Moles - Risk Factors

What are your risk factors for developing moles? Briefly, describe your history and experience with moles.

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What causes moles, and what are risk factors for developing moles?

The genes we inherit from our parents, along with the amount of sun we are exposed to (especially before adulthood) are the major factors in determining the number of moles that we will develop. The more sun one gets, the higher the risk of moles in that area. However, moles may also occur in fully sun-protected areas like the palms, soles, and genitals.

Both moles and freckles (medically termed ephelides) are darker than the surrounding skin. Moles may be raised, slightly raised, or completely flat while freckles are always totally flat. Freckles and "liver spots" (medically termed lentigines) are due to an increase in the amount of dark pigment called melanin. Moles are more common in people prone to freckles. Freckles are flat spots that are tan, slightly reddish, or light-brown and typically appear during the sunny months. They are most often found in people with light complexions. Many people with blond or red hair and green or blue eyes are more prone to these types of skin growths. Sun avoidance and sun protection, including the regular use of sunscreen may help to suppress the appearance of some types of moles and freckles.

Moles occur in all races (Caucasian, Asian, African, and Indian) and skin colors. Moles also are seen in animals.

Do babies get moles?

Yes. Moles may be present at birth or gradually appear later in life. Many children continue to develop moles through the teenage years and into young adulthood. Moles tend to grow very slightly in proportion to normal body growth. Congenital moles are moles present at birth and so must develop during fetal development. Other moles may later arise as a result of factors that are not genetic, but environmental, such as sun exposure.

Can I still get new moles as an adult?

Yes. While many moles arise in the first years of life, the total number of moles typically peaks in the second or third decade of life to an average of 35. Most people do not develop new regular moles after the age of 30. Adults often develop non-mole growths like freckles, lentigines, "liver spots," and seborrheic keratoses in later adulthood.

New moles appearing after age 35 may require close observation, medical evaluation, and possible biopsy. A brand-new mole in an adult may be a sign of an evolving abnormal mole or early melanoma. It is important to have any new or changing mole evaluated by your dermatologist.

What else could it be?

There are many mole look-alikes, including freckles, lentigines, "liver spots," seborrheic keratoses, melanomas, neurofibromas, hemangiomas, skin tags, café au lait macules, and pigmented basal cell cancers. The optimal way to distinguish between these other growths is by consultation with a dermatologist, which may include a skin biopsy. Sometimes, a mole may occur adjacent to or on top of a non-mole growth like a freckle or seborrheic keratosis. When in doubt, a skin biopsy can be very helpful in diagnosis.

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