Moles and Skin Lesions

Moles
The average adult has between 15- 40 moles, which appear between childhood and up to the age
of 40 years. Moles are small dark marks on the skin. Most of them are usually brownish but
some are darker or similar to skin colour. A mole is made of a collection of melanocyte pigment
cells, which give the mole its colour. Moles can be flat or raised, smooth or rough. Some moles
may have hair growing from them.
Moles are normal and appear in childhood. If a child is exposed to more sunlight the number of
moles may increase. Some people have many moles visible on the skin, which is normal as the
number of moles we get is controlled by genes. Moles can start to look different over time and
are sometimes a response to hormonal changes, adolescence and the menopause or during
pregnancy. Sometimes moles will disappear over time.
Illustrated below are a few normal moles, which can be flat or raised.

Surgical removal under local anesthetic is a simple and effective procedure to remove moles and
takes about 30 minutes. This treatment for moles usually produces a satisfactory aesthetic result
with minimal scarring.
Excision , Shave Excision, Cautery, Curretage and Cryotherapy are the main methods available
for Mole Removal

Skin Lesions
What is a Skin Lesion?
The Skin Lesions are patches or superficial skin growth. Skin lesions can be divided into two
main categories, primary skin lesions and secondary skin lesions. Primary skin lesions such as
moles vary in colour and texture and can be present from the birth or can start to grow after birth.
It may be connected with infectious diseases such as warts, acne, and environmental affects such
as sun burn, pressure, or allergic reactions. Secondary skin lesions are those changes in the skin
due to primary skin lesions
Skin lesions may occur due to various conditions and diseases. Most people have moles or
birthmarks from birth, but some people get moles , freckles or birthmarks later on in life because
of factors such as infection from bacteria, viruses, fungi, or parasites. Acne, warts and scabies are
the best examples of skin infections that cause skin lesions. Some people get skin lesions as a
results of allergic reactions and sensitivity to environmental factors. Other than the above

reasons, infections such as chicken pox, small pox, cancers, herpes can also temporally cause the
skin lesions.

Common Skin Lesions

Seborrhoeic Warts is a very common skin lesion. Seborrhoeic Warts are common as our age
increases and usually present themselves in the late 30s. Their cause is not well understood.
Seborrhoeic Warts tend to be brown in colour and have a rough surface with a "stuck on"
appearance. Seborrhoeic Warts are not harmful, however can be easily treated by cryotherapy
(freezing) or by curettage (scraping) under local anesthetic. Seborrhoeic Warts may reoccur
despite successful removal.

Sebaceous Cysts is a another common skin lesion. Sebaceous Cysts are caused by a blockage
of the sebaceous gland of the hair follicle. Sebaceous Cysts usually present themselves as smooth
firm swellings in the skin and can become intermittently infected (red and sore). Common areas
that Sebaceous Cysts can appear, are the face, neck, chest and scalp. Treatment for Sebaceous
Cysts usually involves surgical removal under local anesthetic, which leaves a linear scar behind.

Sebaceous Cysts
are caused by blockage of the sebaceous gland of the hair follicle. They usually present as
smooth firm swellngs in the skin and can become intermittently infected (red and sore). Common
areas are the face, neck, chest and scalp. Treatment usually involves surgical removal under local
anaesthetic, which leaves a linear scar behind.

Treatments for Moles and Skin Lesions

It is better to examine skin frequently, if you have moles and skin lesions or suspect you might
due to an infection, as early detection is better for effective treatment. Treatments for moles and
skin lesions depends on the primary causes of the moles or skin lesions, type of skin lesions and
your overall health condition. Removal of moles and skin lesions is not very long procedure, it is
a quick and very straightforward.

Skin Cancer
Moles that change in colour, size, shape or surface may represent skin cancer and should be
assessed by a doctor. There are 3 main types of skin cancer, all of which are caused by sun
exposure.
Basal Cell Carcinoma (BCC)
Basal Cell Carcinoma is the most common form of skin cancer and usually presents as a lump
just under the skin. Sometimes there is a characteristic "rolled edge" and this may later break
down to form a "rodent ulcer". Surgical excision is usually an effective treatment for Basal Cell
Carcinoma although regular review and high factor sunscreen is recommended subsequently.

Squamous Cell Carcinoma (SCC)

Squamous Cell Carcinoma is the second most common form of skin cancer and tends to
present on sun exposed areas of the body (face, arms, hands). Squamous Cell Carcinoma appears
more superficially and scaly than BCC and can often occur at a site of previous skin damage.
Small tumours can be surgically removed but larger lesions may require cryotherapy (freezing)
or fluorouracil cream (cell cycle slowing).

Malignant Melanoma
Malignant Melanoma affects 6000 people in the UK every year and causes 2000 deaths
annually. Malignant Melanoma can appear like a normal mole initially but if left untreated, can
then spread to other parts of the body. The main features of Malignant Melanoma tend to be
change in colour (darker), size (>6mm), border (irregular) and surface (uneven). Any such
changes should be seen by a doctor, as surgical removal is simple and effective treatment for
malignant melanoma moles in the early stages of melanoma.

Common Pigmentation Blemishes

Lentigo are sometimes called freckles or age spots and are the result of cumulative damage to
the skin by sunlight. Lentigos are usually flat spots with increased pigmentation. The edges are
seldom uniform and the pigmentation tends to vary from light to dark in different lesions

Melasma
Melasma appears as dark irregular but well defined areas of increased pigmentation on the
cheeks, nose, upper lip and forehead. Melasma particularly affects pregnant women and those
taking hormonal contraceptives or HRT. Melasma is thought to be caused by stimulation of
melanocytes by the female sex hormones (oestrogen + progesterone). There may also be genetic
tendancy and association with thyroid disease.

The most effective ways to treat pigmentation problems include:

Hydroquinone 4% cream to reduce the production of melanin

Tretinoin 0.05% cream to increase the turnover of skin cells

Azeleic acid 20% cream to reduce melanocyte activity

Chemical peels to strip away superficial pigmentation

IPL / Laser to selectively target and destroy abnormal pigment