Condition

Moles

Moles are ordinary clusters of pigment cells in the skin, and almost all of them stay harmless for a whole lifetime. What matters is not how many you have, but whether one of them is changing - because a changing mole is the earliest sign of melanoma, and the earliest melanoma is the one that is easiest to cure.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026

Start here

Most of the moles I look at are completely normal, and having a lot of them is not a disease — it is mostly inherited, plus the sun you got before you were old enough to choose. A mole is not judged on how it looks today, but on whether it has changed and whether it looks like the rest of your moles. People worry about the dark one they have had since they were nine and ignore the new pink one from last year; it should be the other way around. So if a mole is changing, get it looked at in person — a mole that turns out to be nothing costs you one appointment, and a melanoma found late costs a great deal more.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

−
How commonVery common - most adults have somewhere between 10 and 40 moles
Who gets itAlmost everyone. Most moles appear in childhood, the teens and the twenties
Curable or managedNot a disease. Most moles need nothing at all, and any mole can be removed if there is a reason to
Prescription neededNo. Nothing you put on the skin changes a mole. Removal is a minor in-office procedure
Time to improveNot a treatment question. A mole that is changing should be examined within weeks, not months

What It Is

−

A mole is a small collection of pigment cells, a melanocytic nevus. Normally melanocytes sit spaced along the base of the outer layer and hand pigment to the cells around them; in a mole they have grouped into nests, and those nests are the brown or tan spot you see.

Moles come in a few ordinary forms — nests at the base of the outer layer make a flat brown mole, a junctional nevus; nests in both layers make a slightly raised one, a compound nevus; nests entirely in the deeper layer make the soft, skin-colored dome many people have on the face, an intradermal nevus. All three are normal, and one can slowly become the next.

Some moles have their own names. A congenital mole is one you were born with. An atypical or dysplastic mole is larger, with an uneven edge and more than one shade of brown; several of them mark slightly higher melanoma risk, though each mole is usually benign. A halo nevus has a pale ring where the immune system is dismantling it, normal in teenagers. A Spitz nevus is a pink or red dome that appears quickly in a child and often needs removing, because it can be hard to tell from melanoma under the microscope.

Plenty of spots people call moles are not. Freckles are pigment without nests and darken with sun. Sun spots are flat brown patches from years of light exposure. Seborrheic keratoses are waxy, stuck-on growths, extremely common after 40. Skin tags, dermatosis papulosa nigra and cherry angiomas are different again. None turn into melanoma, but telling them apart by eye is what a skin exam is for.

Symptoms

−
A plain brown spot

Flat and Even

A flat brown or black spot with one color throughout and a smooth, round outline. Most people have between ten and forty of these. Ones that stay the same year after year are the least concerning.
A soft dome

Raised

A raised, soft, often paler mole that may carry a hair, common on the face and trunk. Height alone is not a worrying feature. Catching it with a razor may make it bleed without meaning anything.
An unusual-looking mole

Atypical

A mole that is larger, with fuzzy edges or more than one shade of brown, which can look untidy without being dangerous. Someone with many of these has a higher risk of melanoma and is usually checked regularly. Photographs help track them.

How It Looks by Skin Tone

−
Several small tan to mid-brown moles on the shoulder and upper arm of an adult with light skin, each evenly colored with smooth edges, with one larger mole among them.Several mid to dark brown moles on the shoulder and upper arm of an adult with medium olive-toned skin, with one larger mole that is uneven in shape.Several dark brown to near-black moles on the shoulder and upper arm of an adult with brown skin, each small, evenly colored and smooth-edged, on even-toned surrounding skin.Several dark brown to near-black moles on the shoulder and upper arm of an adult with deep brown skin, each small, evenly colored and smooth-edged.
LightMediumBrownDeep

People with deeper skin tones get melanoma far less often. What matters more is that when it happens it is found later and the outcome is worse — partly the pattern is different, partly nobody involved is expecting it.

Melanoma in deeper skin tones most often appears on skin that gets little sun: the palms, the soles, the sides of the fingers and toes, under a nail, sometimes inside the mouth or on the genitals. This is acral lentiginous melanoma. Sun exposure does not explain it, so the usual sunscreen advice does not cover it. Checking your soles, between your toes, your palms and your nails is a real part of a self-check. Nails need their own note. A brown or black stripe running the length of a nail is longitudinal melanonychia. Several even, stable stripes across different nails are common and usually normal in deeper skin tones. One stripe deserves attention if it is new in an adult, widening, darkening, blurred at the edges, or spreading pigment onto the surrounding skin or cuticle — the Hutchinson sign. Any of those should be examined, not photographed and watched. Two more things. Redness in an unusual mole is hard to see on deeper skin tones, so texture, growth and asymmetry carry more weight than color. And a sore on the foot or hand that will not heal is worth showing to someone, because that is how melanoma gets misread as a wound or a fungal problem for months.

Where It Shows Up

−
Back view of a whole body with red marks across the upper and middle back, both shoulders, the back of the head and both buttocks.
Back, shoulders and the places you cannot see
Most moles sit on skin that saw sun in childhood, and the back and shoulders carry the most. The ones that matter are the ones nobody looks at: the back, the scalp and the buttocks. Melanoma turns up in all of them.
Front view of a whole body with red marks across the chest and abdomen, on both upper arms and thighs, and on both hands and feet.
Chest, arms, legs, and the soles and nails
Moles can form anywhere, and the chest, arms and legs are the usual places on the front. The soles of the feet, between the toes and under the nails are the ones worth checking on purpose, especially on deeper skin tones, where they are the commonest sites for melanoma.

Causes

−

Moles form when pigment cells stop lining up singly along the base of the skin and clump into nests. One genetic change in a single pigment cell is usually enough to start it. That cell divides a number of times, forms a small colony, and stops. Most moles carry a change in a gene called BRAF, and the cells then switch on a built-in brake. That brake is why almost all moles reach their size in your teens and then sit unchanged for life.

Two things decide how many you end up with: your genes, and the ultraviolet light you got while young. Childhood sunburns in particular raise the number you form, which is why mole count runs in families and tracks with early sun.

Melanoma happens when a pigment cell escapes that brake. It can start inside an existing mole or, more often, on skin where there was no mole. On sun-exposed skin, years of accumulated ultraviolet damage is the main driver. On palms, soles and nails it is not sun, and the cause is not well understood. We know what raises the risk; we do not know why one cell in one spot goes wrong.

Risk Factors

−

These raise the chance of having many moles, unusual ones, or one turning into melanoma. Most are not choices; knowing which apply changes how closely your skin should be watched.

Inherited
Skin that burns easily
Burns and does not tan, especially with red or blond hair and freckles — the highest melanoma risk of any skin type.
Inherited
Family history of melanoma
A parent, sibling or child with melanoma raises your risk and is a reason for regular checks.
Inherited
A large congenital mole
Small birthmark moles carry little extra risk. Large ones, over about 20 centimeters at adult size, are followed by a specialist.
Moles & past cancer
A high mole count
More than about 50 moles is a recognized risk marker — more pigment cells that could go wrong.
Moles & past cancer
Atypical moles
Several large, uneven, multi-colored moles - dysplastic nevi - raise risk, particularly with a family history.
Moles & past cancer
A previous melanoma or skin cancer
The strongest predictor of another; lifelong follow-up.
Sun exposure
Sunburns, especially in childhood
Intense, occasional burns are linked to melanoma more strongly than steady daily exposure.
Sun exposure
Tanning beds
They raise melanoma risk, more so the younger you start. No safe version.
Age & immune health
Age
New moles are normal in the first few decades and unusual after 40. A genuinely new pigmented spot in an older adult is worth examining.
Age & immune health
A weakened immune system
Transplant medicines and untreated HIV raise skin cancer risk. Never stop a prescribed medicine on your own - ask your doctor.

Course

−

Moles have a life cycle, and knowing the normal version makes the abnormal easier to spot. Three things are out of step with it — a mole that changes after it should have stopped, a new pigmented spot in an adult over 40, and a mole unlike all your others. None mean melanoma; all mean an in-person look.

CongenitalBirth to age 2
Around one in a hundred babies is born with a mole

Most are small and grow with the child.

AppearingAges 2 to 20
Almost all of your moles arrive now

New ones keep arriving through childhood and the teens; existing ones grow slowly with the child.

SettlingAges 20 to 40
The count peaks and then holds

Moles may lift off the surface or lose color. Pregnancy can darken them; one that changes shape still needs looking at.

StableAges 40 to 60
Very few genuinely new moles form

Existing ones soften and pale. Waxy, stuck-on seborrheic keratoses appear and get mistaken for new moles.

FadingAge 60 onward
Mole count falls as older moles disappear

Against that background a new or changing spot stands out more, and matters more.

What Makes It Better & Worse

−

Moles are four problems — how many moles you form, ultraviolet damage building up in them, one cell escaping its growth brake, and how long a change goes unnoticed. Step four is the one you control — a thin melanoma is usually cured by removing it.

1How many moles you form

What helps

  • Use sunscreen daily on exposed skin Broad spectrum, SPF 30 or higher, reapplied outdoors.
  • Use shade, clothing and hats A long-sleeved shirt outperforms any bottle.
  • Protect children from burning Risk is largely set before adulthood.

What makes it worse

  • Sunburn Raises mole count and damages the cells inside.

2Ultraviolet damage building up

What helps

  • Never use a tanning bed No protective base tan, no safe dose.

What makes it worse

  • Tanning beds A concentrated dose of the damaging wavelengths.
  • Intense occasional sun Holiday exposure matters more than steady daily sun.
  • Skipping sunscreen in cloud and winter Ultraviolet passes cloud and reflects off snow.

3One cell escaping its growth brake

What helps

  • Get a changing mole looked at within weeks Change is the reason to book.
  • Have any mole removed as a biopsy The laboratory makes early diagnosis possible.

What makes it worse

  • A mole lasered, frozen or home-treated Nothing left for a laboratory to examine.
  • A weakened immune system Immune-suppressing treatment raises skin cancer risk.

4How long a change goes unnoticed

What helps

  • Learn the ABCDE signs Asymmetry, Border, Color, Diameter, Evolving — the one that matters most.
  • Learn the ugly duckling sign The mole that does not belong in the family.
  • Check your own skin about once a month Include back, scalp, soles, palms and nails.
  • Take photographs Comparison over months beats memory.
  • Book a full skin exam if you are at risk Many moles, atypical moles or family history.

What makes it worse

  • Waiting to see if a change settles down Three months of waiting is three months of growth.
  • Assuming a painless mole is fine Pain and itch are late signs.
  • Only checking the parts you can see easily Scalp, back, buttocks, soles and nails all count.
  • Relying on a phone app A reassuring result is no reason to cancel.
  • Being told once that a mole is fine A mole examined five years ago was fine five years ago.

Over-the-Counter Products

−

Everything here you can buy without seeing anyone.

Sunscreen, SPF 30 or higher
Sunscreen, SPF 30 or higher
Moderate evidence
Broad spectrum, used daily on exposed skin and reapplied on long days outdoors. It does not change a mole you already have. What it does is lower the ultraviolet damage building up inside your pigment cells, and in children it lowers the number of moles they form. Shade, a hat and a long-sleeved shirt do more than any bottle.
A mole-checking phone app
A mole-checking phone app
Never use
Apps that grade a photograph of a mole miss melanomas, and the harm is in what people do with a reassuring result. Use one as a way to store dated photographs if you like that, and treat the score itself as meaningless. Nothing an app says is a reason to cancel or postpone an appointment.
Mole removal creams and kits
Mole removal creams and kits
Never use
Creams, acid pens and freezing kits sold for removing moles at home burn a hole in the skin. They leave a scar that is usually worse than the mole, they often leave pigment cells behind, and they destroy the tissue a laboratory would have examined. If the mole was a melanoma, the visible part is gone and the rest of it is still growing. There is no situation in which these are the right answer.

Prescriptions

−

These need a prescription.

No prescription treatments listed yet.

Procedures

−

These are done in the office, usually over several visits.

16:9 hero for Surgical Excision. Never cropped: the tone strip and the corner logo depend on the full frame.Diagram: how Surgical Excision works in the skin
Always
The standard for any mole that is genuinely in doubt: the whole mole is cut out under local anesthetic with a narrow margin of normal skin and sent for examination under a microscope. Taking all of it matters, because the pathologist has to see the full depth and the edges. It leaves a line scar, and results come back in a week or two.
A gloved clinician taking a small round punch sample from a spot on a patient's forehead16:9 hero for Punch Biopsy. Never cropped: the tone strip and the corner logo depend on the full frame.
Strong evidence
A small circular blade removes a small mole whole, down through the full thickness of the skin, and it is closed with a stitch or two. It suits moles smaller than the punch. Used to take a sample from part of a larger suspicious mole it can under-read the depth, so for those an excision is the better choice.
16:9 hero for Shave Removal. Never cropped: the tone strip and the corner logo depend on the full frame.Diagram: how Shave Removal works in the skin
Moderate evidence
A raised mole that catches on a razor or a collar can be shaved off flush with the skin under local anesthetic, leaving a flat pale mark rather than a line scar. It is a reasonable choice for a mole that is not suspicious, and the tissue still goes to the laboratory. Two honest limits: pigment left at the base can grow back, and a shave through a melanoma cuts across it rather than under it.
16:9 hero for Cryotherapy (Liquid Nitrogen). Never cropped: the tone strip and the corner logo depend on the full frame.Diagram: how Cryotherapy (Liquid Nitrogen) works in the skin
Never use
Freezing is excellent for several other skin growths and is the wrong tool for a mole. It destroys the tissue, so nothing can be examined, and it commonly leaves the deeper pigment cells behind along with a pale mark. Lasering or burning a mole off has the same two problems. If a mole is worth removing, it is worth removing in a way that can be checked.

When to See a Dermatologist

−

A changing mole is worth seeing in person within weeks rather than months, and none of what follows means melanoma — your own look is not the same as a look through a lens. Book if a mole is changing in size, shape, color, height or texture, if it has an uneven border or more than one shade, if one half does not match the other, if it is larger than about 6 millimeters and you are not sure it always was, if it looks unlike your others, or if a new pigmented spot has appeared and you are over 40. Go sooner if a mole bleeds unprovoked, itches or is sore over weeks, develops a returning scab, if a spot appears on a palm, a sole, between the toes or as a new dark stripe in a nail, or for any spot that will not heal or pink bump growing steadily, since not all melanomas carry pigment. Most people are told it is normal; in real doubt the mole comes off under local anesthetic and goes under a microscope, the only certain way to know, and no blood test screens for melanoma.

— Dr. Schwarz, Board Certified Dermatologist

Complications

−

Lookalikes

−

Seborrheic Keratosis

The commonest thing people bring in as a new mole after 40. Both are brown and both can be raised, but a seborrheic keratosis looks stuck on top of the skin rather than set into it, with a waxy, crumbly or warty surface. Moles are smooth and sit flush with the skin around them. Seborrheic keratoses arrive in numbers with age and never turn into melanoma, though a heavily pigmented one can be hard to tell apart by eye.

Sun Spots (Solar Lentigines)

Flat brown patches that people count as moles because they are brown and they were not there before. They differ in where they are and how they behave: sun spots sit on the backs of the hands, the forearms, the chest and the face, they arrive in groups on sun-exposed skin after about 40, and they have a slightly ragged rather than round outline. Moles arrive in childhood and the teens and are round and evenly colored.

Basal Cell Carcinoma

A pigmented basal cell carcinoma can look like a dark raised mole, which is how it gets left alone for years. The differences are that it keeps growing, it is pearly or shiny with fine vessels running over it, and it often develops a rolled edge with a central dip or a scab that heals and then breaks down again. A mole does none of that. Any pigmented bump that will not heal is worth examining.

Myths

+
  • "A mole I have had for years is safe." Most melanomas appear on skin that had no mole, and the rest can arise in a mole of any age. What matters is whether it is changing now.
  • "Melanoma is always black." It can be brown, black, pink, red, skin-colored or a mix. Amelanotic melanoma has little or no pigment and gets mistaken for a pimple or a harmless bump, which is why a new growing spot deserves a look.
  • "If it does not itch, bleed or hurt, it is fine." Early melanoma usually causes no symptoms. Bleeding and pain are late signs. Waiting for symptoms means waiting for it to progress.
  • "People with deeper skin tones do not get melanoma." They get it less often, but they do get it, and it is found later. It appears more on the palms, soles, fingers, toes and nails.
  • "Bumping, shaving or scratching a mole turns it into cancer." Injury does not cause melanoma. A mole that bleeds after a knock proves nothing; one that bleeds on its own, repeatedly, is a reason to be seen.
  • "Cutting into a melanoma makes it spread." An old fear with nothing behind it. A biopsy is how melanoma is diagnosed, and delaying it is what allows spread.
  • "You can safely remove a mole at home." Home removal kits burn a hole in the skin, leave a scar, and destroy the tissue a laboratory would have examined. If it was a melanoma, the visible part is gone and the rest is still there.
  • "A mole with a hair growing out of it cannot be cancerous." No truth to it. Hair says nothing about whether a mole is dangerous.
  • "Only moles in sun-exposed places matter." Melanoma turns up on the scalp, the soles, between the toes, under nails, the buttocks and the genitals. A full check includes the places the sun never reaches.
  • "A dermatologist can always tell just by looking." Examination and dermoscopy are good, not perfect. When there is real doubt the microscope settles it, and a benign biopsy is a good outcome, not a wasted one.

Questions Patients Ask

+

How do I tell a normal mole from a dangerous one?

Use two checks together. ABCDE covers asymmetry, an uneven border, more than one color, a diameter above about 6 millimeters, and - most important - evolving, meaning changing. The ugly duckling check asks whether the mole looks like your others. A spot that fails either, or passes both but keeps changing, should be examined in person.

Is it normal to get new moles as an adult?

New moles keep appearing through the teens and twenties and become uncommon after about 40. Many new pigmented spots in older adults turn out to be seborrheic keratoses or sun spots. That is a reason to have a new spot identified, not to assume it is one of those.

Can I have a mole removed just because I do not like it?

Yes, and it is a reasonable request. What matters is how it is done — cut out under local anesthetic and sent to a laboratory. Lasering, freezing or burning leaves nothing to examine, so ask for the version that gets checked.

Does having a lot of moles mean I will get melanoma?

No. Your risk is higher than average and regular checks are worth doing, but most people with a high mole count never develop melanoma. The response is a schedule of skin exams, not worry.

Can melanoma appear where there was no mole?

Yes — most melanomas arise on skin that had no mole before. That is why a new spot that grows, or a sore that will not heal, deserves the same attention as a changing mole.

My mole changed during pregnancy. Is that expected?

Moles commonly darken slightly in pregnancy, and skin stretching over a growing abdomen or breasts can change a mole's shape. Melanoma does occur in pregnancy, though. A mole that changes in shape, border or color should be looked at while you are pregnant, not after.

References

+