How Alarming Are Moles?

Small and larger brown moles appear in the strangest places – some are there from birth. But most of them appear only in the course of childhood.

On average, an adult has 20 moles – in contrast, as a baby he hardly had one. It is rare for a mole to form before birth: Normally, the cells that are later responsible for the pigmentation of the skin are deposited in the epidermis of the unborn child during its development. Sometimes some of these cells do not reach the uppermost layer of skin, but remain in a deeper layer, “unfold” there – and give the baby a permanent individual feature at this point: a mole.

Children Score Highest

Areal moles and punctate moles are medically the same things. It is the maldevelopment of the pigment-forming cells (“melanocytes” and “nevus cells”) that stems from a change in the genetic material in the cell nucleus. The affected cells produce too much pigment, which forms a small growth (medically “nevus”). The less self-protection the skin has, the faster the harmless malformations develop – for example, in light skin types, and in children.

A major trigger is sun exposure, especially when sunburns occur on the skin. Children have a much thinner epithelium than adults. The UV rays can penetrate the top layer of the skin and (dis)disrupt the genetic material of the pigment-forming cells. Most mottling thus forms in childhood. After all, children spend three times as much time in the sun as adults when splashing around, playing, and building sandcastles in the summer.

Whether hormones influence the number of moles is also being discussed in expert circles. It would be an explanation why many spots do not appear until puberty. The clear heredity of the birthmarks has not yet been proven. However, the moles often appear in the same or similar places within a family. What is clear, however, is that parents with many moles should also keep a close eye on their children’s skin.

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Many Spots – No Gain

Moles can vary in shape, color, and size: They show up from light brown to blue-black, lie flat in the skin level, or are raised; some marks are hairy. Almost all of these small and larger mottles are harmless and benign. The dermatologist must remove individual ones, however, if they change suspiciously and could become malignant. A certain form, experts call it “dysplastic nevus”, can become a skin cancer (malignant melanoma) in adulthood.

About 30 percent of malignant melanomas develop from moles. Although the likelihood of developing the disease is low (14 out of 100,000 people are affected), the risk increases with the number of moles. The same applies to sun exposure that is not appropriate for the skin type and to immunodeficiency. Those who have particularly many, large, or very different moles should have them checked by a dermatologist from time to time. Reasonable suspicion exists if a mole changes in any way, itches, bleeds, or weeps.

Very rarely, a birthmark disappears on its own, as the accumulated pigment in the cells dissolves – leaving only a tiny spot behind. Doctors now want to find out how this happens and thus develop another method of gently removing unwanted or questionable marks.

What Are Freckles?

The many light brown sprouts that appear on uncovered areas of skin (face, arms…), especially in lighter skin types (blond and red-haired people), are the result of  maldevelopment of the pigment-forming cells – they produce more pigment than other cells; however, the skin pigment is not evenly distributed in the epidermis, but forms small islands. In summer, the speckles become darker due to sunlight, in winter they become lighter or disappear completely. Freckles, however, are clearly hereditary and almost always benign. And since Pippi Longstocking became the idol of all subsequent generations of children in the 1970s, freckles have been considered particularly chic!

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When Self-examining For Suspicious Moles On Their Children, Parents Can Be Guided By The “ABCDE Rule”:

A = Asymmetry
Are the spots asymmetrical or irregular?
B = Boundary
Are the moles indistinctly bordered or have frayed edges?
C = Colorit
Has the color (Color) changed or is the mole black, blue or grayish?
D = Diameter
Is a birthmark larger than five millimeters?
E = Elevation
Is the birthmark palpable or has it become palpable?

Sun Protection Is Important

Most birthmarks appear on areas that are particularly exposed to the sun in summer, i.e. on the arms, shoulders… Since their skin hardly has any protection of its own, children should ideally not be exposed to direct sunlight before the end of their second year and should always wear a cap and UV-protective clothing even in the shade. Children two years and older who play and splash in the sun need consistent sun protection in the form of clothing (according to the Australian UV standard) and creams (at least factor 30).
The younger the children are, the higher the proportion of physical sunscreen in the creams should be and the lower the chemical one. A sun protection factor of strength 50 in the UVB range already filters out 92 percent of UVB radiation, while a protection factor of 60 takes about 93.5 percent of the radiation.