Sunday, January 20, 2013

"Don't Pick That Mole" --- dispelling the myth



My daughter recently asked, “Is it true that pulling hair out of moles or picking at moles causes them to turn into cancer?”

She was trying to help one of her girlfriends understand something her mother had pounded into her from childhood: “Don’t touch that mole! If you pick, you’ll turn it into cancer!”

So, once again I am here to dispel another myth. Hundreds of my patients have asked the same question over the years. 

The cancer in question here is melanoma. 
THE BOTTOM LINE: There is no convincing scientific evidence that picking a mole turns it into cancer (melanoma). That also applies to nicking during shaving, catching with a comb or brush, or any other trauma. Traumatized moles, however, if removed, can show abnormal features under a microscope even if they are not cancerous.

The usual scenario is that a traumatized mole might look scary for a few days but it should heal the same way traumatized skin anywhere heals, back to its normal appearance after about two weeks. If it doesn't heal, see a doctor.

The ‘moles’ we are talking about are the common type, raised slightly above the skin, regular in shape (round mostly), ranging in color from skin tone to tan-brown to darker brown, and about the size of a pea or a red bean. They can occur anywhere on the body. Moles from birth (congenital moles) can be much larger and darker, but occasionally they can look like the common moles as well.

The majority of melanomas originate from normal skin, entirely independent of moles. We know that individuals with large numbers of moles on their body, especially ones called ‘atypical’ or ‘dysplastic’ moles, have a higher risk for melanoma. This is probably based on mutated genes that affect normal skin as well as moles. The number of moles may simply be one sign of innate genetic programming or altered genes from ultraviolet light. Fortunately, there are also genes that limit the growth of most moles for a lifetime unless they also become mutated.

CAN ANYTHING BE DONE TO PREVENT MELANOMA?

Melanoma is a potentially deadly cancer. One out of every eight individuals with melanoma dies from melanoma. You definitely DO NOT want to get a melanoma if you can avoid it. So the question about picking as a risk factor is an important one simply because you have control over it.

The only controllable behavior associated with both increased numbers of moles and melanoma risk is EXPOSURE TO ULTRA-VIOLET LIGHT. Ultraviolet light from sun or tanning beds has the potential to alter genes that can lead to more moles and increased risk of melanoma. Genetic studies are still in early stages, but there is enough epidemiological evidence to link ultraviolet light with melanoma in many cases (though not those that occur in skin of color).

Persons of light color (red hair, freckles, blue eyes, etc.) and those with many moles should make every effort to avoid exposure to the sun, starting in early childhood. And concerning sunscreens: don’t be fooled into thinking that they fully protect against sun damage and skin cancer. They partially protect against sunburn, so people often think they can stay out longer, which explains some of the theories that sunscreens cause skin cancer when it is really the increased sun damage in most cases.

In summary, the only real control we have to prevent melanoma is to avoid sun exposure and UV tanning beds. It does not provide complete protection, but it’s the best we have.

An important measure, while not prevention per se, is to monitor your skin with a Skin Self Exam. Look at your skin and your moles once per month approximately. If you see obvious new growth or new black color in the space of a month or two, see a doctor, get it checked. Many cases of melanoma become deadly because of delays in diagnosis. Some links:


So, in conclusion, don’t pick at your moles, monitor them regularly. And don’t be foolish in the sun.

Best regards,