Talking Moles: How to Identify Suspects and Prevent Skin Cancer

A mole orbiting around the corner of the mouth has since the 50s of the last century become a symbol of sexual desire. It took the full weight of the film industry, of advertising, and of the work of Norma Jeane, an actress who would later be called Marilyn Monroe, a name as fake as the black stain that paints itself every day — and every night —. .- in his face.

It is all the same curious that a small circular and dark detail made up on the face of a woman can take on so much importance. But he got it, and more so after the mysterious death of Marilyn, which turned her into a hard-to-understand legend, which is what the film seeks to deal with. Blondwith Ana de Armas, nominated for the Oscar for Best Actress.

Monroe’s enigmatic legacy has various manifestations in popular culture. “Who killed Marilyn? , asked Los Prisioneros incisively in the 80s. During this same decade, Madonna rose to fame with a mole painted on her mouth. A bit like a tribute, but also to exalt the sexual and disruptive symbol he was trying to be. And she was not the only one to reproduce it: even a comedy like hot shots — featuring Charlie Sheen — poked fun at the resource through a character who kept his mole in a purse.

But beyond fiction, moles can indeed “tell us something”; more specifically, to use them as indicators of our state of health. For example, the high presence of so-called “flesh moles” – which are strictly not moles – could be an indication of insulin resistance and diabetes.

Although almost everyone has a nevus, as moles are also called, on their body, and the vast majority of them are benign, some could be a reflection of melanoma, a type of cancer of the skin rare but very deadly. “Hence the importance of having regular medical check-ups,” says Claudia Moreno, dermatologist at Clínica Indisa.

In 2018, the World Health Organization (WHO) established that the rate of skin cancer in Chile has fallen from 20 to 25 cases per 100,000 inhabitants. This ranks it as the third most common type of cancer in the country. In addition, he estimated that one in 10 Chileans will have some type of skin cancer in their lifetime.

It is worth asking the question: what are they and how do these circular spots appear on the skin? Nevi are tumors or lesions that originate in melanocytes, cells that produce melanin, the pigment that gives eye color and also moles: these can be brown – lighter or darker – , black, pink, blue or gray

When melanocytes grow in groups, moles are formed which, as Claudia Moreno explains, can be flat or raised, depending on whether they are located only on the epidermis or between it and the dermis. Others are hidden under the dermis and only visible under the effect of light. In these cases, its coloring is usually grayish or bluish.

According to the Cancer Institute of the United States, most adults have between 10 and 40 common moles, which are usually located on the upper trunk and areas most exposed to the sun. Very rarely are they found on the scalp, breasts or buttocks.

Although the most common moles are present from birth, many can appear during childhood and continue to form until the age of 40. With old age, the nevi begin to disappear, and in their place another type of spots appears on the skin, the so-called seborrheic keratoses.

Héctor Fuenzalida, dermatologist at Integramedica, explains that these spots are often mistaken for moles, but in reality they are “raised brown or blackish structures, which usually appear after 40 or 50 years, especially in people with dark hair” .

As mentioned, most moles or nevi are benign tumors. However, it is possible for the pigment-producing cells, the melanocytes, to become cancerous by growing out of control, eventually resulting in melanoma. It usually appears in areas where there were no moles or other “spots” before. Although, as Fuenzalida says, it can happen that it occurs on a nevus that has already been declared benign.

“An irregular area of ​​skin begins to appear, which grows disproportionately on the surface, horizontally and asymmetrically”, adds Claudia Moreno, who warns that “people are often confused, because they do not have the memory of the existence of such a mole”. before or not”.

This is something that mostly happens to people who have a lot of moles. “In these cases, it is more difficult to identify a new stain,” says Moreno.

Luz Rodríguez, specialist in dermatology, epidemiology and aesthetic medicine at Clínica NúcleoSalud, explains that this type of skin cancer is less common than basal cell carcinoma or squamous cell carcinoma, but “if not detected in time , it spreads faster to other parts of the body. In fact, melanoma can invade nearby tissues and spread to other parts of the body, such as the lungs, liver, bones, or even the brain.

The formation of melanomas is mainly due to two factors: genetics and exposure to the sun. Those who have family members with a history are at higher risk of developing one, as are those who have had this type of cancer before.

Exposure to UV rays, meanwhile, is the main external factor causing such skin cancer, a risk that increases in the weather, as the capacity of solar radiation is in its potential potency and the gentle pasa horas tumbada bajo the sun.

“Be careful that when the day is cloudy, UV rays still pass through the clouds and affect our skin”, warns Luz Rodríguez. The same goes with smoke or pollution: “many people tend to believe that there is less sun, but ultraviolet radiation is still present, so it is essential to take care of yourself. Environmental pollution resulting from the emission of combustion gases and microparticles has been shown to enhance the harmful effect of ultraviolet radiation.

And the sun isn’t the only source of UV rays that threaten the skin. “Solariums are also an important source,” says Rodríguez.

The clearer the skin, the greater the degree of damage that ultraviolet radiation can produce. People with red hair or light hair and eyes are also generally more exposed to the effects of the sun.

Although a medical examination is the only way to determine whether or not a mole is cancerous, self-assessment can help identify the presence of melanoma early, which can be essential for an optimistic diagnosis and for receive a treatment that prevents its spread and ultimately root it.

Elizabeth Valle, dermatologist at Clínica Bupa Santiago, says that one of the most used methods to identify suspicious nevi is the so-called “ABCDE”, which consists of evaluating the following manifestations:

• Asymmetry : One half of the mole is different from the other.
• borders : Check if these are irregular.
• Color : if there are two or more colors in the same mole or if its coloration is irregular.
• Diameter : if the mole measures more than six millimeters.
• Evolution : if a newly appearing mole changes in size, shape, texture, color or growth in height. Same with an old nevus that changes or produces new symptoms, such as itching or bleeding.

Other signs to suspect, according to the Cancer Institute of the United States, are if the skin on the surface becomes dry or scaly, if the mole becomes hard or feels lumpy, or if it oozes fluid.

Claudia Moreno says the main precautionary measure is to avoid solar radiation. “This means, on the one hand, being aware of exposure habits: avoiding direct sunlight during the hours of greatest exposure, which would be between 11 a.m. and 4 p.m., preferring shade, and using elements of protection of the skin”.

Clothing such as wide-brimmed hats that protect the ears, neck, décolleté and nape of the neck, as well as sunglasses – which protect both the eyes and the area around the eyes -, shirts or shirts with long sleeves and pants – which cover the arms and legs – are part of the ideology of prevention.

Still, going out in pants and long-sleeved shirts can be torture given the nearly 40 degrees that hit much of the country in the summer. If you are going to expose your skin, you should apply sun protection every three or four hours, with a factor of 50, which is the highest. Luz Rodríguez says those who go to the beach or swimming pool must renew their protection every two hours.

Finally, performing a periodic self-examination is essential. Elizabeth Valle says if you have a history of melanoma, it’s ideal to have it once a month, and schedule an annual check-up with a specialist for a full physical exam. “If a dermatologist suspects that a lesion is atypical or malignant, they will indicate its removal and will always request a biopsy”, the results of which will determine the next steps.