Moles and children: when to check for these skin spots

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Catherine Le Nevez
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On average, an adult has 20-30 moles. Of these, congenital ones - those that appear within one year of age are considered to be such - are only 1%. While it is important to keep the moles under control for an early prevention of any skin melanoma, it is equally true that it would be excessive to subject all children to a dermatological examination every time a new mole appears.



So when to start checking? We asked the doctor Maya EL Hachem, director of dermatology at the Bambino Gesù Children's Hospital in the city. Which first of all clarifies that i sort of (that in common parlance we call moles) are spots on the skin caused by melanocytes, cells of the epidermis that produce melanin and which accumulate give rise to moles and only rarely to malignant tumors (melanomas).



In this article

  • Why it is important to monitor for moles 
  • When the baby should be checked
  • When and how often to get checkups by the dermatologist
  • The rule of the ABCDE
  • When are the moles to be removed
  • What is epiluminescence?

Why it is important to monitor for moles

Monitoring of moles is important, especially after puberty, for the prevention of melanoma or for its early removal. It is a malignant neoplasm that is not always curable. It is rare in the child, therefore one must not overdo it with alarmism.



When the baby should be checked

The appearance of new moles in pediatric age is physiological, therefore noticing a new nevus should not be a reason for a dermatological visit.



The child should be checked if he has a congenital nevus from the first days or weeks or months of life: the subsequent treatment or follow-up program will be defined by the dermatologist who takes care of him.

Another reason for the control of prepubertal moles is the appearance of atypical nevi (more frequent in children than in adults), typically characterized by a pinkish-red or blackish color.

However, the prevention of melanoma does not only provide for the control of the nevi, on the contrary, it is much more important Sun protection. The sun is very good for many aspects (mood, bones, ...), but you have to know how to take it.

So it is important:

  • avoid the canonical hours (12-16) and in infants also 10.30-17.30 / 18
  • apply very high protection until you are tanned, then lower to 30 or 20 depending on the phototype, repeat the application every 2 hours or after the bath even if the cream is water resistant
  • the protective cream should not be applied only on the nevus but on the whole baby's skin
  • the protection must be applied on the photo-exposed areas, not only at the sea, but also during sports activities, walks in the open air, trips by car, by boat ....

  • in the evening apply a moisturizer.

When and how often to get checkups by the dermatologist

Check-ups should be performed after puberty, unless the pediatrician finds something special for which he deems it necessary to consult the specialist. The periodicity of the checks is defined by the dermatologist according to the nevi he finds and the risk factors: methods and extent of sun exposure, direct familiarity with melanoma, skin phototype with light hair, light eyes, freckles .... Generally in adolescence the range could vary from 1 to 3-4 years.

[Read also: sunscreen and baby, what you need to know]

The rule of the ABCDE

This rule can be useful to remember the clinical characteristics to be evaluated in order to identify an atypical mole and therefore direct parents to consult the specialist. In particular, it is necessary to consider:


- A as Asymmetry;
- B as Irregular edges;
- C as inhomogeneous color;
- D like Size> 0.8cm;
- And as an Evolution of any of the above characteristics.

Even if in children the change of moles is inevitable and therefore this rule, in pediatric age, cannot constitute an absolute criterion.

When are the moles to be removed

Moles should be removed if they are considered to be at risk on clinical examination and epiluminescence. In the small non-cooperating child, the operation takes place under general anesthesia, but as specified above, these are exceptional cases. In collaborating children (they tend to be from 6 years of age if they do not have cognitive problems), the removal takes place under local anesthesia on an outpatient basis. In our hospital we have developed an information booklet with cartoons and we invite parents to read it together with their son or daughter, at home, while waiting for the surgery. The same information written in the booklet is first provided to the child and parents (in different languages) during the outpatient visit where the mole is scheduled to be removed.

What is epiluminescence?

It is a very useful investigation for evaluate congenital nevi and their frequent changes during the child's growth and all acquired nevi presenting atypical clinical characteristics. This examination must be requested exclusively by the dermatologist since not all nevi require this investigation and only the specialist is able to identify those at risk.

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Questions and answers

Why is it important to monitor children's moles? 

Monitoring of moles is important, especially after puberty, for the prevention of melanoma or for its early removal. It can be a malignant neoplasm that is not always curable.

Moles and children: how to do prevention? 

Prevention of melanoma does not only involve snow control, on the contrary, sun protection is much more important.

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  • in
  • sort of
  • dermatology
  • skin
  • melanin
  • in children
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