Women’s Cancer Communication Project

Coordinated by the European Institute of Women’s Health


Everyone has moles. They can appear anywhere on the skin, alone or in groups. They are normally brown in colour and can be various sizes and shapes. The brown colour is caused by melanin. Most moles appear during the first 20 years of a persons life. As the years pass, moles usually change slowly, becoming raised and lighter in colour. Some may never change. Moles may darken, which can happen after exposure to the sun and sometimes during therapy with certain steroid drugs. During the teen years and pregnancy, moles tend to become darker and larger and new ones may appear. It is important to remember that not all moles look alike.

  • They may be skin-coloured or pink, light tan to brown or even blue-black.
  • Their shape can vary – they can be round,  oval, or even irregular shapes.
  • They may be flat or raised, large or small, with or without hairs.

Some moles may develop into a form of skin cancer known as malignant melanoma. Sunburns may increase the risk of melanoma. Moles that appear at birth are called congenital nevi. When such a mole is more than eight inches in diameter, it poses the greatest risk of skin cancer. Moles known as atypical moles/dysplastic moles are larger than average – usually larger than a pencil sharpener and irregular in shape. They tend to have uneven colouring. These moles tend to be hereditary. Persons with atypical moles may have a greater than average chance of developing malignant melanoma. Moles should always be checked regularly for any changes. Use the ABCDEFG rule to help you remember what to look for when inspecting your moles:

Asymmetry: when one half of the mole does not match the other half.

Border irregularity: when the edges are ragged or blurred.

Colour: when the colour is not the same all over.

Diameter: when the mole is greater than one quarter of an inch in size.

Evolving: Any moles that look different from others or changing in size, shape, colour, or becomes itchy, tender or bleeding, show to your doctor or dermatologist as soon as possible.

Firm: Any mole that feels firm should be shown to your doctor or dermatologist immediately!

Growing: A mole that appears to be growing should be shown to your doctor or dermatologist immediately!

If you notice any changes while examining your moles (use the ABCDEFG rule) and if you find changes it is necessary for you to, consult your doctor or dermatologist immediately!

Remember! The majority of moles and other blemishes are non cancerous (benign).

Occasionally though a mole may be a cancerous growth. Therefore it is best to get medical advice if a mole changes in size, shape, or colour, or any other blemish is out of the ordinary.

After a person reaches middle age, other dark areas may appear that are not moles. These brown, wart-like growths that appear on the face or trunk and look as if they have been stuck to the skin may be seborrheic keratoses. Multiple small grey brownspots that may appear on the wrists, back of hands, forearms and face could be actinic lentigines. These are also called liver spots or age spots. Seborrheic keratoses and actinic lentigines are very easily diagnosed by a doctor and are not cancerous.


You may notice darkened spots that are not moles. The most common of these are freckles. Sun exposure may make freckles darker and they may fade in winter. Freckles usually are limited to sun exposed areas like the face, neck and upper back. Blondes and redheads can freckle more easily.

Freckles and other Brown spots

A Brown spot or what we call freckles are usually found on  skin that has been exposed to the sun.  The scientific name for these different types of spots are ephelides, the plural of ephelis which normally fade during winter months and lentigines is the plural for lentigo

The difference between these is that an ephelis and a lentigo is that an ephelis will fade normally during winter months while lentigos will persists even in the absence of any ultraviolet (UV) stimulation. Ephelides and lentigines can occur in the same individuals and the risk factors for either are generally the same.

Who gets ephelides?

Ephelides are mostly common in fair skinned people, especially children with red hair. It is believed that the MC1R gene is thought to be the main cause. This is an inherited characteristic that can sometimes affect people that have darker skin types.

What causes ephelides?

An ephelis is brown because of the pigment melanin. Melanin is made by melanocytes and diffused into keratinocytes. Melanin production by melanocytes decreases during the winter months, and increases when the skin is exposed to the UV radiation in sunlight. The colour is due to the localised accumulation of melanin in keratinocytes. There is no increase in the number of melanocytes.

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