SkinCancerNet Spotlight Article
Moles in Children: What Parents Should Know
Moles on a young child’s skin are
generally nothing to worry about. It is normal for new moles to
appear during childhood and adolescence. Moles will grow as the
child grows. Some moles will darken, and others will lighten. These
changes are expected in children and seldom a sign of melanoma — a
type of skin cancer that can begin in a mole.
While melanoma is rare in young children, it is helpful for parents
to know that there are different types of moles. Most moles are
harmless, but there are a few types that should be examined by a
dermatologist just to be sure. The following guide explains why.
A Parent’s Guide to Moles
Common mole. Also referred to as a beauty mark or acquired nevus
(mole), a common mole is harmless. Most moles that develop on a
child’s skin are common moles.
Common moles appear during childhood and adolescence. These moles
arise on skin that gets sun exposure and begin as a flat, round spot
that is one color throughout. As the child grows, this benign
(non-cancerous) mole grows symmetrically. This is, both sides look
the same. A benign mole may rise above the surface of the skin and
can lighten over time. During puberty, however, benign moles
generally darken. Regardless of whether a mole lightens or darkens,
the color stays uniform throughout. By the time a child become an
adult, there are typically 12 to 20 common moles on the skin. Few
benign moles develop after 30 years of age.
recommend: Common moles develop in children and
teenagers and are generally nothing to worry about. If a
mole looks different from the others, itches, or bleeds,
the mole should be examined by a dermatologist.
Congenital mole. When a child is
born with a mole, dermatologists refer to the mole as a congenital
nevus. Congenital moles are considered a type of birthmark. About 1%
of newborns have a congenital mole.
These moles take various forms. Some look like common moles. Others
are bluish-gray spots that can resemble a bruise. The latter are
called Mongolian spots and are more common in Asian, Native
American, brown, and black skin. Mongolian spots often fade during
Most congenital moles are harmless. A large or giant congenital
nevus, however, poses an increased risk of melanoma. What
defines a congenital mole as a giant is its diameter. When the
diameter is greater than 20 centimeters (about 8 inches), it is
considered a giant. Some estimates indicate that having a large or
giant congenital nevus increases the risk of developing melanoma by
4.5% to 10%. Other studies conclude that this risk may be even
recommend: When a child has a giant congenital
nevus, the mole should be examined by a dermatologist.
The risk of developing melanoma is greatest during the
first 10 years of life and especially high during the
first 5 years.
Dysplastic mole. A mole is
classified as dysplastic when it does not look like a common mole.
Common moles are symmetrical, have one consistent color throughout,
and tend to be smaller in diameter than a pencil.
Dysplastic moles, also known as atypical moles, do not have these
features. Instead, dysplastic moles have one or more of these
traits: Asymmetrical (if folded in half, the sides would not match),
an irregular border, more than 1 color in the mole, and a diameter
that exceeds 6 millimeters (about the diameter of a pencil eraser).
recommend: If your child has dysplastic moles, the
child should have routine skin exams after puberty.
Spitz nevus. This mole so
closely resembles melanoma that it is not possible for a
dermatologist to look at a Spitz nevus on the skin and tell whether
or not it is a melanoma. A Spitz nevus often is a pink, raised,
dome-shaped lesion. It also can contain variable colors such as red,
black, and brown. The mole may bleed. It can have an opening that
Most Spitz nevi appear on the skin during the first 20 years of
life. Spitz nevi also develop in adults.
recommend: When a lesion resembles a Spitz nevus, it
should be examined by a dermatologist — regardless of
the person’s age.
Other Risk Factors Parents Should
If numerous moles develop on your child’s skin or a mole is larger
than 6 millimeters, this increases the risk of developing melanoma.
Even if the moles look harmless, there is still an increased risk.
Several studies have found a relationship between the number of
moles and an increased risk of developing melanoma. A study that
looked at melanoma in Australian patients aged 15 to 19 years old
found that more than 50% of these patients had in excess of 100
moles. These patients also tended to have a greater density of moles
on their skin and moles larger than 5 millimeters.
Other risk factors that can significantly increase the risk of
developing melanoma include a family history of melanoma, weak
immune system, and tendency to get sunburn. Some medical conditions
such as xeroderma pigmentosum (a rare genetic disease) and familial
atypical mole and melanoma syndrome (FAMM) also increase the risk.
FAMM occurs when a person has one or more close blood relatives with
melanoma, lots of moles (50 or more), some dysplastic moles, and
moles that display certain characteristics when viewed under a
Melanoma Rising in Teens and Young Adults
While moles on a young child’s skin are generally nothing to
worry about, it is important to teach healthy habits, such as sun
protection, early. Melanoma, while rare in young children, is rising
among teenagers and young adults. It is now the second most common
cancer in people 15 to 29 years of age. Any spot on the skin that
looks different from the others or is changing, bleeding, or itching
should be examined by a dermatologist.
For information about teaching your child healthy habits at a young
age, read 3 Habits Parents Should Encourage for a Lifetime of
Aber CG, Alvarez Connelly, E, Schachner L. “Skin Cancer in the
Pediatric Population.” In Nouri, K. Skin Cancer. China, The
McGraw-Hill Companies, Inc; 2008. p. 415-30.
American Academy of Dermatology. “2008 Melanoma Fact Sheet.”
Last accessed June 26, 2008.
Barnhill RL, Rabinovitz H. “Benign Melanocytic Neoplasms.” In
Bolognia JL, Jorizzo JL, Rapini RP et al, editors.
Dermatology. Spain, Mosby Elsevier; 2008. p. 1724.
Gallagher RP, Rivers JK, Lee TK et al. “Broad-spectrum
sunscreen use and the development of new nevi in white children: A
randomized controlled trial.” JAMA 2000; 283: 2955-60.
Gelbard SN, Tripp JM, Marghoob AA et al. “Management of Spitz
nevi: a survey of dermatologists in the United States.” J Am Acad
Dermatol 2002; 47: 224-30.
Habif TP, Campbell JL, Chapman MS et al. “Nevi, melanocytic, nevi,
moles.” In: Dermatology DDxDeck. China, Mosby Elsevier; 2006.
Ibid. “Atypical mole syndrome.” #136.
Ibid. “Congenital melanocytic nevi.” #139.
Jafarian F, Powell J, Kokta V et al. “Malignant melanoma in
childhood and adolescence: report of 13 cases.” J Am Acad
Dermatol 2005; 53: 816-22.
Zaenglein AL, Heintz P, Kamino H et al. “Congenital Spitz
nevus clinically mimicking melanoma.” J Am Acad Dermatol
2002; 47: 441-4.
content solely developed by the American Academy of Dermatology
Melanoma is the second most
common cancer in people aged 15 to 29 years of age.
2008 Melanoma Fact Sheet
American Academy of Dermatology
A small congenital mole on the foot of an 8-year-old girl;
it was removed when it began to grow.
This close-up of a
shows that the color is not the
same throughout. The color is
darker in the middle.
A Spitz nevus is often pink, raised,
(Photos used with permission of the
American Academy of Dermatology
National Library of Dermatologic