Mole Evaluation & Removal

What Are Moles?

Moles (medically known as melanocytic nevi) are growths on the skin that form when pigment-producing cells called melanocytes grow in a cluster rather than spreading evenly throughout the skin. They are extremely common — most adults have between 10 and 40 moles, and the vast majority are completely benign.

Most moles develop during childhood and adolescence, with new moles becoming less common after age 30. Any new mole appearing after age 35 warrants professional evaluation. Moles may darken with sun exposure or during pregnancy — these changes are typically benign, but a dermatologist should be the one to make that determination.

While most moles are harmless, some can undergo changes over time and develop into melanoma — the most dangerous form of skin cancer. According to the American Academy of Dermatology, melanoma is one of the most common cancers among adults under 30, and early detection dramatically improves survival rates.

Types of Moles

• Common acquired moles: Small, round or oval, uniformly colored (tan to brown), smooth-bordered growths that develop after birth. Most moles fall into this category and are benign.
• Congenital moles: Present at birth. Generally benign, though larger congenital nevi (>20cm) carry a somewhat elevated lifetime risk of melanoma and should be monitored closely.
• Dysplastic (atypical) nevi: Larger than typical moles, with irregular borders and uneven coloring. Dysplastic nevi are not cancer, but they are associated with an increased risk of melanoma — particularly in people with many atypical moles or a family history of melanoma.
• Spitz nevi: Pink, red, or multi-colored raised moles that can resemble melanoma under the microscope. Most common in children. Should always be evaluated by a dermatologist.

The ABCDE Warning Signs of Melanoma

The ABCDE criteria are a clinically validated tool used by dermatologists — and patients performing self-exams — to identify moles that warrant professional evaluation. If a mole shows any of the following characteristics, schedule an appointment promptly.

Note: Some early melanomas don't fit the ABCDE criteria. Any mole that looks different from your others — the "ugly duckling" sign — should be evaluated by a dermatologist.

Who Should Have Regular Skin Exams?

The AAD recommends annual full-body skin exams for all adults. The following groups are at elevated risk and should be especially diligent:

• People with more than 50 moles
• Anyone with a personal or family history of melanoma or atypical moles
• Fair-skinned individuals who burn easily
• People with a history of significant sun exposure, sunburns, or tanning bed use
• Anyone who has had a previous skin cancer diagnosis
• People with suppressed immune systems (organ transplant recipients, those on immunosuppressive therapy)

Mole Evaluation & Removal at Dermatology of Seattle

Our board-certified dermatologists use clinical examination and dermoscopy — a non-invasive technique that magnifies and illuminates skin lesions — to evaluate moles with greater accuracy than the naked eye alone.

Full-Body Skin Exams

A thorough head-to-toe examination of all skin surfaces, including areas not easily visible in a mirror. We document concerning lesions and create a personalized monitoring plan.

Biopsy for Suspicious Moles

When a mole shows worrying features, a biopsy is performed in-office under local anesthesia. The tissue sample is sent to a dermatopathologist for analysis. Results are typically returned within one week, and your dermatologist will contact you to discuss findings and next steps.

Mole Removal Options

• Surgical excision with margins — the preferred method for suspicious or atypical moles; removed with a margin of surrounding tissue and sent to pathology
• Shave removal — appropriate for raised, benign moles; a quick in-office procedure with minimal recovery
• Punch biopsy — used for smaller suspicious lesions requiring full-thickness tissue sampling