these lymph nodes grow and become palpable.
Cancerous lymph nodes can also turn matted and merge together. They will feel lumpy and hard when touching the skin. The enlarged lymph node can be the first symptom of advanced disease.
When melanoma spreads beyond the lymph nodes, it can reach other organs. Metastasis is the name of how cancer cells spread from its original location to other organs.
The most common places melanoma spreads to include:
In these stages, symptoms depend on where melanoma spreads. For example, if it spreads to the lungs, the patient might experience symptoms such as constant cough and difficulty breathing.
On the other hand, the disease might manifest itself as a continuous headache, personality changes, seizures, or visual disturbances if it spreads to the brain.
Bone metastasis can produce chronic pain and fragile bones. Liver metastasis can lead to hepatic insufficiency with jaundice ( yellow skin) and bleeding issues. Symptoms like weight loss and chronic fatigue are common to all metastasis sites.
What are the differential diagnoses for melanoma?
Sometimes other, not cancerous, skin lesion can be mistaken for an abnormal mole. Some vital differential diagnosis to keep in mind for melanoma include:
- Seborrheic keratoses
- Pyogenic granulomas
- Wart due to Human Papillomavirus (HPV)
- Nonmelanoma skin cancer: Squamous cell carcinoma and basal cell carcinoma, sebaceous carcinoma
- Blue nevus
- Halo nevus
- Normal mole
- Pigmented spindle cell tumor
What should you do if I have a bleeding mole or itchy mole?
Although most moles are harmless, you should consult your primary care physician or a dermatologist whenever you have a new mole, a funny-looking mole, an itchy mole, or a bleeding mole. Your doctor will examine the mole and decide whether you need further testing or not.
Remember, the early detection of a cancerous mole has the potential to be life-saving, and perhaps it may save you from having to go through painful chemotherapy. The earlier you are diagnosed with melanoma, or any other form of cancer, the better your prognosis will be.
How is melanoma diagnosed?
Once you have gone to the doctor with a suspicious mole or a new mole, he or she will examine it. Still, more importantly, it will order some tests to have more information about the lesion.
The diagnosis is made through an excisional biopsy; the dermatologist will remove your skin’s entire suspicious area for microscopic observation.
By observing the cells present in the mole and cytochemical studies, the pathologist will determine whether the lesion is malignant or not and will provide the results to your dermatologist through a pathology report.
Once a diagnosis is made, the next step is determining the stage. Melanoma staging depends on the tumor’s thickness, lymph node involvement, and the presence or absence of distant metastasis. Staging will determine the treatment.
How does melanoma staging work?
Melanoma staging might require additional testing with CT scans, MRIs, and blood tests. Doctors use the TNM system to stage most types of cancer.
The T stands for the extension of the original tumor, its thickness, and whether it is ulcerated or not. Breslow depth is a measurement from the surface of the skin to the deepest part of the tumor.
Breslow thickness is an essential factor in determining how much the tumor has progressed. The thinner the tumor, the better the prognosis; thicker tumors have a poorer prognosis.
N stands for nearby lymph nodes. It indicates if the tumor has spread to nearby lymph nodes or not. This category also includes in-transit tumors, those that have left the primary site and are on their way to a lymph node but haven’t reached it yet.
M stands for metastasis, representing the tumor’s spread to distant sites such as the bones or the brain. After the T, N, and M are identified, a stage is assigned. Stages go from one to four; the bigger the number, the worst the prognosis.
What does each stage represent
We can divide melanoma staging into three main groups:
- Early Melanoma: This group comprises stages 0 and I. Tumors in this stage are smaller than 1mm in Breslow depth.
- Intermediate or high-risk melanomas: These tumors are still localized but have traits such as ulceration that put them at higher risk of spreading. Stage II melanomas are more profound than 1mm Breslow depth, and although they have not yet traveled to nearby lymph nodes, they are at high risk of doing so. In these cases, doctors may perform a sentinel lymph node biopsy to ensure the tumor hasn’t already spread to those lymph nodes.
- Advanced melanoma: In these stages, the tumor has already spread to other body parts. In stage III melanoma, cancer has spread to nearby lymph nodes or more than 2 cm away from the original tumor through a lymph vessel. Some times the affected lymph nodes are enlarged. However, this is not always the case. In stage IV melanoma, cancer cells have already spread to other organs like the brain, bones, liver, lungs, or the gastrointestinal tract. The diagnosis is made through imaging studies such as CT scans and MRIs. High LDH levels in the blood are highly suggestive of metastasis.
What is the treatment for an itchy mole?
Most moles don’t need any treatment. If a mole is itchy or bothers, you should go to a dermatologist. If your dermatologist determines the mole is melanoma, there are several treatment options available.
For early-stage melanoma, surgical removal of the tumor is the standard of care. Some stages might also require excision of the nearby lymph nodes just in case.
Patients with stage three disease and beyond also require adjuvant therapy with chemotherapy or radiotherapy. Stage four disease can also benefit from immunotherapy, intralesional chemotherapy, and in some cases, palliative therapy.
How can I prevent melanoma skin cancer?
The best way to prevent itchy moles and melanoma is to avoid risk factors. The main risk factor for melanoma is exposing yourself to not too much UV radiation (sunlight). Having a good sun cream and using it regularly is the best possible protection against melanoma.
What is the prognosis for melanoma?
Early melanoma stages have a great prognosis, with a mortality rate below 2%. Once the tumor has spread to regional lymph nodes, mortality rises to almost 30%. In advanced stages, mortality reaches a staggering 80%. This is why early detection is critical.
Do you have symptoms of skin cancer?
This tool is a skin cancer symptoms checker. It gathers the most important signs, symptoms, and risk factors for developing this condition. Therefore, it would help anyone who uses it to determine the likelihood that their symptoms are because of skin cancer. The best of it is that it is free and would only take a few minutes to complete.