What do I do about my hated moles?

The Kit’s editor-at-large warns to make sure that’s what they actually are first

I’ve always had a few moles on my body, but in my 40s they’ve proliferated on my torso to the point that, should I ever have the opportunity to remove my clothes in front of another human — that’s a different issue — I’d be super self-conscious. What should I do? — Patricia, Toronto

There’s an expression that gets thrown around a lot about how, the older you get, the more comfortable in your skin you become. Unfortunately, I think that’s metaphorical.

While it’s true that we tend to settle into ourselves as we mature, that we find our voices, and our confidence in our ability to use them grows, I don’t know too many people who get more comfortable in their actual, literal skin. Most people, in fact, look at their skin with increasing disdain as they move through their lives.

To that point, I would almost guarantee that whomever you may one day remove your clothes in front of feels exactly that way about their surgery scars or love handles or weird patch of hair that didn’t use to be there … You know, all the things that mark the human body, but that we don’t notice on others because their features are obscured by our absolute fixation on our own perceived flaws. I have a birthmark on the middle of my calf, for example. It looks like I was hit with a brown bingo stamper, and I hate it and I’ve almost had it removed many times. I mentioned my intention to cut it off to my husband not too long ago. He admitted that he’d never noticed it.

Take from that what you will, but know this: “People want their skin to be smooth — whether that means they are bothered by their brown spots or acne or a mole — but how many people actually have smooth skin like that? I’d say that’s very, very rare,” explains Dr. Julia Carroll, director and founder of Compass Dermatology and professor at the University of Toronto Medical School. So I’m not telling you not to be bothered, I’m just begging you not to be straight-up mortified by your body because, well, that sucks, and life is hard enough.

In order to address your situation and gain some peace of mind, though, Carroll suggests starting by talking to your doctor about any issue you might be having with moles or your skin; and don’t worry, despite COVID-19 limitations, you can still see a doctor either virtually or in person depending on the need, so there is no reason to avoid seeking medical advice if you are having health concerns.

While you wait for your appointment, however, you might be interested to know that a condition called seborrheic keratosis is incredibly common and is defined by a proliferation of marks that kind of look like moles at first glance, but aren’t. These noncancerous (read: totally harmless and purely cosmetic) skin growths tend to be genetic.

“They almost feel stuck on skin,” Carroll says. “Sometimes they have a smooth pebbly surface, sometimes they have a rough dry surface. It's very common to have one or two and then get sort of a shower of them over a short period of time; pregnancy can do that, but dermatologists typically call them ‘wisdom spots’ because they often come with age.” Some people, she explains, become peppered with hundreds.

Moles, on the other hand, don’t typically multiply at a great rate. “You get the odd mole here and there over your lifetime, but getting a lot as an adult would be strange,” Carroll says. If, however, you have a mole that is changing, you should book an appointment with your family doctor or dermatologist. The short list of concerns to keep an eye out for? Asymmetry, a border that becomes undefined, changing colour and increasing size.

“I tell my patients to check their moles once a month. Moles on your body are like constellations in the sky; they look confusing at first, but you can easily pick out the Big Dipper after you get to know what it looks like — and so you can more easily spot if things might be changing.”

If, however, one might in fact be dealing with seborrheic keratosis (and Carroll estimates that some 80 per cent of her patients have some of these markings, so odds are that whomever might take their shirt off in your company will likely have a few as well) there are a few options to minimize their appearance or remove them all together. Slathering on good body moisturizer is the easiest way to help the markings blend in — “especially in the winter when people complain that they get itchy and irritated and appear drier than the surrounding skin.”

If nixing them completely is a route that’s of interest, then the most common procedure is cryotherapy. “We basically spray them with liquid nitrogen, which, on average, gets rid of about 70 per cent. It feels very cool and then they get crusty and peel off over the course of a couple of weeks.”

It’s possible that some may return or new markings may appear, so Carroll’s patients typically return once a year to have the procedure done. If a spot is particularly large or in a medically sensitive area, then a doctor might consider removing it by incision or with an ablative laser. But generally, after the marks are removed by cryotherapy, you simply dot on a little antibiotic ointment at first and then use sunscreen regularly to help preserve the results.

So while removing them isn’t complicated, coming to terms with them as they appear might be. “I think you look at these marks on your body and are reminded of something you used to see on your parents or grandparents, which links you to an aging adult,” Carroll says. “If you're struggling with that, there are deeper reasons as to why these particular spots bother you.” I know that aging has its disagreeable angles, but please remember that there are so many adventures ahead — and it’d be a shame to let a few spots blur the view.