Moles

Moles (naevi) are common, usually harmless dark spots or bumps on the skin. Most Indians have a handful. The one thing to watch for is change — size, shape, colour, bleeding, or itching in a previously stable mole, which can signal melanoma.

The ABCDE of worrying moles

• A — Asymmetry (one half doesn't match the other).
• B — Border irregular, notched, or blurred.
• C — Colour varied (brown, black, red, white, blue within one mole).
• D — Diameter larger than 6 mm (about a pencil eraser).
• E — Evolving — changing in size, shape, colour, itching, bleeding, or new after age 30.
• A mole that looks different from the rest ("ugly duckling" sign) is suspicious even if it doesn't meet ABCDE.

About skin cancer in Indian skin

• Melanoma is less common in darker skin than in fair skin but not rare, and often presents late — on palms, soles, nail beds, and inside the mouth (acral lentiginous melanoma).
• A dark streak under the fingernail or toenail that is new, widening, or involving the nail fold needs urgent review.
• Outdoor workers, albinism, chronic non-healing ulcers, and radiation-exposed skin have higher risk.

When to see a doctor

• Any mole that meets ABCDE or is the "ugly duckling".
• A sore that doesn't heal in 4 weeks.
• A dark patch inside the mouth, on the palm, sole, or under a nail.
• A scaly or crusted lesion on sun-exposed skin that grows or bleeds.
• Family history of melanoma.

Removal

• Cosmetic removal of benign moles is safe in trained hands — skin clinics can use surgical shave excision, laser, or radiofrequency.
• Any mole removed for a medical reason should be sent for histopathology — biopsy is the only way to confirm or rule out melanoma. Don't go to a clinic that "burns off" suspicious moles without pathology.
• Don't use over-the-counter acid or herbal pastes to remove moles — these can be disfiguring and can hide cancer.