Having multiple moles, brown spots, or raised growths can make it difficult to know which ones are harmless and which ones deserve closer attention. A spot may have been present for years without causing symptoms, but patients often still wonder whether it could eventually represent something concerning.
Recently, a 32-year-old woman visited Village Dermatology for evaluation of longstanding skin lesions on her abdomen and right upper back, along with a comprehensive examination of her existing moles and counseling about sun exposure.
The lesions had been present for years, were asymptomatic, and had never been treated.
Her visit raises a common question:
“I have several moles and skin spots—how do I know if any of them could be skin cancer?”
A comprehensive skin examination with dermoscopy was performed. The reassuring finding was that no evidence of malignancy was identified during this visit.
Instead, her examination revealed several common benign conditions, including benign nevi, lentigines, seborrheic keratoses, cherry angiomas, and an intradermal nevus. She was also evaluated for seborrheic dermatitis of the scalp and concerns related to sun-induced skin aging.
For patients searching for a mole check or skin cancer screening in Houston or Katy, Texas, her case demonstrates how a dermatologist can distinguish common benign growths from lesions that may require closer monitoring.
Why Have a Dermatologist Check Moles That Have Been There for Years?
A longstanding mole is not automatically dangerous, but duration alone cannot determine whether a skin lesion is benign.
This patient did not have a personal history of:
Melanoma
Basal cell carcinoma
Squamous cell carcinoma
Actinic keratoses
Dysplastic or atypical nevi
Previous skin cancer
She also reported no family history of melanoma or non-melanoma skin cancer.
Even with this reassuring history, a comprehensive examination provided an opportunity to document her existing lesions and establish a baseline for future monitoring.
What Did Her Full-Body Skin Examination Show?
The examination included the scalp, face, ears, neck, chest, abdomen, back, arms, legs, breasts, hands, feet, groin, buttocks, genital area, digits, and nails.
A dermatoscope was used during the examination to evaluate skin lesions more closely.
Most importantly, no findings concerning for malignancy were identified.
Several benign conditions were documented, each with its own appearance and recommendations.
What Are Benign Nevi?
Nevi, commonly called moles, are pigmented collections of cells within the skin.
This patient's moles appeared regular, symmetrical, and evenly colored, supporting their benign appearance.
They were distributed throughout the body, including a small nevus in the right cymba concha of the ear, measuring approximately 0.3 × 0.2 cm.
No treatment was necessary.
Instead, the patient was advised to perform monthly self-skin examinations and monitor her moles for changes.
What Changes in a Mole Should I Watch For?
Knowing what is normal for your skin makes it easier to recognize something new or changing.
Contact your dermatologist if a mole begins to:
Change in size
Change in shape
Develop new or uneven colors
Itch persistently
Burn
Bleed
Change noticeably compared with its previous appearance
A changing mole does not automatically mean melanoma, but meaningful changes deserve professional evaluation.
What Was the Mole on Her Scalp?
An intradermal nevus was identified on the frontal scalp.
An intradermal nevus is another type of benign mole. In this patient's case, no treatment was required.
As with her other nevi, she was advised to monitor the lesion and contact the office if it changed in size, shape, or color or developed symptoms such as itching, burning, or bleeding.
Scalp lesions can be particularly difficult to monitor independently because they may be hidden by hair. Including the scalp during a comprehensive dermatologic examination can therefore be useful.
What Are Lentigines?
The examination also identified lentigines, appearing as light tan macules in areas associated with sun exposure.
Lentigines are benign pigmented lesions associated with sun-exposed and sun-damaged skin.
They do not require treatment for medical reasons.
Depending on a patient's cosmetic goals, options discussed for lentigines may include:
Sun protection
Retinoids
Bleaching products
Chemical peels
Laser treatments
For this patient, an important part of management was preventing additional sun damage.
How Much Sunscreen Should I Actually Use?
The patient received detailed sun-protection counseling.
A broad-spectrum sunscreen with SPF 30 or higher was recommended, with application approximately 15 minutes before expected sun exposure.
She was also advised to:
Reapply sunscreen approximately every two hours during ongoing exposure
Reapply after swimming or significant sweating
Use approximately one ounce for exposed body skin
Protect the lips with an SPF-containing lip balm
Consider sun-protective clothing
Consistent sun protection helps reduce additional ultraviolet damage and plays an important role in preventing photoaging.
What Are Seborrheic Keratoses?
The patient's examination also identified seborrheic keratoses.
These are benign, often waxy or warty-appearing growths that become increasingly common with age.
Seborrheic keratoses generally do not require treatment.
However, because pigmented or raised growths can sometimes be difficult for patients to identify on their own, an examination can help determine whether a lesion has the expected features of a benign seborrheic keratosis.
What Are Cherry Angiomas?
Cherry angiomas were also identified throughout the patient's body.
These are benign vascular growths and do not require medical treatment.
Patients who want them removed for cosmetic reasons can discuss procedures such as laser treatment or electrodesiccation with their dermatologist.
The presence of cherry angiomas does not mean that skin cancer is present.
Why Was Her Scalp Flaking?
In addition to her skin lesions, the patient was found to have seborrheic dermatitis of the scalp.
Seborrheic dermatitis is a chronic condition that can improve and flare over time.
She was advised to wash her hair regularly, avoid applying oil serums directly to the scalp, and limit conditioner primarily to the ends of the hair.
She was prescribed ketoconazole 2% shampoo.
The instructions were to lather the shampoo into the scalp, leave it in place for approximately 5–10 minutes, and then rinse. It could be repeated one to three times per week for maintenance.
Why Does Seborrheic Dermatitis Keep Coming Back?
Seborrheic dermatitis tends to be chronic rather than a one-time rash.
Patients can experience periods when the scalp is relatively clear followed by recurrent flaking or irritation. Stress may also contribute to flares.
Medicated shampoos can therefore become part of a maintenance regimen rather than simply being used once.
Patients should contact their dermatologist if seborrheic dermatitis continues worsening or does not improve despite treatment.
What About Fine Lines and Sun-Damaged Skin?
The patient also asked about fine lines around the eyes and photoaging.
Photoaging, sometimes called dermatoheliosis, refers to skin changes associated with cumulative sun exposure. These changes can include:
Fine lines and wrinkles
Uneven pigmentation
Changes in texture
Thinning of the skin
Daily broad-spectrum sun protection was emphasized as an important part of preventing additional photoaging.
Vitamin C serums were also discussed for antioxidant and collagen-supportive skin care.
Cosmetic procedures, including microneedling and laser resurfacing, were reviewed, while the timing of other cosmetic treatments was discussed in the context of the patient's breastfeeding status.
Can Tretinoin Help With Photoaging?
Topical retinoids such as tretinoin are commonly discussed for concerns involving skin texture and photoaging.
A prescription for tretinoin 0.025% cream was documented, with instructions to apply a pea-sized amount to the full face two to three nights per week, moisturize afterward, and gradually increase frequency as tolerated.
Importantly, the visit documentation also notes that the patient was currently breastfeeding and that tretinoin and Botox were discussed as cosmetic treatments not recommended until breastfeeding was completed. Patients who are pregnant, breastfeeding, or planning pregnancy should therefore discuss retinoid use directly with their prescribing clinician before starting treatment.
Why Are Self-Skin Checks Important Even After a Normal Exam?
A reassuring examination is good news, but it does not mean patients should stop monitoring their skin.
Skin changes can develop between office visits.
Monthly self-examinations allow patients to become familiar with their existing moles and spots so that a meaningful change is easier to notice.
This patient's existing lesions were benign during the current examination, and observation was appropriate.
If a spot begins changing, however, she was advised to contact the office rather than simply waiting for a future routine visit.
When Should I Schedule a Mole Check?
Consider a dermatology appointment when you notice:
A new or changing mole
A spot changing in size, shape, or color
Unexplained bleeding
Persistent itching or burning
A lesion that looks noticeably different from your other moles
A growth you cannot confidently identify
A scalp lesion that is difficult to monitor
Multiple lesions that you would like professionally evaluated
You do not need to wait until a lesion becomes painful before having it examined.
Mole Checks and Skin Cancer Screening in Houston and Katy, Texas
This 32-year-old patient's visit provides a reassuring example of why professional skin examinations can be valuable.
Although she presented with longstanding lesions on her abdomen and upper back and wanted her existing moles evaluated, no findings concerning for malignancy were identified during her examination.
Her skin findings were consistent with common benign conditions, including benign nevi, an intradermal nevus, lentigines, seborrheic keratoses, and cherry angiomas. The visit also provided an opportunity to address scalp seborrheic dermatitis, sun protection, and photoaging.
If you have moles, brown spots, raised growths, or a lesion you are unsure about, a dermatologic examination can help determine what can simply be monitored and whether any area requires additional evaluation.
Patients looking for a mole check in Houston, Texas, skin cancer screening in Katy, Texas, or evaluation of a suspicious or changing skin lesion can schedule an appointment with Village Dermatology.
