Moles

Moles, also known as nevi, are pigmented skin growths caused by clusters of melanocytes, which are pigment-producing cells. They may appear flat or raised and can vary in colour from light brown to nearly black. Moles are very common, and most adults have between 10 to 40 moles on their bodies.

Some moles are present from birth, while others appear gradually over time, often during childhood or adolescence. In most cases, moles are harmless and do not require treatment. However, changes in size, shape, or colour may indicate a risk of skin cancer and should be evaluated by a dermatologist.

The exact cause of mole formation is not fully understood. But genetics and environmental factors, particularly sun exposure, play a role. Some of the key contributing factors include:

• Genetic predisposition – if your parents or siblings have numerous or atypical moles, you are more likely to develop them too.
• Hormonal changes – moles may darken or appear during puberty, pregnancy, or hormonal treatments due to increased melanin activity.
• Immune and cellular factors – some immune conditions and skin disorders may influence how melanocytes behave.
• Skin type – individuals with fair skin, light hair, and light-coloured eyes are more prone to mole formation.
• Sun exposure – ultraviolet (UV) rays from the sun or tanning beds stimulate melanocyte activity, leading to the development of new moles and changes in existing ones.

Benign moles typically have a consistent and predictable appearance. As such, knowing what normal moles look like helps you detect any changes that may warrant medical attention.

These characteristics include, but are not limited to:

• Size – most harmless moles are smaller than 6 mm in diameter, about the size of a pencil eraser. Larger moles, especially if growing, should be examined.
• Symmetry – a healthy mole is usually round or oval with both halves looking similar. Asymmetry, where one side does not mirror the other, may be a warning sign.
• Stable appearance – benign moles remain consistent in shape, colour, and size over time. Any noticeable evolution could indicate an abnormality.
• Uniform colour – normal moles are typically a single shade of brown, tan, or black. Moles that contain multiple colours, including red, white, blue, or grey, require closer inspection.
• Well-defined borders – benign moles tend to have smooth, clearly defined edges. In contrast, moles with blurry, jagged, or notched borders may indicate atypia.

Although moles can form in anyone, there are certain individuals who are more predisposed due to several factors. The groups that are at higher risk are:

• Family history of moles or melanoma – genetics play a strong role. If close relatives have numerous or atypical moles, your risk is higher.
• Hormonal changes – puberty, pregnancy, and hormonal therapy can increase melanin activity, causing new moles to appear or existing ones to darken.
• Weakened immune system – those with autoimmune conditions, organ transplants, or certain medications may have altered skin cell regulation, increasing mole activity.
• Fair-skinned individuals – those with lighter skin tones, blue or green eyes, and blonde or red hair produce less melanin and are more vulnerable to UV-related skin damage.
• Frequent sun exposure – living in sunny climates like Singapore or spending lots of time outdoors without sun protection can stimulate melanocyte activity, leading to more mole development.
• Excessive use of tanning beds – artificial UV radiation is just as damaging as natural sunlight and significantly raises the risk of both mole formation and skin cancer.

Moles consist of melanocytes, the same cells involved in melanoma. Although most moles remain stable, a small number may undergo changes that lead to uncontrolled cell growth.

Melanoma arises when melanocytes become cancerous and begin to multiply abnormally. This can occur within an existing mole or develop as a new lesion.

Some of the triggers for mole-to-melanoma transformation may include:

• Chronic irritation or trauma – repeated friction, rubbing, or injury to a mole may stimulate abnormal changes, although this is less common.
• Genetic mutations – certain inherited or acquired mutations may disrupt normal cell growth controls.
• UV damage – excessive ultraviolet exposure from the sun or tanning beds damages DNA and increases the risk of abnormal melanocyte behaviour.
• Weakened immune defences – a suppressed immune system may fail to detect and remove abnormal cells early on.

About 25% to 30% of melanomas arise from pre-existing moles, with the rest appearing as new lesions. This is why routine monitoring and early intervention are critical.

Most moles are completely harmless and do not change throughout your lifetime. However, certain signs may suggest that a mole is becoming atypical or possibly cancerous.

You should consult a dermatologist if a mole:

• Becomes itchy, painful, or starts to bleed
• Develops a crusty, scaly, or rough texture
• Has a blurry, irregular, or poorly defined border
• It is larger than 6 mm (about the width of a pencil eraser)
• It starts to change rapidly in size, shape, or colour without a clear cause
• Looks different from your other moles, known as the “ugly duckling” sign

The ABCDE rule is a simple but effective tool for identifying potentially suspicious moles:

• A: Asymmetry – one half of the mole does not match the other
• B: Border – the edges are irregular, jagged, or poorly defined
• C: Colour – uneven tones or multiple colours present
• D: Diameter – larger than 5 to 6 mm
• E: Evolution – changes in any aspect, such as size, colour, height, sensation

When it comes to diagnosing moles, we use a structured and meticulous approach to accurately assess and diagnose moles. Our goal is to differentiate between harmless and suspicious lesions to ensure safe and timely treatment.

Our diagnostic process includes:

• Comprehensive skin examination – our dermatologist visually assesses the mole’s size, colour, texture, and shape. This includes checking for asymmetry, border irregularity, and other warning signs. A full-body mole check may be recommended for patients with numerous moles.
• Medical history and symptom review – you will be asked about any recent changes, family history of skin cancer, sun exposure habits, or personal risk factors.
• Dermoscopy – a non-invasive tool that provides a magnified view of the mole’s internal structure and pigmentation patterns. This helps distinguish benign moles from atypical or malignant ones.
• Skin biopsy – if the mole appears suspicious, a biopsy may be performed to confirm the diagnosis. This involves removing a small tissue sample and sending it to a laboratory for histological examination. Some of the potential methods include:

• • Excision biopsy – the entire mole is removed with a scalpel
  • Punch biopsy – a circular blade removes a deeper skin core
  • Shave biopsy – surface layers of the mole are shaved off

Mole removal may be suggested for medical, aesthetic, or practical reasons. Even benign moles can sometimes cause discomfort or interfere with daily life.

Some of the common reasons for mole removal include:

• Aesthetic concerns – many patients choose to remove facial or visible moles for cosmetic reasons
• Irritation and friction – moles that catch on clothing, jewellery, or shaving razors can become inflamed or painful
• Personal preference – some individuals opt for removal to eliminate worry, even if the mole is harmless
• Suspicion of malignancy – moles that are evolving or show signs of atypia should be removed and examined under a microscope

Before any removal, our dermatologist will perform a thorough assessment to ensure the right technique is chosen based on the mole's type, depth, and location.

At Cove Aesthetic Clinic, mole removal is a safe and straightforward outpatient procedure performed by trained medical professionals. The appropriate method depends on the mole’s type, size, depth, location, and whether it shows any signs of potential malignancy.

Each removal technique is selected carefully to balance clinical effectiveness, aesthetic outcomes, and, when needed, histological assessment.

Whether you are concerned about a changing mole or simply wish to remove one for cosmetic reasons, expert evaluation is the first step. At Cove Aesthetic Clinic, our experienced team offers safe, effective mole assessment and removal tailored to your needs, with a focus on both medical accuracy and aesthetic outcomes.

Book a consultation with us today to have your moles assessed and explore the most suitable treatment options for your skin.