On the defense: Whether you call them beauty marks or moles, we report on the latest ways to keep tabs on your skin spots
By Malwina Gudowska
While most childhood memories are composed of bosom friends and pivotal events, my youthful days can be mapped out in a connect-the-dots trajectory—literally. I rarely spent serious time in the sun, but I have plenty of little dark marks on my skin, including the four moles on one side of my face that I’ve had since birth.
At seven, when I dressed up as Madonna circa 1984 for Halloween, my mother drew a small mark above my lip with her brown eyeliner to mimic Madge’s signature mole. A couple of years later, as if I’d willed it to happen, a mark appeared above my lip, just a centimetre down from where the Material Girl’s spot had been. I was no longer a fake; I was part of the Marilyn (Monroe), Cindy (Crawford) and Madonna club. Plus, my mole quintet was complete! But what I thought was a blessing—who wouldn’t like the comparison to Cindy Crawford?—became a curse when a cruel classmate took notice and used it as a source of inspiration for his playground intimidation tactics. Upset and teary-eyed, I sought refuge near the balance beams, and a teacher came up to ask what had happened. “David says that if you connect all the moles on my face, they make an upside-down house,” I said.
“Those aren’t moles, my dear,” the teacher replied. “Those are beauty marks.”
More than 20 years later, I’m less concerned about the shape my beauty marks make. Like Crawford, who has said she frets that her signature lip mole might one day become cancerous, I worry about my beauty marks going rogue. According to the B.C. Cancer Agency, one in six Canadians will be diagnosed with skin cancer at some point in their lifetime. “The young person’s disease,” it’s one of the most common cancers in young adults. This year, an estimated 5,500 Canadians will be diagnosed with melanoma, the most aggressive and deadliest form of skin cancer (the other two are basal-cell carcinoma and squamous-cell carcinoma), and 950 will die from it, according to the Canadian Cancer Registry Database.
“We are in an epidemic of skin cancers,” says Dr. Harvey Lui, head of the department of dermatology and skin science at the University of British Columbia. He says that if melanoma is detected early and treated, the survival rate is high. If it’s caught too late, the rate of surviving five years drops to 16 per cent.
Melanoma is more common in people with light skin who freckle easily, because they are more susceptible to the damaging effects of ultraviolet radiation from the sun and tanning beds. Both freckles and moles are pigmented spots on the skin, the result of increased production of melanin (the skin’s pigment). But freckles are harmless, come and go depending on sun exposure and appear on commonly sun-kissed areas like the face and shoulders. Moles, on the other hand, can appear anywhere on the body and occur when melanocytes, the skin cells that make the pigment, grow in a cluster. The ABCDEs of melanoma outline what to look for in your spots: an Asymmetrical shape, irregular Borders, multiple Colours, a Diameter larger than a pencil eraser, and any Evolution in size, shape, texture or colour.
Lui has been working for the past 10 years on the Verisante Aura, a non-invasive optical system that rapidly scans suspicious spots for 21 different cancer biomarkers. Last October, Health Canada approved the Aura, and the company expects the tool to be available in doctors’ offices later this year. Lui and his team are also working on a range of other optical techniques for the detection of skin cancer, including fluorescents (where the skin is examined using a glow-in-the-dark light method that can detect abnormalities) and speckle analysis (the pattern of light that bounces off the skin is analyzed). There are also online resources such as myskincheck.ca, and U.S. residents can download SpotCheck, a mobile app that allows users to take a photo of a suspicious mole and send it to a board-certified dermatologist, who will respond with comments.
Although skin cancer can develop in an existing mole, the good news for Cindy and me is that most melanoma appears in new moles, says Dr. Paul Cohen, a Toronto-based dermatologist. He was involved with last year’s viral hit video “Dear 16-Year-Old Me,” a public service announcement with the powerful message that the onus of checking skin for suspicious marks is still first and foremost on us. “The majority of funny-looking moles are found by patients themselves, or their spouse or partner. We just diagnose them and treat them,” says Cohen. “Women do breast exams once a month, so look at your skin.”
While atypical moles (large ones with irregular borders, which present a higher risk for skin cancer) can be hereditary, excessive sun exposure is more to blame for the formation of cancerous moles. “There is enough energy in ultraviolet rays to actually change the chemical bonds of the molecules in your skin,” says Lui. “When the DNA mutates, that’s when you start to get the potential for cancer.”
Before we spoke, Dr. John Arlette hadn’t used the term “beauty mark” in years; he prefers “mole,” a more objective descriptor. “Mole is a term that everyone can understand—beauty mark is subjective for the patient,” he says. A Calgary-based dermatologist, Arlette is a leading expert on the management and removal of facial melanoma, and he also removes plenty of moles for purely aesthetic purposes.
I visit him to try the Total Skin Review, a program Arlette developed to give patients a complete overview of their skin. As opposed to mole-mapping—a common technique that involves photographing each mark to provide a baseline for future visits—Arlette looks at the skin’s entire surface, not just spot-by-spot. “There are a lot of things that happen where the sun has never shone,” he says. (True to his point, both moles I’ve had removed were in places where the sun rarely shone: my bikini line and my
Arlette goes through my facial moles one by one, letting me know I’m in the clear. Finally, he gets to my Madonna mole. “It’s located in an open space, and the way you scar means removing the mole”—here he pauses—“removing the beauty mark would leave a large scar.” I vow to keep an eye on it. If it’s ever medically necessary, I will deal with its removal, but until then the roof of my upside-down house stays.