Do the moles on your arm mean you’ll get cancer?
This week experts said having 11 of them on your arm is a danger sign. So should YOU be worried?
STANDING in my underwear as a doctor scrutinises my body through a magnifying glass is exquisitely embarrassing — the awkwardness I remember in the school changing rooms was but a shadow of the deep mortification I’m experiencing.
But my embarrassment is very much secondary to the hard knot of fear forming in my stomach about what I may soon discover about my health.
I’m having my moles checked for skin cancer. With fair skin that burns easily and a couple of moles that are bigger than I’d like, it’s something that’s worried me for years.
Only recently, when a mysterious pink bump appeared on my arm, I convinced myself it was cancer — particularly when it started bleeding — but was too scared to see the doctor about it.
A study published this week has pushed my paranoia to the forefront. Researchers at King’s College London have discovered that people who have 11 or more moles — measuring at least 2 mm in diameter — on their right arm are likely to have more than 100 across their whole body, which is linked to a higher risk of malignant melanoma.
This is the most serious type of skin cancer, the kind that can spread — and potentially kill. People with a genetic susceptibility to melanoma may also be more likely to develop cancer of the pancreas, brain, breast and kidney.
Eleven moles on your right arm (it could equally be the left — the researchers picked ‘right’ because they wanted to make it easier for us to remember) makes you a ‘moley person’, someone who should be aware of their skin and consider getting it checked by a GP ( particularly if you’re over 25, as melanoma is rare before this age).
I’ve never thought of myself as ‘moley’, but have been self- conscious about having a lot of them on my arms. But until now, my biggest concern was that they were unsightly. As I read about the new study I felt sick — a panicky count revealed there are 13 moles on my right arm and 14 on the left. Or what could be moles — but are they freckles?
Either way, I have enough tan-coloured blotches to send me running to the nearest dermatologist. DR ALEXIS GRANITE, the consultant performing the inspection of my skin at London’s Cadogan Clinic, tells me I’m one of many calls she’s had within hours of the scary mole story breaking.
I tell her my father, who is in his 80s, has had treatment for four basal cell carcinomas over the years — these are skin cancers linked to sun exposure, which are very unlikely to spread.
But Dr Granite assures me this does not, in itself, raise my risk of melanoma, which is more dangerous. However, my moles might.
A mole is a collection of hundreds of melanocytes — the cells that contain melanin, which gives skin pigment, says Veronique Bataille, a consultant dermatologist at King’s College London and one of the researchers involved in this week’s mole study.
‘Moles are quite different from freckles, which are areas where melanin has leaked into the skin from nearby normal melanocytes — freckles tend to be lighter in colour and their edges blend naturally into the skin. People usually have lots of freckles rather than isolated ones, and they may come and go with sun exposure.’
The worry with moles, I learn, is not simply that an existing one will become cancerous — in fact, only between 20 and 40 per cent of melanomas are thought to arise in long-standing moles. The rest develop in single melanocytes that go ‘bad’.
Having lots of moles is a sign that your melanocytes are very active and, therefore, ‘more likely to tip over the edge and start misbehaving,’ says Dr Bataille, who adds that the risk of a single mole developing into melanoma is still low.
People with at least 100 moles are thought to have at least five times the normal risk of malignant melanoma; with 50 moles, the risk is only double. The average Caucasian has between 20 to 30 moles, but quite why some people have more or less is unknown.
Sun exposure may play a role. But a large part of the story is thought to be genetics. Scientists have found a number of genes that determine how moley you are.
After a brief visual assessment, Dr Granite confirms that at least 11 of the blemishes on each of my arms are, indeed, moles. But a quick tally of my body — a smattering on my chest, legs, back, face, even one on my scalp — suggests my total is near 50, rather than the dreaded 100. But are any of mine a cause for concern? To inspect them further, Dr Granite uses a dermatoscope — like an illuminated magnifying glass — to get a closer look; she’s looking out for unusual colours, shapes and edges as well as asymmetry.
I can’t say this close scrutiny is my idea of fun, but with fear trumping embarrassment, I draw Dr Granite’s attention to two moles in particular.
The first, on my right side, is nearly 1 cm across, very dark in colour and raised. It’s always worried me, but Dr Granite reassures me it’s unlikely to cause me any harm. ‘That looks like a congenital mole — one you’ve had since birth. Small congenital moles are not so risky.’
Though we are born with some of our moles, most appear later in childhood, says Dr Bav Shergill, a consultant dermatologist and a spokesman for the British Association of Dermatologists — in fact, you can continue developing new moles in your 30s or 40s.
‘We tend to be a bit concerned if patients get more after that — as it’s unusual and suggests they could be melanomas.’ MOLES have a natural life cycle. ‘ They are flat and brown under the age of ten, and become a bit more bobbly through the teens.
‘In your 30s and 40s, they lose their colour a bit and become more fleshy and raised, and may have hairs popping out of them.’ (And, yes, it is safe to remove the hairs, though he advises shaving rather than plucking to avoid inflaming the skin.) Moles may even disappear in later life.
Oh, and they are not to be confused with skin tags, which are overgrowths of skin, usually unpigmented, that flourish unattractively in folds such as the armpits. Moles that have been raised and fleshy for years are less of a concern than flat ones, says Dr Bataille, because their cells have reached maturity and, therefore, are more ‘stable’.
Any bleeding or crusting is also a worry. ‘ But if you knock a mole and it bleeds, it’s not dangerous — it’s only if it bleeds on its own that it can indicate cancer,’ says Dr Bataille.
So the good news is that the unappealing mole on my right side is fine. But what about the other troubling blemish on my right thigh? It’s a dark brown, bumpy oval that’s about 5mm long — I can even see it through tights. I’ve had it as long as I can remember.
As well as having a lot of moles, a separate risk factor is to have
larger moles (more than 5 mm in diameter). Moles in areas that are not normally exposed to the sun — the breasts, buttocks, palms of the hands or feet — suggest a greater risk.
Dr Granite says my thigh mole looks ‘completely fine’. But she draws a cross next to it so that it can be inspected further. I think I’ve stopped breathing.
Dr Granite delivers her verdict. My high number of moles puts me at a ‘ slightly increased’ risk, but I’m missing some of the main risk factors, such as a first-degree relative who has had the condition, red hair or lightcoloured eyes. ‘Overall your skin looks perfectly healthy,’ she says.
To keep an eye on your moles, you can get them ‘mapped’, where photos are taken to be compared against future images of them. This part of my consultation is done by the FotoFinder — a high-tech camera. They’re the kind of selfie poses even Kim Kardashian might think twice about. A bit of computer wizardry later, it grades my thigh mole 0.38 out of 1 — not very risky, I’m told, and the dermatologist’s opinion counts more than the computer’s anyway.
Leaving the clinic blushing slightly, I am relieved that my moles are not going to kill me any time soon. In fact, I’ve learned that a high mole count could, in fact, be the secret to eternal youth.
A study by Dr Bataille and her colleagues in 2007 found that very moley twins — with 100 or more moles — had longer telomeres, the protective ‘ends’ on our strings of DNA.
This gives you a lower risk of age-related diseases such as osteoporosis and also keeps you looking younger for longer.
Not a trade-off I would have chosen, in truth, but it’s a silver lining.