The Daily Mail, 12th April,2016
Some things are part of who we are, like fixed earlobes or square nails.
That’s how I’d always seen the mole on the back of my left thigh.
15 years ago it was a neat, round, slightly raised brown dot, like something you’d make with the tip of a marker pen.
But in the last couple of years it’s been changing.
The border now has jagged asymmetrical edges and it’s grown in size fourfold, its surface turned scaly.
Instead of an even brown, its pigment is now darker in parts.
I knew these weren’t good signs and that my history of sunburns as a child – I grew up in Australia – put me at increased risk, even with my olive skin.
As a fully paid-up member of the vain hypochondriacs club I went to see leading dermatologist Dr Noor Almaani, who specialises in moles, both malignant and benign.
She works at King Edward VII NHS Hospital in Windsor and The Private Clinic in Harley Street, London where I stood in her surgery in my knickers while she looked at every mole on my body with a ‘dermatoscope’.
This is a hand-held magnifier that doctors place over moles to see what’s really going on in the deeper layers of the skin.
While Dr Almaani is almost certain the mole on my leg is a harmless ‘serborrheic keratosis’, she thinks it’s best cut out and checked out.
‘The fact that it has doubled in size in the last year, is asymmetrical and that you only have one like it on your whole body is enough reason to have it removed and tested,’ she said.
Like me, almost all normal adults will have around 10-40 moles of varied shapes, colours and textures on their bodies by their 40th birthdays – very few of which turn out to be cancerous.
But how can we know that what we have really doesn’t need to be checked by a specialist for skin cancer?
Writing for Healthista, below, dermatologists describe reveal the four main types of benign lumps, bumps and growths that can develop on skin with age – and exactly what to do about them…
1. Benign moles
What are they?
Small coloured spots on the skin that can be flat or raised, smooth or rough and may have hair growing from them.
‘Benign moles are incredibly common,’ Dr Almaani said.
‘The vast majority we see are what we call “typical moles” so their borders are smooth and they’re symmetrical in shape and almost the same colour all over – this is normal’.
What can be done?
A family history of skin cancer, a history of sunburn or sunbed use, inflammation or bleeding that could signal cancer are among other reasons they might be removed.
However, it’s possible for benign moles to turn cancerous later in life, Dr Almaani said.
‘You need to keep checking,’ she added.
Privately, benign moles can be removed.
‘If the mole is raised it can be surgically shaved off in a procedure done under a local anaesthetic that takes about half an hour,’ she continued.
‘This might leave a small scar a bit lighter than the skin surrounding it.’
If the mole is flat, there’s little that can be done except cutting it out, also a quick procedure under local anaesthetic.
A dermatologist cuts into the skin around the mole and removes it, then stitches the skin together again, leaving a scar that’s usually a straight line.
‘The only reason you can get a mole removed on the NHS is if your doctor suspects a malignancy and refers you for treatment, in which case it will usually be biopsied or removed and sent for testing,’ she said.
Private cost for removal: Around £600
What am I looking for?
‘You’re looking for change,’ Dr Almaani said.
Check your whole body regularly and know where you have moles so you can be aware of any changes as you age.
Remember it’s normal to have between 10 and 40 moles by age 40, Dr Almaani advised.
‘If you have always had moles and one or some of them start to change, report that.
‘But likewise, if you have never had moles and develop one in your 40s, tell your doctor.’
Never ignore red flags such as itching, pain, discharge, bleeding or a change in colour, texture or size, she added.
Also, be aware of the ABCDs of skin cancer, from Cancer Research UK – having even one of the following features of a mole warrants getting it checked.
THE ABCDs are:
Asymmetry – this is when the two halves of your mole don’t look the same
Border – the edges of your mole are blurred, jagged or irregular
Colour – there’s more than one shade present in your mole
Diameter – your mole is wider than six millimetres (about the size of a pencil eraser)
Skin cancer types
Though the differences aren’t always obvious to the naked eye, a specialist can identify the type of skin cancer to determine the treatment you need.
Basal cell carcinoma (BCC)
‘By far the most common cancer in the body affecting 75 in 100 cases, this is a mild type of skin cancer and in 99.99 per cent of cases is limited to the skin’, Dr Almaani said.
‘A dermatologist can scrape, freeze or cut them out but there is usually no urgency in treating these’.
Squamous cell carcinoma (SCC)
This makes up about 20 per cent of skin cancers and while it doesn’t often spread, it still should be treated urgently, according to Cancer Research UK.
This is a rare type of skin cancer and in the UK, most are found and treated at an early stage.
Under guidelines from the National Institute for Clinic Excellence, if a GP suspects either squamous cell carcinoma or malignant melanoma, you should be seen by a specialist within two weeks on the NHS, Dr Almaani said.
A biopsy might be taken, or the whole thing might be surgically removed.
‘We usually prefer to take out the whole mole to assess the depth of the cancer. We might also take a biopsy of the lymph nodes to check the cancer hasn’t spread.’
For most, surgery will be enough because the cancer will not have spread.
‘If it was a deep cancer, we will usually follow the patient every two months for about three years to ensure it doesn’t come back.’
If the cancer has spread, chemotherapy and radiotherapy along with medication will be prescribed.
‘I can’t stress enough how good survival is for skin cancer so see your doctor early if any mole changes,’ Dr Almaani said.
WHAT TO DO
Ask for a referral if you’re in any doubt.
According to NICE guidelines, if your doctor has any suspicions or isn’t sure, he or she should refer you to a specialist within two weeks for a biopsy or removal and testing.
This article first appeared on and is re-published here with the permission with Healthista. *
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