Almost every inhabitant of the Earth who has a non-black skin color has at least one mole, which in medicine is called nothing more than a melanocytic nevus. The word “nevus”, which is somewhat unusual for the Russian language, is borrowed from Latin and means the same birthmark or birthmark. In the course of life, for unknown reasons, new moles appear where previously clean skin was, and old ones disappear somewhere. It frightens some people, and causes inconvenience to others, especially when dark spots begin to “decorate” the forehead, nose, and cheeks. Let’s try to figure out what moles, or, scientifically, nevi are, what they are, where they come from and whether it is possible to somehow influence their appearance.
What is nevus
In the skin of people and animals there are special cells - melanocytes that produce a dark pigment - melanin. In animals, it affects the color, determines the color of the eyes. In humans, it is melanin that is responsible for the intensity of tanning, that is, it protects against ultraviolet and other rays harmful to the body. When the pigment is evenly distributed over the skin cells, it has a uniform color, tone. If suddenly - for reasons unknown to science so far - an excess amount accumulates in individual cells, such areas begin to stand out against the general background, that is, a birthmark or pigmented nevus appears. Nevus melanocytic is the same. More synonyms of the same concept are nevus melaniform or non-cellular. The color of these formations varies from black to light brown, sometimes purple. If the birthmark is red (wine) in color, it is called a flaming nevus and is formed due to a large accumulation not of pigment, but of capillaries too close to the skin surface. For example: a flaming nevus on the head and part of the forehead is in Gorbachev, the last president of the Soviet Union.
In some people, it may be on the same level with the skin, in others, a melanocytic nevus protrudes somewhat above its surface. The photo above shows a slightly protruding pigmented nevus. In infants, such marks are almost not observed, although scientists tend to believe that they are simply too small to be noticeable. They begin to manifest more clearly somewhere from 9-10 years of age. In most cases, simple pigmented nevi behave peacefully and do not cause any problems, except for cosmetic defects.
Types of Birthmarks
Melanocytic nevus of the skin is of two types:
1. Congenital
In terms of size, these pigmented formations are small (up to 1.5 cm in diameter), medium (up to 10 cm) and large, or gigantic (more than 10 cm). Congenital nevi of any size also grow in diameter with the growth of the child. The greatest danger is the middle nevi, large and gigantic, since it is they that most often degenerate into malignant melanomas. For what reasons babies with large and giant birthmarks are born, specialists find it difficult to say for sure. According to statistics, about 5% of babies born with a giant nevus develop skin cancer in the first year of life or a little older. Therefore, parents whose babies were born with large birthmarks should definitely consult a specialist. If the giant nevus is located on the face, the doctor may recommend laser discoloration, and if it is removed from other parts of the body. The latter procedure is also recommended if the large birthmark has a dark color and a tuberous surface.
2. Acquired
During life, age spots may appear on any part of the body, including the scalp, genitals, palms, soles of the feet. English scientists have found that a large number of moles reduces the risk of osteoporosis by about 2 times and significantly reduces the appearance of wrinkles, and degeneration of nevi into malignant melanomas is observed in about 16% of people with pigment marks.
Causes of moles
Scientists in each case cannot say why a person has a melanocytic nevus. But there are a number of common causes leading to pigmentation.
So, congenital birthmarks can appear if the following has happened during pregnancy:
1. Intrauterine infections (herpes, toxoplasmosis, smallpox and others).
2. Pregnant intake of certain drugs.
3. Increased intake of vitamin A.
4. Drinking alcohol.
5. Diabetes mellitus in a pregnant woman.
6. Lack of trace elements.
7. Heredity. Very often, it is already in the DNA that the melanocytic nevus will appear in the child on the body in a certain place. Moreover, often hereditary birthmarks are identical in the baby and his mother or very close to that.
Acquired nevus may appear for the following reasons:
1. Large doses of ultraviolet radiation. An abnormal tan and excessive enthusiasm for a solarium provoke an increased production of the pigment melanin, which leads to the formation of moles.
2. Changes at the hormonal level. This includes any condition (illness, pregnancy, puberty, menopause, stress, and so on) in which hormonal disruptions are observed. They, in turn, cause additional skin pigmentation, although in some cases, on the contrary, they can lead to the disappearance of existing birthmarks.
3. Radiation.
4. X-ray.
5. Skin injuries. They can cause the movement of melanocytes closer to the surface of the skin, that is, age spots will become more noticeable.
Mole classification
The medical names of nevuses sometimes cause some confusion. However, in fact, everything here is quite simple and logical. Human skin includes layers: epidermis (closest to the surface), dermis (medium, thickest) and hypodermis (deepest). Depending on the location of the accumulation of melanocytes, the following types of age spots are distinguished:
- epidermal nevus (located in the upper layers of the skin - the epidermis);
- intradermal (respectively, accumulation of melanocytes is observed in a deeper layer - the dermis);
- borderline melanocytic nevus (this is an increased amount of melanin between the epidermis and dermis);
- hypodermal (the location of the pigment in the hypodermis) - this type of nevi does not appear externally, but under certain circumstances melanocytes can move closer to the skin surface.
The structure and nature of the manifestation distinguish the following types of nevi:
- complicated;
- atypical;
- returnable;
- papillomatous melanocytic nevus;
- blue;
- Mongolian spot ;
- hairy (one or several hairs grow out of a mole, often darker, regardless of whether the person is blond or brunette).
- the nevuses of Setton, Clark, Spitz,
Let's consider some types in more detail.
What is papillomatous intradermal melanocytic pigmented nevus
This long and somewhat difficult to understand definition contains several concepts at once. So, it has already been noted above that the terms “melanocytic” and “pigmentary” mean the accumulation of the pigment melanin in the melanocytes producing it. Intradermal nevus in essence means the location of accumulations of melanocytes in the deeper layers of the skin and externally represents a tubercle protruding above its surface. Its synonym in medicine is the expression "intradermal melanocytic nevus." If it has a flesh color, and even located on a leg, there is a great resemblance to papilloma. Hence the name - papillomatous nevus. Such formations appear mainly on the head (scalp), neck, face, but can be observed on any other part of the body. Their color, in addition to flesh, is brown, brown, black, and the finely tuberous structure vaguely resembles cauliflower. In medicine, you can find other names, for example, nevus warty, linear, hyperkeratotic. There are 2 forms: organic, when papillomatous moles are observed singly, and disseminated, when there are many such warty tubercles. Often they are located where large blood and nerve vessels pass. If a person has such a pattern, this may indicate diseases of the central nervous system, in particular epilepsy. Although the papillomatous intradermal melanocytic nevus of the skin, appearing with birth, is constantly growing little by little, it is referred to as benign melanoma-dangerous types of pigmented formations. Despite this, it must be shown to a dermatologist what to find out if it is a nevus, papilloma or melanoma. It is especially important to see a doctor if a papillomatous mole suddenly begins to hurt, itch or change color. When making a diagnosis, the doctor conducts a visual examination, and, if necessary, does siascopy, ultrasound, and biopsy.
Complex melanocytic nevus
This definition is used when a mole, originating in the epidermis, grows into the dermis. Outwardly, it looks a bit like a wart with a diameter not exceeding 1 cm. Like other types of nevi, the complex is considered benign, however, according to medical statistics, in more than 50% of cases it can degenerate into melanoma. Therefore, it is referred to as melanoma-hazardous formations. In its structure, a complex nevus can be smooth, bumpy, hairy, warty, and in color more often dark - from brown to black.
Atypical nevus
It is believed that approximately one in ten people has atypical or dysplastic melanocytic nevus on the skin. The photo above shows how it might look. These birthmarks were given this name due to their fuzzy, as if blurred borders, asymmetry, size (as a rule, they exceed 6 mm), dissimilarity to other moles. The color of atypical nevi can be very different - from light beige or pink to dark brown. In medicine, there is a synonym for this pigmented formation - Clark's nevus. If you find yourself in such a strange birthmark, you must definitely consult a doctor to make sure that there is no melanoma. Doctors believe that atypical nevi in themselves do not pose a health hazard, but people who have them are at risk for skin cancer, and it’s not necessary at the place of the age spots. During life, atypical nevi, like any others, can disappear on their own, but this is not a reason for exclusion of a person from the risk group.
Return nevus
The so-called pigment spots appearing at the place where the mole was removed. Recurrent nevus, as a rule, means that the mole tissues were not completely removed and a second operation is required.
Nevus Spitz
This is another pigmented formation, due to the presence of which people are at risk for melanoma. Such birthmarks appear on the skin more often in children under 10 years of age, but adults are also not immune from them. A distinctive feature of the Spitz nevus is its rapid growth. So, suddenly appearing on the skin, in just a few months, it can increase in diameter from a couple of millimeters to a centimeter or more. Another unpleasant feature of it is that it can give metastases to neighboring areas of the skin and lymph nodes. But, despite this, in most cases, Spitz nevi are considered benign and are easily amenable to timely treatment.
Nevus Setton
Sometimes birthmarks appear on the body with a white border around the edge. They have two names - Setton's melanocytic nevus and halo nevus. In some people, such formations are single, in others they can be many, and mainly on the back. According to scientists, the white border is caused by the fact that the cells in it are destroyed by the cells of the immune system. Over the years, Setton's nevi can become completely discolored or completely fade, leaving a bright spot for memory. In the vast majority of cases, such bordered moles are not dangerous. But scientists have found that their presence, especially in large numbers, may be due to the presence of diseases such as vitiligo and thyroiditis, or melanoma, which has not yet manifested itself.
Nevus Becker
This birthmark with its size resembles a giant melanocytic nevus. In about a quarter of cases, such pigmentation occurs in the fetus in the womb. A distinctive feature of Becker nevi is:
- growth of hairs on them;
- rash of acne on them;
- an increase in size to a certain point, then the cessation of growth and some lightening of the color.
Most often, such birthmarks remain in humans for life. They do not represent a danger, but their owners from time to time should still be shown to a dermatologist.
How dangerous birthmarks are
Some people believe that moles can eventually develop into melanoma or other types of skin cancer. However, this is wrong. In the vast majority of cases, any birthmark (or melanocytic nevus) does not threaten anything. You need to worry and immediately rush to the doctor (dermatologist, oncologist) if suddenly the following changes begin to occur with a mole:
- its color has changed, anyway, in which direction;
- it became asymmetric (for example, convex on one side);
- the color or structure of the rim of the birthmark has changed;
- mole began to hurt, itch, bleed;
- sharply increased the size of the birthmark.
In all cases, if the newly emerged mole differs from the existing ones, or if the old one suddenly becomes somehow unusual, you should consult a doctor as soon as possible.
What to do with moles?
If nevi are in no way annoying, and if they are located in safe areas of the skin, you just need to watch them. If they are located where they can often be injured (on the palms of the hands, on the feet, on the neck, on the head, on the waist) or on the face, which causes cosmetic defects, they are recommended to be removed. It is only necessary to entrust such operations to doctors - a surgeon, a dermatologist. Epidermal nevi is recommended to be removed only by surgical operation. It is carried out under local anesthesia, therefore it is painless. Papillomatous melanocytic nevus of the skin, especially located on the pedicle, is sometimes more advisable to remove with liquid nitrogen. In recent years, laser treatment of moles and their excision with a radio knife have also been successfully used.
After the operation, the doctor, as a rule, sends the removed fragments to a histological examination to be completely sure that there is no cancer.
It is completely unacceptable to remove the nevus independently, by folk methods. Especially often, people try to get rid of papillomatous nevi with legs, bandaging them with a thread. This leads to blocking the access of blood to the mole, and it can really disappear. But in most cases, this method of "treatment" provokes the development of changes in the cells of the epidermis or dermis and leads to disastrous consequences.