Understanding the Risks of a Crusty Mole: What You Should Know

Any alteration in a mole's color or texture warrants a discussion with a healthcare professional. While these changes can often be benign, they may sometimes signify that a mole has developed into a cancerous condition.

Moles, typically appearing in adolescence, are clusters of skin pigment cells. Although most moles are harmless, certain changes in their appearance could be cause for concern, particularly if a mole begins to alter in color, shape, or texture. One significant change to watch for is scabbing, which can sometimes indicate melanoma—a serious and potentially fatal form of skin cancer that originates in melanocytes, the pigment-producing cells of the skin. If you observe that a mole has scabbed over, it’s essential to be cautious. This might be a sign of melanoma, or it could simply be due to an accidental injury. Read on to learn how to recognize concerning moles and when to consult a healthcare provider.

When you notice a mole that has developed a scab or appears crusty, there are typically two explanations:

1. You might have accidentally scraped or injured the mole, leading to the crusty appearance.
2. The scabbing could potentially indicate the presence of melanoma.

Indicators of Concern in Scabbing Moles

Dermatologists often look for specific changes when assessing moles for cancer. A crusty or scabby mole could be a warning signal, especially if it is painful or bleeds. Other concerning signs include changes in size, shape, color, or if the mole itches. Melanomas can produce scabs because they cause alterations in the behavior of healthy skin cells, leading to changes in color, texture, or the development of scabs.

Non-Healing Scabs Must Be Evaluated

If you notice a scab on a mole that does not appear to heal, it’s crucial to seek medical advice. While not all scabby moles indicate cancer, persistent scabs can be a symptom, making it important to have them evaluated if you cannot attribute the scabbing to a known cause.

The Skin Cancer Foundation recommends using two strategies for identifying concerning moles: the ABCDE method and the "ugly duckling" concept.

• A = Asymmetry: Healthy moles are usually round or oval and symmetrical. Melanomas tend to have an irregular shape.
• B = Border: Normal moles typically have smooth, well-defined borders, whereas melanomas can show irregular or jagged edges.
• C = Color: Regular moles usually possess a uniform color. In contrast, melanomas may present multiple colors such as black, brown, red, white, or blue.
• D = Diameter: Healthy moles are often smaller than a pencil eraser. If a mole is larger than this or continues to grow, consult a dermatologist.
• E = Evolving: Observe any changes in a mole, including crusting, bleeding, or elevation over time.

The "ugly duckling" approach involves evaluating your moles for any that look distinctly different from others:

• A mole that is notably darker or lighter than your other moles.
• A mole that has a different texture compared to the rest.
• A mole that is a different size than your other moles.

Most cancerous lesions are identified by individuals rather than doctors. Since you know your body best, regular self-exams are key to early detection. Consider the following tips to simplify this process:

• Set a reminder for regular skin checks—monthly or bi-monthly—especially if you have a personal or family history of skin cancer.
• Utilize apps like UMSkinCheck for notifications and guidance on performing skin cancer self-exams.
• Consider apps that help track skin changes over time, though they should not replace professional consultations.
• Document changes by taking photographs of your moles from the same angle to accurately monitor them over time.

In addition to home screenings, visit a dermatologist annually, or more frequently based on your risk factors. Those with a family history of melanoma may need check-ups every six months, while personal histories may necessitate visits every three months. Other risk factors include:

• A family history of other cancers, like pancreatic cancer.
• The total number of pigmented moles; a higher count increases melanoma risk.

Everyone should have yearly skin examinations; those with risk factors should be seen more frequently. If you notice a scabbed or crusty mole without an identifiable cause, schedule an appointment with a doctor. A professional can examine the mole and conduct tests if necessary to determine its significance. Timely detection is crucial in the successful treatment of melanoma. Don’t hesitate to seek medical advice about moles that concern you—the outcome could depend on early intervention.

About 20% to 30% of melanomas develop from existing moles, while others arise in different areas of the skin. Keep an eye on your moles for changes such as scabbing or crusting, and consult a dermatologist if these changes occur. It's also important to remember that other forms of skin cancer, like basal cell and squamous cell carcinomas, can also lead to scabbing or bleeding. Ensure you have comprehensive skin examinations, discussing with your doctor how often you should come in for these evaluations based on your medical history and risk factors.