Monday 14 October 2019

Dear Dr Nina: 'I have a mole that is itchy and sore'

Most moles appear before the age of 30
Most moles appear before the age of 30

Nina Byrnes

Q I have fair skin and have a lot of reddish moles, which I get checked every couple of years. A new one appeared on my chest recently, next to a new scar that is a result of a cyst removal, and it is very itchy. I normally wouldn't worry about a new mole, but I haven't been exposed to the sun for months and, as I said, it is itchy and a bit sore. Is this a regular mole or could it be something more sinister?

Dr Nina replies:  Moles are small spots on the skin made up of pigmented cells. The amount you have will depend on your genetics and your skin's exposure to ultraviolet light.

The World Health Organisation has classified UV rays from the sun and artificial devices as carcinogenic. Children are born with few or none, but new moles may develop up to the age of 40.

Normal moles do change. They start flat, then may rise over time before flattening out again and sometimes disappearing.

Skin cancer can occur on all types of skin. The majority of native Irish people are classified as having fair skin, which immediately puts us at a higher risk of skin cancer. It takes 20 to 30 years for skin cancer to develop, but damage is often done in childhood. Tanned skin is damaged skin. Those who have more than 100 moles over their bodies may be at higher risk of abnormal moles and it is important to keep an eye on them.

The first sign of melanoma may be a change in an existing mole or a new, atypical mole appearing. When looking at moles, there are a few important points to consider. If a mole is changing or has any of the features listed below, a trip to the doctor is in order.

When observing a mole, consider the ABCDE classification. 'A' stands for asymmetry. Does the mole have an irregular shape or two different halves? 'B' is for border. Are the edges notched or scalloped? 'C' is for colour. Are there more than two colours or uneven distribution of colour within the mole? 'D' is for diameter. Is it growing or changing in size? Finally, 'E' is for evolving. Are there new changes such as crusting, bleeding or itching? Most moles appear before the age of 30. Any new mole appearing after this carries a higher risk of abnormality and should be watched closely for the signs above. If you have a large number of moles it is worth having an annual check-up with a skin specialist.

There are two main types of skin cancer: non-melanoma and melanoma. Non-melanoma cancer is more common, affecting just over 6,000 Irish people a year.

These cancers rarely spread but can invade skin locally. Basal cell carcinomas and squamous cell carcinomas are types of non-melanomatous skin disease. Melanoma is potentially fatal and affects approximately 600 Irish people a year. It can spread to other parts of the body, such as the lung, liver and brain.

To protect your skin and reduce your risk of skin cancer, avoid the sun, especially from 10am to 4pm when the rays are strongest, in Ireland and abroad. Wear protective clothing: long sleeves, hat and sunglasses (min 99pc UVA protection for adults and children). Wear sunscreen all year round. Factor 30 in winter, factor 50 in summer. Do not use tanning beds. Check your skin top to toe once a month. Report any changes to your doctor.

Irish Independent

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