A mole is a cluster of pigment-producing cells in the skin, and having a number of them is entirely ordinary. What clinicians pay attention to is not how a mole looks in isolation but whether it has changed, and any new or changing mark that persists is a reason to arrange an appointment.
What is actually happening in the skin?
Melanocytes normally sit spread along the base of the epidermis, one among many neighbouring cells, supplying pigment upwards. A mole forms where they gather instead into a cluster, and every mole on your body began that way.
Where that cluster sits determines a good deal about how it looks. Clusters at the junction between epidermis and dermis tend to produce flatter, darker ones. Clusters that have settled into the dermis below tend to produce raised, softer, often paler ones. Many contain both arrangements and may shift between them across a lifetime, which is one reason something flat in your twenties can be raised by your fifties.
That slow evolution is normal and it is precisely what makes the subject confusing. Moles are not static, so change by itself does not mean very much. What clinicians are interested in is change that is recent, relatively rapid, or inconsistent with the rest of yours.
Most appear during childhood and early adult life. New ones arriving later are looked at with more attention, not because they are usually a problem, but because the base rate has shifted.
How would a dermatologist describe it?
The clinical word for a mole is a naevus, plural naevi, and you will hear it used for every mole in the room. A congenital naevus is a mole present from birth. An atypical or dysplastic naevus is one whose appearance departs from the usual pattern, a description of how it looks rather than a diagnosis in itself.
Junctional, compound and intradermal describe where in the skin the cluster sits, which maps onto the flat, mixed and raised appearances above.
The dermatoscope is central here. It is a magnifier with its own light source, applied to the skin, revealing patterns of pigment and small vessels below the surface that are invisible from a normal viewing distance. Clinicians assess moles by those patterns, which is why an assessment can be both quick and far more informative than looking closely by eye.
The phrase that matters most in this area is the ugly duckling. Clinicians look for the one that stands out from a person’s own others, because they vary hugely between people while tending to resemble each other within one person. That comparison is why the whole skin gets examined rather than the single spot you came about.
Published guidance sets out the features and changes that should prompt an appointment. Those criteria belong to the bodies that publish them, they are stated precisely there, and they are linked below rather than paraphrased here, because a paraphrase of a checklist is exactly the kind of thing that goes subtly wrong.
What usually happens at a consultation?
Expect questions about the specific one you came about: how long it has been there, what has changed, over what period, whether it itches, bleeds or crusts. Then broader ones: your sun exposure through life, any history of sunburn, use of sunbeds, your family history, and whether you have had anything removed before.
The examination generally covers your whole skin rather than one spot, for the comparison reason above, and uses the dermatoscope. Clinicians frequently photograph what they find, with your agreement, since a dated image gives a fixed point to compare against later.
Where examination cannot settle the question, a clinician will explain what they propose next. Being told that further assessment is needed is unsettling to hear, and it is worth knowing that it reflects the limits of looking rather than a conclusion having been reached.
What is worth asking?
Ask what specifically the clinician was looking at, and what they saw. The reasoning is more useful than the verdict, because it tells you what to watch for in future without turning every mole into a source of worry.
Ask what changes would be worth making an appointment about. Getting that stated plainly, in your case, is far better than trying to apply a general list, and it settles the question of when to act that otherwise sits unresolved for years.
Enquire about photography, and how best to do it. Comparison over time is the single most useful thing available to you, and a clinician can tell you what makes an image useful rather than merely reassuring.
If something is being arranged, find out when to expect it and who to contact if you hear nothing. This is the point at which people most often fall through a gap, and it takes moments to close.
What this page does not do
It does not assess your moles, does not describe what any particular mole means, and offers no checklist to apply at home. Judging a mark on your own skin against a description is exactly the task that goes wrong, in both directions, which is why the published criteria are linked at source and an examination is the answer this page keeps returning to. This page carries no commercial content of any kind.
Common questions
How many moles is a normal number to have?
There is a wide range and no single normal. What matters clinically is your own pattern and whether anything departs from it, which is one reason clinicians look at all of your skin rather than only the mole you point out. Your baseline is the comparison that counts.
What should I actually be watching for?
Change is the short answer: in size, shape or colour, or the appearance of symptoms such as itching, bleeding or crusting. Published guidance from the NHS sets out what prompts an appointment, and it is worth reading at source rather than through any summary.
Do moles change normally?
Moles do evolve slowly over a lifetime, and some appear or fade with age, so change alone is not automatically alarming. What clinicians want to assess is change that is recent, relatively quick, or out of keeping with your other moles. Assessment is what settles it.
Is it worth photographing my moles?
Dated photographs are genuinely useful, because change is the thing that matters and memory is poor at judging it. Consistent lighting and distance make comparison easier. This is one of the few forms of self-monitoring that produces information a clinician can actually use.
Can a mole be checked without removing it?
Yes. Examination with a dermatoscope, a magnifier with its own light source, is how most moles are assessed, and it involves nothing being removed. Where looking cannot settle the question, a clinician will explain what further step they are proposing and why.
Sources
- Moles — conditions — NHS (United Kingdom) · accessed
- Symptoms of melanoma skin cancer — NHS (United Kingdom) · accessed
Last updated . How this page was written.