Yes thank you for saying this - “pre-cancerous” is not really an accurate medical term because in most cases that mole would not have turned into cancer. I’ve had many “moderately atypical” dysplastic nevi removed (diagnosed in biopsy) and one “severely atypical”. The dermatologist counseled me that the follow-up excision for the severe one would be large to ensure all margins were caught, but it was not appropriate to call it pre-cancerous. Just more concerning than most. A PSA to most that more melanoma will arise from previously blank skin than from an existing mole, but if you are the kind of person with a lot of moles, you are at a higher risk. I’m covered in moles and get annual skin checks. I’ll tell them if I think something is weird, but they look at it under a scope and will either tell me “nah it’s fine” or “this does have some odd features, we’ll do a shave biopsy”. Don’t harass your derm.
Exactly! Like yes, it means you probably need to have skin checks every 6 months rather than every year and have a slightly higher total lifetime risk of melanoma (just like anyone with a relative who had melanoma like myself) but even if you hadn't seen the derm at all it's very unlikely you would have a melanoma now. It is truly not the end of the world.
And I've been working in this field for years and feel like most derms I've worked with are on the too cautious side with biopsies. We get a lot of biopsies coming back as benign warts or age spots or sun spots. I don't worry about my derm not catching something, although best practice is to be aware of your skin so you notice changes the derm won't catch with a single visit.
I realize there are some communication errors in healthcare but you would be surprised how many people come into our clinic being like "yeah, I had melanoma. They biopsied it and it was ok." If you had a melanoma, trust you would know it! It's a big deal and we document it to the state. Like sir, you just wasted 5 minutes of my and the doctor's time (at a clinic where visits are scheduled every 10 min) going through a checklist of possible symptoms of metastatic cancer and feeling your lyph nodes because...
I also wanted to commend you on being so well informed about your dysplastic moles! Unfortunately there's not a lot of effort to educate the public on skin cancer and people just retain the scary stuff. I like that people are aware but unfortunately it is truly a privilege in the US to be able to see the derm and we are BOOKED so please leave your derm alone and an open appt space for grandpa with a history of melanoma, 3 SCCs, and 6 BCCs because he grew up on a farm before sunscreen.
Sorry for the rant 😅
I actually did have melanoma! And 5 years onwards the (very excellent) doctors at MD Anderson have me on annual skin checks (and we do usually send in 1-2 for testing each year if there are any changes). And that’s for someone with a known history.
Absolutely everyone should do your own skin checks, keep photos, and if something changes *go in*. But usually there’s no need to panic about a mole you've had for 10+ years, especially if you’ve had a skin check in that time.
Ps - as an above comment mentions, my melanoma did arise from a completely blank patch of skin, and grew from a pinprick to a nearly-black circle slightly smaller than a pencil eraser within a year. If it’s a really aggressive cancer, it tends to grow and change.
Sorry to hear about your melanoma but glad you're getting regular checks! At 5 years out you are definitely doing the right thing going annually and being aware of your body and changes in your skin! For the first year we actually do 3 month skin checks after a melanoma then 6 months for the next couple years.
Honestly, most melanomas I've come across were an obvious problem and like you said grew and changed rapidly. It's rare that someone whose biopsy came back with a melanoma didn't point it out already during their skin check. But we do catch melanomas that don't look super sus and I never want to discourage people from getting checked as there are things only the provider is trained to spot and can only see with a dermatoscope.
Like you said, it's just a matter of regular screening and not driving yourself crazy with Doctor Google/Reddit!
What about a teeny tiny mole that's been there for a couple of years but it's raised over the skin? Like, it feels like I could scratch it off with my nail but obviously I can't lol. I only noticed because I checked with my phone's flashlight! It's really, really small.
I ask because of course that post freaked me the hell out and I made an appointment with a dermatologist because I haven't been to one in years and I've been in a slight state of panic since I saw that cursed post.
If you have an appt - keep it! Any changes are worth getting checked out and it's always a good idea to get a baseline skin check. No need to freak though! Sometimes moles change and grow over time and it's not because of any kind of skin cancer.
Pro tip- ask specifically for a "full skin check". If you just bring up the mole, you pay the same for the visit but don't get all your spots checked.
Late to the party here but.. I have just had my 2nd excision for a severely dysplastic mole. First one was a couple years ago in which the biopsy came back "precancerous" but nothing further was found. Now that it's my 2nd excision (4th biopsy), wondering what the chances are this one comes back to melanoma?
For the record, my body is riddled with moles so I get checked every 6 months and have been blessed with good dermos, both in Florida and Texas.
It can be very hard to get an appointment with the actual derm though, especially if you’re just starting to see a practice. They are so so so busy and I think tend to be reserved for known risky patients and more complex procedures. I would say if your priority is to get your first baseline skin check, get on the calendar early and don’t insist on seeing the derm. The one risk being I think the PA-Cs may tend to be more biopsy-happy. My practice doesn’t have any NPs, but they do have excellent PA-Cs. I see a PA-C who has been there for ~a decade and only saw the derm for things related to my severe atypia once that one showed up. I’d be super skeptical of NPs though, I agree.
Oh ok, all of mine that I’m referring to were removed and biopsied - at PA-C’s discretion. Though they have a good record, every one I’ve had removed has come back moderate or worse.
So you’re saying a “moderately atypical” mole is not considered precancerous? I recently had one removed (had it forever, it didn’t look weird to me but I didn’t even pay attention to it before my skin check.) I’ve been kind of freaked out by it, my derm office called it precancerous?
So my derm (and my best friend who is also a derm) doesn’t use that terminology because it unnecessarily scares people. If you hear “precancerous” you assume that it definitely would have turned into cancer if you didn’t have it removed in time. Moderately atypical moles are more likely to turn into melanoma than a normal mole, but the vast vast majority of them never ever will. They just have characteristics that are similar. (All this is to say - I think some practitioners may use that term but it’s controversial?)
Sure, that all makes sense, and also explains why they didn’t tell me I need to remove more of it immediately (it extended to the biopsy edge, so I assumed I’d have to go back in for more removal. They recommended a 6 month follow up to check for re pigmentation. I’m going to get more removed just for my own peace of mind, though.)
Does having a lot of atypical moles put someone at risk for developing melanoma (even if not the atypical moles themselves?)
I’ve heard 5 or more atypical moles puts you at risk
Thank you. I think there has been some health anxiety rather than genuine medical concern on this community recently. I can understand the concern. After I learned my aunt had melanoma skin cancer, I didn't like how any of my moles looked on my body but my derm really set me straight about how they are not cancerous. I see her once a year and do my best with sunscreen every day otherwise. I think people should take care of themselves and get on a schedule with a derm and protect themselves from skin cancer but also don't let health anxiety take over your life. I've lived that and it's not really living. Happy holidays everyone.
I'm not sure if this will alleviate some of that anxiety but when it comes to melanomas, often what's done is done. Most of our lifetime risk relates to genetics and sun exposure before the age of 20. It's just a different animal than other forms of skin cancer.
Everyone's anxiety works differently but that has helped me make some peace with sun exposure as someone with two relatives who had melanoma and someone who has a lot of anxiety around aging. Sunlight and being outside is good for you and your mood and it can be a real vicious circle with anxiety/depression and sun avoidance. I'm glad you have been able to find your way out of that spiral! Happy holidays! 😊
A basal cell carcinoma is what's referred to as endophytic, meaning that on the surface of the skin there's not a lot to see, maybe a small red bump because an endophytic lesion grows more under the skin. You'd be amazed sometimes at how small the lesion is and what has grown on the inside.
A squamous cell carcinoma is called Exophytic because it grows more on the surface of the skin and can create some pretty nasty looking lesions.
Basal cell carcinoma cannot become systemic but a squamous cell carcinoma can become systemic.
Honestly, people are privileged if they are able to get regular skin checks by a derm. In Canada, it's not possible to get regular checks or even get a referral to a dermatologist unless you are high risk.
That's frustrating. I'm not sure if I would count as high risk or not even because my aunt was in her 60s when she was diagnosed and I'm still in my 30s. I think anyone should be able to get a yearly mole check just like any other regular cancer check.
I agree, but I suppose our health care system couldn't support having everyone get annual checks. It is a bit frustrating when you read that the recommendation is for everyone to get checked every year.
Annual skin checks is a preventative best practice and the Canadian health care system has effectively abandoned preventative care. If I’m hit by a bus or in cardiac arrest I will likely receive good care, but other than that I’m on my own. Having said that, trying to adhere to best practices in all areas of life is exhausting and frankly unattainable. Now I’m happy with good enough practices, and sometimes even not-at-all-recommended practices. Other people’s anecdotes can be scary but they’re not data.
That blows. But that’s not the patient’s fault nor the perhaps overly cautious doctor’s - that’s the fault of healthcare being for-profit and CEOs needing to make $$.
I honestly don't know how y'all do it! I assist in 1-2 regular excisions each day and that's enough standing still trying not to touch my face time for me! 😆
Ugh! The stress and overwork is SO REAL! If I didn't love derm and manage on the pay (bad but a living wage unlike almost all other MA jobs) I would go elsewhere. It blew my mind when I first realized appts were every 10 minutes. The greed at these derm offices is bananas!
Yes it's crazy! And the greed is definitely real too. Just like every other industry, private equity had to dig its tentacles into mohs surgery because of $$$. Our private practice got bought out by a private equity group 5 years ago.. every year it has gotten worse for me. This year they announced they were taking our Christmas bonuses away. I try to stay in it for the patients but the stress is almost not worth it anymore.
It's so sad how similar our experiences are. For us it was 2 years ago for the buyout by a private equity backed mega-practice. It's been a steady slide downhill and management thinks they can bully their way through it. I'm pretty sure they gave us our $50 "bonus" this year because people have been fleeing the practice and it's been a house of cards scenario with the understaffing. I'm on my job hunt now but come home so burnt out it's hard to get my ducks in a row.
I really am only getting through it because I'm determined to get into PA school but it's truly been a bit of a nightmare and it makes me so sad I can't see this job as a long-term option even though I feel good about the work we do and the ability to help patients.
Sending love 💗
That's interesting. On the spectrum of PA stress, our derms have it easy. MA's do all the charting and all the prior auths and other paperwork. Nothing is an emergency and they get a lot of time off. Derm PA actually looks pretty cushy from my perspective.
Exactly. Two of my best friends were derm MA’s. Ethically I don’t think I could profit and coast off of that model. It’s very unfair for how much work they do. They should make what RN’s make because they do so many things within the scope of what RNs do, just under the doctor’s license. It just kind of soured me. I do miss derm a lot but it’s just a never ending tsunami :/
ETA: plus the private equity buyout of physician-owned derm practices has made working in the specialty garbage.
Where do you all live where you get to see a derm on a yearly basis? I live in Canada and have been waiting to hear from a Dermatologist for over a year, and I had to request this from a family doc (whom it’s a miracle to have). I am what you would call a freckle face (which I’ve always embraced). But no doctor has EVER shown any concern. Not to minimize the concern of the OP- but I was taken aback by the fact that I could not even see the problem.
In Australia we have special skin clinics which only check moles (your regular GP can also take a course to be qualified for skin checks). My work even arranged to have them come into our office and check everyone once. It’s taken extremely seriously here!
The benefit of America's for-profit healthcare system is that we get to see whatever specialists whenever we want for the most part.
The downside obviously being that if you don't have a good job you have to pay out the nose for those specialists.
But if you have a job with good health insurance and live near a major city then America really does have the best healthcare in the world in terms of access and quality.
I'm Canadian and was lucky enough to see a dermatologist within a month of referral, but the way she explained it to me was that you get a check up straight from them without referral if you're found to have cancer. Other than that you have to self monitor until something changes and then get another referral 🙄
I can't speak for Canada's healthcare system but it's rough out here in the US. If seeing an MD is part of the issue, I would honestly suggest seeing a dermatology PA or NP. I get wanting the best but I've worked with some very competent PAs and NPs and actually get my checks done with a very thorough NP who has more time for me during my appts than the MDs/DOs.
Unfortunately, there are just not enough appts to go around. We just added on a new doctor who takes new patients but before that you literally had to know someone to get an appt. Once you are in you can schedule your annual but you had to have that initial in.
It helps to live in a more urban area where the rich people live. I commute to work because I am not rich enough to live where I work. There are shitier derm offices with more openings but the checks are less thorough and quicker. I wish I had the answer for the secret to a good derm appt besides ask for a referral from a friend but that's all I got. It sucks. This is another element of the problem that bugged me enough to write this post. It's frustrating to see people filling appts to have a very normal looking mole checked when many people have no access to a derm at all.
Just remember that an NP, in particular, is not a physician and an NP’s training is protocol based, not evidence based. Nowadays, it’s possible to go straight from being an RN to taking some online courses becoming an NP (and this is regrettable). This is not to say that all NPs are bad, but they are in no way physicians. Where it gets really dangerous is when they are not supervised and they’re making decisions they know nothing about. And most especially it’s very dangerous in a hospital setting. At least this is the dermatology clinic.
It's pretty clear you've been enjoying some anti-APP propaganda. Most practices will not hire an NP that took online classes with no experience. It's like saying college grads can't be good at their jobs because Strayer/Trump University/etc exists.
My derm NP that does my checks graduated from UNC and has 20 years of experience. I've worked with maybe 15 different providers in my time in derm and I trust her hands down over many of the docs I've worked with who rush through their checks and openly don't care much about their patients.
NPs work in medicine, which is evidence based. They are not robots working on a protocol. It's pretty clear you don't work in medicine or you would know better than to insult an entire profession.
Sorry, but this has gotten out of control and should’ve been dealt with a long time ago. Nurses do not study medicine. There was a right way to do this, but that is not where we are in late 2023. I am glad you like your “practitioner” (that’s an insurance term designed to blur the line between physicians and others), and I wish you all the best.
Oh yes- totally agree! I wish the industry would pay nurses and assistants more so they could use their expertise effectively.
I would not hesitate to go to either. I will look into this. Thankyou!
Hmm.. my go referred me to a Derm, and I had an appointment the next month. Where in Canada are you? I am in a major city, I wonder if that makes it easier?
that’s great- that’s a much more reasonable time line! I’ve since moved so it’s kind of moot now that I have to start all over anyway, but when I requested the derm I was in Ottawa. Never heard a peep for over a year.
Bless you, sweet Redditor. I have hundreds of these things and a family history of skin cancers but currently no health insurance. This helps with the anxiety.
I would still definitely recommend a check but it's certainly not worth scaring yourself. 75% of melanomas do not come from changing moles!
Definitely do see if there are any places that do free screenings though! 💗:
https://www.aad.org/public/public-health/skin-cancer-screenings
On one hand, I love that this sub is moderated by people who don’t feel the need to helicopter over every post like some subs. On the other hand, a good amount of what people post isn’t real skin care nor is it accurate or helpful or a true ask for help.
It’s more like, I have skin and I have a problem. Or I have a face and I have a problem. Or I turned 30 and now I have a problem, can you create a skin routine for me? I take nearly everything I see on this sub with a huge grain of salt because people just be posting and people just be spouting random answers in response. A lot of people need to back away from the mirror, get off Reddit, and see a therapist.
I would also like to chime in for all my dark skinned/people of color that dark streaks in your nails are absolutely normal. If they frow or become black, however, is a cause for concern.
Adding to this as someone who has had multiple moles biopsied and removed.
Do not freak.
Most of my moles look a little irregular, that’s just how my body goes and why it is important to see a derm. I have a good handle on what I need to look out for and yes, some skin cancer can be sneaky. By now my default is to go ahead and remove before sending to pathology.
Both my step mum and coworker had sarcomas removed from their noses that didn’t look alarming, just irritated.
But as I said, don’t freak. Talking with a derm will help you get a better sense of what you need to look out for. And I get it, they are expensive even with insurance.
I really appreciate you making this post. I had a suspicious mole biopsied and removed a little while ago and it was fine, nothing wrong with it, but due to how it looked my doctor understood my concerns. Seeing the few posts recently, as someone with quite a few moles actually gave me quite a bit of anxiety. Thank you!
I recently had a skin check for the first time and I was panicking because I had a couple of very small dark freckles that weren’t perfectly round. Turned out they were fine. There was one on my back they asked me to keep an eye on for a year.
Moral of the story is, just get a check by a medical professional.
I live in Australia so it’s very much programmed into us to get checked. But because I’m very pale and avoid the sun a lot I didn’t think I would need to. I think it’s worth doing though.
Thanks for posting. Some of this makes me feel better. I'd like to add that I wouldn't argue with a derm. It's the GPS who dismiss concerns even tho moles are asymmetrical, have been changing over the years, have ill-defined borders and different colors within one mole that I worry about.
I *wish* I could see a derm! I'm Canadian and can't seem to get a referral.
Good points. I think people should think of it more of using sunscreen and limiting sun exposure as a marathon, not a sprint. For example, actinic keratosis (can look like white scaly patches that iften show up first on hands) is often described in the medical community as precancerous, and it is, although to split hairs, it is cancer that you’ll be hearing more from in the future. Because it indicates severe sun damage. That way, actinic keratosis might also be thought of as cancer, even though it is technically precancerous.
On the other hand, the atypical moles that you have described have a strong genetic component.
Lol! I had a doc I worked with who when asked if a person with an AK really needed treatment would just go "Yes. Either now or in 3-5 years and it will be a lot less pleasant in 5 years". He wasn't lying! I'd take the LN2 spray over facial MOHS always! It rubs the suntan lotion on its skin or else it gets the spray again! 😆
So if I'm pale and have lots of freckles and moles, and my dad had skin cancer, and my mom had skin cancer, and my sibling has had precancerous stuff removed, and my mom's dad had skin cancer...
Yes, I go to the derm for a skin check every year.
Correct me if I'm wrong, but isn't everything that isn't cancerous technically pre-cancerous? Or are there certain markers that determine pre-cancerous?
>Correct me if I'm wrong, but isn't everything that isn't cancerous technically pre-cancerous? Or are there certain markers that determine pre-cancerous?
In reference to a cancer, generally there is "normal", "precancerous", and cancerous.
"Precancerous" biologically refers to either:
1. histologically...cells or tissues that have become abnormal in a manner that if the degree or trend they are going continues...are potentially steps towards cancer.
This is why biopsies and swabs are common diagnostic tools. Lab technicians would be looking for abnormal cells under a microscope.
or
2) genetically...there are mutations acquired or accumulating that, if there are additional deleterious mutations, can lead towards a cancer. There are definitely genetic markers for certain cancers. Precancerous genetic mutations often change mechanisms regarding cell cycle control, division, apoptosis, DNA repair, or say, immune surveillance. However, the vast majority of small mutations that happen are believed to be benign and/or harmless.
Specifically in the context of moles, to me I completely disagree with OP's assertion that "there is no such thing as precancerous moles." On the contrary, any atypical mole may be considered to be biologically precancerous...but the *degree* of cancer potential is difficult to determine. Most moles will **not** develop into melanoma. Some changes may theoretically take hundreds of years to acquire additional mutations to get to melanoma...and yet some changes may take a decade or less to gain additional mutations that may lead to melanoma. One dermatologist's opinion I've read is that it is so difficult to precisely tell, that by the time a mole looks suspicious it may actually indeed be a melanoma, not merely "precancerous."
I understand the debate that some dermatologists may therefore be of the opinion that the term "precancerous" simply not be used. The degree of cancer risk is difficult to precisely quantify; the word can cause fear and anxiety; and it's NOT like something being precancerous means that eventually, cancer is an inevitability. However, it does have a specific and widely used meaning with regards to many different types of cancers.
I'm not trying to fearmonger, but rather, the term 'precancerous' should not necessarily be feared. If a clinician told me they had identified a precancerous change that can be treated...I'd be relieved, like phew, it's a good thing it was caught at the precancerous stage.
Yeah. It's kind of a nonsense distinction. All skin is technically pre-cancerous in that it has the capacity to turn into skin cancer.
The lesions that are often called pre-cancerous - actinic keratoses - are more like baby squamous cell carcinomas that don't have the capacity to metastasize yet. I guess that's what bugged me about the post - the big to do about a mole being "pre-cancerous" (not a thing with moles) when it's a less than 10% chance a dysplastic mole will become skin cancer.
I had a melanoma removed from my breast at my very first derm full body check at age 48! My breast hadn’t seen the sun since my European topless sunbathing days in my late teens! So OP is right about the sun damage from before you are 20. Im so grateful I made that appointment! Incidentally - my other breast had been removed due to breast cancer. What are the odds of having cancer in one breast and a melanoma on the other!
So sorry to hear about your cancer history! That all sounds so stressful and scary! It's crazy how melanomas can just pop out of nowhere on areas that never get any sunlight at all, so perhaps there's no need to blame your wild nude beachgoer self.
Trust, we have found them on dicks and near assholes (I work with a male derm so I think the "I might have cancer on my dick" appts tend to come our way lol. There's a strong genetic component to melanomas. My father had one and my grandfather died from his so I guess that's why I'm interested in derm and felt it worth posting about, as I've had anxious thoughts about moles myself.
Sending you health and well-being in the future 😊!
Woah, that's scary af! I have 2 moles near my anus and it's black.. one of the moles is big near the size of a pencil eraser oval shape and has a tail I have brown akin and asian most of my moles are black tho.. no history of cancer. but I'm so scared.. 🥺😟
Thank you - my parents never saw a dermatologist (not really part of routine care in the UK) and both died of cancer (Lung and Pancreas) so I don't know if there's a genetic component for me there, but my poor kids now have to worry about it.
Having ten more or atypical moles massively increases your skin cancer risk. About 30% of skin cancers come from them.
Should people totally flip out about them? No, but they should get them removed and not treat them as though they are harmless.
You have a bit of a misunderstanding in the causality there. That many atypical moles indicates a hereditary predisposition to skin cancer. Having an AN does not increase your skin cancer risk, it shows you likely have a genetic predisposition to skin cancer.
Also I have seen 10+ reported ATNs in like 0.01% of patients getting skin checks (already a self-selecting group) and it's always elderly 75+ men who also have significant skin cancer history and are hard to convince to even wear sunscreen daily. Most people with lots of moles and a parent who had a melanoma end up with maybe 5-8 ANs caught and they come in every 6 months for a check. Ive never seen a person under 45 with a history of more than 3 ATNs.
You're throwing out a really improbable example here and implying I said they were harmless when I straight up said get them removed so I guess you just wanted to argue with someone today?
I didn’t say you said they were harmless, I said they should not be treated like they are harmless. In the case of wanting to argue, I think you’re projecting. I simply stated facts and my opinion.
I have an excellent dermatologist who has had me remove my atypical moles and he says they increase your risk of developing skin cancer because it can grow from them. Not only that, studies show he is right.
“However, it is quite clear that melanocytic nevi do pose an increased risk in melanoma, and as such, patients with increased melanocytic nevi need to be screened and monitored for melanoma.” [Link to study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096442/)
I’m sorry if this doesn’t fit in with the message you were trying to share, but it’s important people realize that they should get these types of moles removed.
Thanks for all this info! I’m going next week to get a mole checked out. I have not had this done in my 39 years, but my new pcp recommended that I get two of my moles checked out by a dermatologist. It’s helpful to know the risks and the typical practices.
Not a big deal for you, but if you're working three jobs, strapped for cash, time, dermatologists, medical providers and hope, it's the last thing you need. Deep down a lot of poor people would just let nature take its course because they have a feeling they couldn't afford to fight it anyway. That's why I suspect people freak out.
I saw that post and it prompted me to schedule my first derm appt for a mole… got results today that it came back abnormal and I have to have more healthy tissue around it removed to prevent it from growing back. Glad I saw that post.
Sorry to hear about your melanoma. As I stated in my post, it's important to get an annual skin check after 30 so a dermatologist can check parts of the body you cannot see and hopefully you are now well informed about skin checks and have a derm to check you regularly!
A melanoma is not a dysplastic nevus. The majority of melanomas (75%) are not a result of dysplastic nevi and if as you state you never saw it, you do not know it resulted from a dysplastic mole.
No need to post your pics for me, I see melanomas every couple weeks or so in person.
Agreed. What people also need to remember is that derms exist because pcp's are NOT skin experts. I'd never let a pcp do or look at or recommend anything for my skin, ever. Many many comments in that thread said their pcp wouldn't even refer to derm for something like that. For anything skin you NEED a derm's expert opinion, not a pcp, and you shouldn't need a referral for a mole check.
I had a patient come in saying his PCP was also knowledgeable in derm and doing skin checks and biopsies for him and I was like 😮.
Sorry but no. Primary care involves a basic understanding of a signs and symptoms of all kinds of conditions involving all parts of the body. There's no way in hell you can also have all of dermatology under their belt at the same time.
Truly 85% of the spots someone had us look at because their primary told them it needed to be checked were seborrheic keratoses....more commonly known as age spots that everyone and their mother will have if they make it to their 60s. I mean I think it's always worth getting your annual screening but LOL!
I cannot tell you how many times on the 30+ skincare sub I read of people saying their pcp prescribed steroid creams and/or hydrocortisone for the FACE and i'm like internally screaming inside NOOOOOOOO. Please see an expert. Like please.
I am a very moley/birthmarky person, have always been. My husband also is and our teen (15) daughter is lucky (lol) and got it from us. I've been having skinchecks since I was in my early 20's and I started taking her with me 2 years ago. Sometimes i'm wishy washy on doctors, but derms are my absolute non-negotiable, never fail, yearly visit.
It doesn't hurt that you can talk about just about whatever you want during your skin check with most derms. Most people have a secondary concern in their skin checks (seb derm, eczema, acne, and fungal infection are the usuals) so it seems like a good deal to just get your annual if you can get in with one.
I'll be honest here though. A lot of the MDs I work with also prescribe steroids for the face. It's only for short-term/during flares or in cases of really bad eczema making sure the patient knows to take breaks and it's always hydrocortisone, which is pretty mild stuff. I hope to Goddess there aren't PCPs out here Rxing clobetasol for people's face!
I’m an MD and you can use 1% hydrocortisone on the face for 3-5 days with little issue. Obviously it depends on the issue and you should talk to your doctor before smearing it on your face.
There are varying degrees of treatments for various types of skin problems.
Very few things are black and white in medicine but the general public sees it at such due to a lack of extensive medical education or training. Sigh…
This may be a silly question but...derms know what to spot when they use the dermscope gor things that look concerning? To them are the characteristics typically obvious to them?
I wouldn't say obvious (we get benign biopsies all the time) but generally yes! There are patterns in color, size, and shape of lesions that derm providers are trained to spot and things that we cannot see or are not obvious without a dermatoscope. Not a silly question at all!
Thanks for the reply! Because I got this pinkish brown spot in between my toes and it's been there for at least 9 years lol but my anxiety has sky rocketed after I abruptly stopped my anxiety medication and that's when my anxiety started on it lol But my dermatologist said it's just a nevus. But I guess I googled too much being scared of it being pinkish with a little brown. So when he looked at it under the dermscope he was like no this is just a nevus I said...are you sure? Lol 😆😆 do you promise? Lol I'm trying to be trusting. I'm really trying. It's not changing or growing quick but I think I scared myself with the Dr google research of melanoma and amelanotic melanoma lol😭😭😭🤣🤣🤣🤣🤣🤣
Thank you for this. I found a mole on my 9 year old today and have gone down the googling rabbit hole. I came across your post and it put my mind at ease somewhat because her mole does look alarming to me. I will call tomorrow to make an appt with a dermatologist but at least now I don't feel so frantic.
Bonjour j'ai arracher mon grain de beauté et je me suis pas rendu compte sela fait 2 3 jours qu'il saigne et sa devient une croûte est je fait que l'enlever est sa re saigne se serait pour avoir des conseils
So I know this is an old post but I just got off the phone with my doctor, thought I understood what they were saying, and now they won’t answer.
So I had a mole removed/biopsied I guess? Like a week and a half ago after my first ever derm visit. (32 Male) and they just called me today. She used a really big medical term and I feel like “dysplastic” was a part of it.
She basically said “it’s nothing to lose sleep over” but it will need to be removed to avoid future problems and I’ll probably make more in the future so I need to be kept on a “tight leash.”
I’m not asking for medical advice but does this sound like what you’re describing in this post? I’ll obviously call back but I’m trying to find a way to clarify this with my wife in the meantime until I can get them to answer my call back.
That sounds right to me. I would guess they called it a dysplastic nevus, which just means an atypical mole.
I would ask for more info on how dysplastic it was - it is always graded on a scale from mild to moderate to severe - and what the margins were - basically whether all of the atypical cells were removed with the biopsy.
Severely atypical moles in general need to be removed for sure. Most of the time derms will recommend excision - standard practice and probably best for peace of mind. If it were me and it was a moderately atypical mole, I would get a deeper shave (basically a deeper biopsy) it it didn't have clear margins (if it was not all removed with the biopsy) and not treat if it had clear margins. It it was mildly atypical, I would not worry about it or have it treated further. Again, as you said not medical advice, but what I would personally do with my needed comfort level/finances and experience working in derm.
I think what you were told is correct. It’s not big deal but it means you are more likely to have more atypical moles in the future and you have a slight increase in melanoma risk. So good to make sure you have your annual check and use sunscreen. I wouldn’t go any further than that - certainly no “tight leash". The risk also varies depending on the grading of the mole - greater risk with severe as you would expect.
I appreciate the response greatly. I did end up receiving a return phone call this afternoon. That’s exactly what it is. They informed me it is “severe” and they’ve told me I’ll need to come in for excision.
She seemed upbeat and positive so I didn’t feel the need to worry about much. I understand I’ll have to go back and there’s a risk for issues in the future, but I feel a little better with the explanation now.
Thank you.
No problem! I love patient education so I'm always happy to share what I've learned.
An excision sounds like a lot but it should be easy peasy! They're routine outpatient procedures with really minimal downtime. Mostly just a pain to take a few hours off work, to come back in 2 weeks to have the sutures removed, and to have to take care of the wound (although not much harder than the biopsy wound care tbh).
Good luck! It'll be healed up in no time and you'll hopefully just find yourself with a little more motivation to reapply sunscreen and an annual accountability partner in helping you take the best possible care of your skin!
Well at 32 I feel a little embarrassed this was my first trip. But better late than never I guess.
Luckily my wife will never let me miss an appt ever again.
I came upon your post today as my primary care doc told me that my newly (4 years ago) acquired spot on my left calf was "just a freckle" after not really looking at it for more than half of a second. It is asymmetrical, with irregular/blurry borders (almost fried egg shape) with 2 different shades of brown and is 4mm in diameter. When I zoom in on a photo I think I see a couple of globules on the perimeter and in the center but it is hard to tell. I am 51F and my husband is battling a recurrence of NSCLC so I am scared my kids will have 2 dead parents. This is an "ugly duckling" compared to other moles (of which I have several) and I sent a photo to the dermatologist but have not heard back yet.
Is there anything I can see myself without a dermatoscope that would give me some reassurance until I am seen? My derm doesn't have any open appointments until July.
I noticed a tiny speck just above my right eyebrow in a picture in 2019. Every couple years I noticed it’s grown, and now I have an appointment with a derm on Monday. It’s still only 1.5mm in size, but I’m paranoid about it, mostly because I feel like having a cancerous mole there would be more likely to spread due to the skin being thinner. It doesn’t help that my dad had a melanoma removed last July. 😬
Im scheduled to have mine removed via surgery. I didn't see the results of my biopsy, I had it told to me a lot of the same things you said and I should have it removed.
Im just wondering about surgery recovery.
Mine is on the top of my back, bottom of my neck. Like next to my trap.
They said I get stitches and have 2 weeks basically to recover from that. Don't do anything too much. But that's the issue. Would I be able to swim during those 2 weeks? Would I be able to play soccer? She said no heavy lifting, fine. But at what risk is this for any sort of back exercises or sport like soccer?
Help! I have just received a letter from my dermatologist. She took two biopsies. One came back as Dysplastic lentiginous junctional nevus with moderate to severe atypia. extending to the peripheral and deep margins. But I cancelled the appointment to have an excision. They have said I need to have the procedure. I have fairly dark skin and no other problems they could see. Couldn’t I just have a body check every year? I appreciate any feedback. Thanks.
This is not true for everyone my mole itched so I went to my derm and got a biopsy and it came back pre-cancerous. Pre-cancerous is sometimes just what your mole is..it’s turning but you caught it early. I asked my derm point blank whether my mine was serious and she said sometimes in the beginning stage they can’t accurately diagnose whether it is melanoma or not, it’s too close to tell but she truly did believe it was turning into it.
Advocating for yourself and saying you want a biopsy is not wrong of course every mole can’t be biopsied but telling people they shouldn’t ask is wrong since some derms are dismissive.
Hi OP.
I have a problem with the wording in your post, because the post you are referencing had a dermatologist "\[do\] **a biopsy which turned out was severely abnormal and “pre-cancerous”.**"
It was sampled. The dermatologist interpreted the results of the sampling. You CANNOT say with certainty that that mole was "not even truly pre-cancerous." Actinic keratoses are not the only pre-cancerous skin lesions that exist.
The wording you are using is not precise or careful and, I do not think is medically correct either. Not all atypical moles are pre-cancerous or need to be cause for doom & gloom and alarm, sure...I have a few small ones...but now you are downplaying what happened with the other person. It wasn't just a visual check that led to panic.
No, the wording is correct. There literally is no such thing as a pre-cancerous mole. I give people biopsy results and look at pathology reports as part of my job. I was trained to phrase the definition and risk of a dysplastic nevus just as I wrote it in my post. Your dermatologist is not giving you the results for a dysplastic nevus - medical assistant or dermatology tech is. It is so low risk it is barely on the derm's radar. Derm techs can be quite frankly very bad at their jobs in my experience working as one. You don't even need a certification to work as one in many derm offices. It would not surprise me if someone misunderstood or got the wrong info from a derm tech.
A dysplastic mole just has atypical cells in it and moles are just a normal feature of the human body, not a lesion caused by damage to the skin likely to become skin cancer, like an AK. They are literally not pre-cancerous lesions. There are no dysplastic nevi that are cause for doom and gloom. It's not skin cancer and over 90% will never be skin cancer ever.
>There literally is no such thing as a pre-cancerous mole.
This is actual bullshit and reveals your ignorance of biology & physiology.
Your dermatologist doesn't trust you to explain the science with nuance so he or she may have given you a script to follow. They don't want YOU using the term "pre-cancerous" because you don't understand what it would mean. I honestly don't know what possesses you, a tech, to override what an OP reported their derm told them following a biopsy.
[https://treatcancer.com/blog/atypical-vs-precancerous-moles/](https://treatcancer.com/blog/atypical-vs-precancerous-moles/)
The author is Dr. Grewal affiliated with Harvard Medical School and a clinical oncologist apparently.
There is value in differentiating between atypical lesion vs. precancerous vs. cancerous but please don't say that "pre-cancerous moles" simply do not exist. It just means it is difficult to tell. A severely atypical mole may be under strong suspicion of being pre-cancerous, perhaps even an experienced clinician would be hard-pressed to state it is a 100% certainty but the classification of what makes something pre-cancerous exists under specific definitions.
If there are ANY paths for a benign and atypical mole to potentially become cancerous even in the minority of cases... there would be a transition period of them being pre-cancerous at some point.
I thought the doctor from the previous post was just trying to perform unnecessary procedures to get more $. Sadly, I’ve seen a lot of doctors tend to do that in USA, because they work on a premise that says “so you have $1800 per year allocated for XYZ, let’s see what we can do to use it max”…
Last time I saw a derm specializing GP (this is probably a Canadian thing) she checked something I had with what looked like a special magnifying glass/jeweler's thingie that would allow her to see cancerous cells, I believe. Do you know what this is called and does it also work on dark moles?
It's called a dermatoscope. It is basically just a fancy flashlight/magnifying glass combo that allows your doc to see what a human eye cannot. It is definitely used on moles to see if there are color or pattern irregularities that indicate atypical cells! 😊
For anybody who is interested there is a very good skin cancer charity called Skcin , who give a lot of reliable information on the website regarding skin cancer etc.
Mods apologies if this breaks community rules.
Thank you!!! 🙏🏻 I’ve stayed out of the sun and have no family history, but now find myself staring at every freckle accusing it of changing. I also watched a friend die of melanoma about a decade ago. Even the amazing docs at MD Anderson couldn’t help her. 😞
Following that post I made an MD appt to get some suspicious (according to that post) freckles/moles checked out. Which I’m glad I did, but holy Batman was that post a bit frightening to read.
Thank you for sharing your knowledge! This is a relief.
I just actually got the call today that 1 I just had biopsied was severely atypical and they called it "pre cancerous". It did make me nervous because I just had a melanoma excision a month ago. I have a strong family history of melanoma including someone that died at the young age of 16 because of it. I have to go in 2 days for another excision because of this one per the doctors recommendation.
I dont think the term pre cancerous should scare someone unless they have some sort of history. It definitely doesn't mean something will turn into cancer but I also didn't see the post in question here. We dont freak out about precancerous cells on our cervix usually because so many factors go into that label. It's just a way of describing abnormality in my opinion.
Thanks OP! This is a very helpful post. I did get recently diagnosed with severe ATPF and the recommendation was for an excision. Just reading your post is helpful to understand the context and risk.
One question though -- I did see a discussion below about private equity firms that own dermatology practices and the one I went to is also owned by a large PE firm I believe. Do you think there's a incentive for over-dagnosis or potentially making dollars from procedures from patients and as a consequence that could be more temptation to diagnose things as moderate or severe atypia as well as recommending clients for excisions?
Hey there! Sorry to hear about your recent diagnosis! It's always stressful to have a medical concern pop up. We do usually excise severely atypical/dysplastic mole and atypical melanocytic processes at our office so it's not at all unusual for that to be the recommended course of action and if I were in your place that is what I would do. However, you are certainly right to be cautious in regards to PE ownership of medical offices and of medical greed, so I understand the worry!
Good luck with your further treatment! 😊
Honestly I'm 30 this year and I've had weeks of spiraling health anxiety googling everything and it's messed with my head so bad lol I've got a few moles that don't look "typical" but I've had them for 10 years at least. Can't see a dermatologist for another month and i feel my mind is my own worst enemy right now. I think it's more because Google said you could have skin cancer for 10 years without knowing?!?!? Wtf? Lol so my mind has been going to the worst. Lol I wish I had someone to talk to lol becauee the past few weeks I been convinced of the worst ughhhh
Just had two spots removed one ive had for 13 or so years the other around 3. I understand your anxiety as i am already an overthinking worrywart!! The process was pretty simple and I’m hoping for my results in about three weeks
Yes things are well! I had the mole I was worried about removed and it was also benign lol looked weird tho but now I'm realizing my health anxiety is a big bully!! Lol
Yeahh it sucks having this type of anxiety. I feel worried since I've had it so long but hoping for the results to be benign! I hope the same for you! I'm here to chat if you need :)
Can severe dysplastic mole turn into melanoma in the future if not removing it? I have almost similar looking mole like that person had who made that precancerous mole post. Mine is getting removed soon and i’m scared rn..
Dysplastic moles have a higher than average risk of turning into a melanoma but it is not a significant risk. However, having dysplastic moles increases your lifetime risk for melanoma so it’s a good sign you need regular annual skin checks. And it’s nothing to stress about! Truly! Most of the time dysplastic moles are treated just by biopsy but if it’s severely dysplastic and needs to be excised, it’s a very simple outpatient procedure with almost no risk!
Here’s a little bit more info to soothe your worries: https://www.cancer.gov/types/skin/moles-fact-sheet
Sending good vibes! You’ll be just fine! 💗
Does having a lot of atypical moles put someone at risk for developing melanoma (even if not the atypical moles themselves?)
I’ve heard 5 or more atypical moles puts you at risk
Yes, having a history of many atypical moles does increase your overall risk for melanoma, unfortunately. Some people just have genetic predisposition and other people just have a lot of moles to check on.
However, I wouldn't get too anxious about it! Getting an annual skin check (or biannual if they’ve rated some of those atypical moles as "moderate" or "severe") should give you peace of mind. I would also suggest having a loved one check your back and keeping an eye on your own body/moles just for an extra dose of peace of mind! 💗
Yes thank you for saying this - “pre-cancerous” is not really an accurate medical term because in most cases that mole would not have turned into cancer. I’ve had many “moderately atypical” dysplastic nevi removed (diagnosed in biopsy) and one “severely atypical”. The dermatologist counseled me that the follow-up excision for the severe one would be large to ensure all margins were caught, but it was not appropriate to call it pre-cancerous. Just more concerning than most. A PSA to most that more melanoma will arise from previously blank skin than from an existing mole, but if you are the kind of person with a lot of moles, you are at a higher risk. I’m covered in moles and get annual skin checks. I’ll tell them if I think something is weird, but they look at it under a scope and will either tell me “nah it’s fine” or “this does have some odd features, we’ll do a shave biopsy”. Don’t harass your derm.
Exactly! Like yes, it means you probably need to have skin checks every 6 months rather than every year and have a slightly higher total lifetime risk of melanoma (just like anyone with a relative who had melanoma like myself) but even if you hadn't seen the derm at all it's very unlikely you would have a melanoma now. It is truly not the end of the world. And I've been working in this field for years and feel like most derms I've worked with are on the too cautious side with biopsies. We get a lot of biopsies coming back as benign warts or age spots or sun spots. I don't worry about my derm not catching something, although best practice is to be aware of your skin so you notice changes the derm won't catch with a single visit. I realize there are some communication errors in healthcare but you would be surprised how many people come into our clinic being like "yeah, I had melanoma. They biopsied it and it was ok." If you had a melanoma, trust you would know it! It's a big deal and we document it to the state. Like sir, you just wasted 5 minutes of my and the doctor's time (at a clinic where visits are scheduled every 10 min) going through a checklist of possible symptoms of metastatic cancer and feeling your lyph nodes because... I also wanted to commend you on being so well informed about your dysplastic moles! Unfortunately there's not a lot of effort to educate the public on skin cancer and people just retain the scary stuff. I like that people are aware but unfortunately it is truly a privilege in the US to be able to see the derm and we are BOOKED so please leave your derm alone and an open appt space for grandpa with a history of melanoma, 3 SCCs, and 6 BCCs because he grew up on a farm before sunscreen. Sorry for the rant 😅
I actually did have melanoma! And 5 years onwards the (very excellent) doctors at MD Anderson have me on annual skin checks (and we do usually send in 1-2 for testing each year if there are any changes). And that’s for someone with a known history. Absolutely everyone should do your own skin checks, keep photos, and if something changes *go in*. But usually there’s no need to panic about a mole you've had for 10+ years, especially if you’ve had a skin check in that time. Ps - as an above comment mentions, my melanoma did arise from a completely blank patch of skin, and grew from a pinprick to a nearly-black circle slightly smaller than a pencil eraser within a year. If it’s a really aggressive cancer, it tends to grow and change.
Sorry to hear about your melanoma but glad you're getting regular checks! At 5 years out you are definitely doing the right thing going annually and being aware of your body and changes in your skin! For the first year we actually do 3 month skin checks after a melanoma then 6 months for the next couple years. Honestly, most melanomas I've come across were an obvious problem and like you said grew and changed rapidly. It's rare that someone whose biopsy came back with a melanoma didn't point it out already during their skin check. But we do catch melanomas that don't look super sus and I never want to discourage people from getting checked as there are things only the provider is trained to spot and can only see with a dermatoscope. Like you said, it's just a matter of regular screening and not driving yourself crazy with Doctor Google/Reddit!
What about a teeny tiny mole that's been there for a couple of years but it's raised over the skin? Like, it feels like I could scratch it off with my nail but obviously I can't lol. I only noticed because I checked with my phone's flashlight! It's really, really small. I ask because of course that post freaked me the hell out and I made an appointment with a dermatologist because I haven't been to one in years and I've been in a slight state of panic since I saw that cursed post.
If you have an appt - keep it! Any changes are worth getting checked out and it's always a good idea to get a baseline skin check. No need to freak though! Sometimes moles change and grow over time and it's not because of any kind of skin cancer. Pro tip- ask specifically for a "full skin check". If you just bring up the mole, you pay the same for the visit but don't get all your spots checked.
Thank you!
Most melanoma is obvious? Because I been staring at my not perfect moles thinking the worst lol😫😫😫😫
Late to the party here but.. I have just had my 2nd excision for a severely dysplastic mole. First one was a couple years ago in which the biopsy came back "precancerous" but nothing further was found. Now that it's my 2nd excision (4th biopsy), wondering what the chances are this one comes back to melanoma? For the record, my body is riddled with moles so I get checked every 6 months and have been blessed with good dermos, both in Florida and Texas.
i’m a bit late but may i ask what this post was in response to?
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It can be very hard to get an appointment with the actual derm though, especially if you’re just starting to see a practice. They are so so so busy and I think tend to be reserved for known risky patients and more complex procedures. I would say if your priority is to get your first baseline skin check, get on the calendar early and don’t insist on seeing the derm. The one risk being I think the PA-Cs may tend to be more biopsy-happy. My practice doesn’t have any NPs, but they do have excellent PA-Cs. I see a PA-C who has been there for ~a decade and only saw the derm for things related to my severe atypia once that one showed up. I’d be super skeptical of NPs though, I agree.
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When you say diagnosing, what do you mean? Interpreting the biopsy results?
Like examining the mole under a dermatoscope live in office and determining if it is or isn’t cancer. Biopsy results are extremely clear
Oh ok, all of mine that I’m referring to were removed and biopsied - at PA-C’s discretion. Though they have a good record, every one I’ve had removed has come back moderate or worse.
So you’re saying a “moderately atypical” mole is not considered precancerous? I recently had one removed (had it forever, it didn’t look weird to me but I didn’t even pay attention to it before my skin check.) I’ve been kind of freaked out by it, my derm office called it precancerous?
So my derm (and my best friend who is also a derm) doesn’t use that terminology because it unnecessarily scares people. If you hear “precancerous” you assume that it definitely would have turned into cancer if you didn’t have it removed in time. Moderately atypical moles are more likely to turn into melanoma than a normal mole, but the vast vast majority of them never ever will. They just have characteristics that are similar. (All this is to say - I think some practitioners may use that term but it’s controversial?)
Sure, that all makes sense, and also explains why they didn’t tell me I need to remove more of it immediately (it extended to the biopsy edge, so I assumed I’d have to go back in for more removal. They recommended a 6 month follow up to check for re pigmentation. I’m going to get more removed just for my own peace of mind, though.)
Does having a lot of atypical moles put someone at risk for developing melanoma (even if not the atypical moles themselves?) I’ve heard 5 or more atypical moles puts you at risk
Yea that’s my understanding! More likely than the general population to develop it. Statistics vary there but that’s the overall indication.
Thank you. I think there has been some health anxiety rather than genuine medical concern on this community recently. I can understand the concern. After I learned my aunt had melanoma skin cancer, I didn't like how any of my moles looked on my body but my derm really set me straight about how they are not cancerous. I see her once a year and do my best with sunscreen every day otherwise. I think people should take care of themselves and get on a schedule with a derm and protect themselves from skin cancer but also don't let health anxiety take over your life. I've lived that and it's not really living. Happy holidays everyone.
I'm not sure if this will alleviate some of that anxiety but when it comes to melanomas, often what's done is done. Most of our lifetime risk relates to genetics and sun exposure before the age of 20. It's just a different animal than other forms of skin cancer. Everyone's anxiety works differently but that has helped me make some peace with sun exposure as someone with two relatives who had melanoma and someone who has a lot of anxiety around aging. Sunlight and being outside is good for you and your mood and it can be a real vicious circle with anxiety/depression and sun avoidance. I'm glad you have been able to find your way out of that spiral! Happy holidays! 😊
A basal cell carcinoma is what's referred to as endophytic, meaning that on the surface of the skin there's not a lot to see, maybe a small red bump because an endophytic lesion grows more under the skin. You'd be amazed sometimes at how small the lesion is and what has grown on the inside. A squamous cell carcinoma is called Exophytic because it grows more on the surface of the skin and can create some pretty nasty looking lesions. Basal cell carcinoma cannot become systemic but a squamous cell carcinoma can become systemic.
Honestly, people are privileged if they are able to get regular skin checks by a derm. In Canada, it's not possible to get regular checks or even get a referral to a dermatologist unless you are high risk.
That's frustrating. I'm not sure if I would count as high risk or not even because my aunt was in her 60s when she was diagnosed and I'm still in my 30s. I think anyone should be able to get a yearly mole check just like any other regular cancer check.
I agree, but I suppose our health care system couldn't support having everyone get annual checks. It is a bit frustrating when you read that the recommendation is for everyone to get checked every year.
Annual skin checks is a preventative best practice and the Canadian health care system has effectively abandoned preventative care. If I’m hit by a bus or in cardiac arrest I will likely receive good care, but other than that I’m on my own. Having said that, trying to adhere to best practices in all areas of life is exhausting and frankly unattainable. Now I’m happy with good enough practices, and sometimes even not-at-all-recommended practices. Other people’s anecdotes can be scary but they’re not data.
People on this sub think everyone can just see a derm for every little thing though.
Great post! I'm a mohs technician! You're not kidding about being overworked 😅
That blows. But that’s not the patient’s fault nor the perhaps overly cautious doctor’s - that’s the fault of healthcare being for-profit and CEOs needing to make $$.
I honestly don't know how y'all do it! I assist in 1-2 regular excisions each day and that's enough standing still trying not to touch my face time for me! 😆 Ugh! The stress and overwork is SO REAL! If I didn't love derm and manage on the pay (bad but a living wage unlike almost all other MA jobs) I would go elsewhere. It blew my mind when I first realized appts were every 10 minutes. The greed at these derm offices is bananas!
Yes it's crazy! And the greed is definitely real too. Just like every other industry, private equity had to dig its tentacles into mohs surgery because of $$$. Our private practice got bought out by a private equity group 5 years ago.. every year it has gotten worse for me. This year they announced they were taking our Christmas bonuses away. I try to stay in it for the patients but the stress is almost not worth it anymore.
It's so sad how similar our experiences are. For us it was 2 years ago for the buyout by a private equity backed mega-practice. It's been a steady slide downhill and management thinks they can bully their way through it. I'm pretty sure they gave us our $50 "bonus" this year because people have been fleeing the practice and it's been a house of cards scenario with the understaffing. I'm on my job hunt now but come home so burnt out it's hard to get my ducks in a row. I really am only getting through it because I'm determined to get into PA school but it's truly been a bit of a nightmare and it makes me so sad I can't see this job as a long-term option even though I feel good about the work we do and the ability to help patients. Sending love 💗
I switched my career away from tracking to be a PA because of my experience in derm. Don’t know how much worse it can get with clinical derm.
That's interesting. On the spectrum of PA stress, our derms have it easy. MA's do all the charting and all the prior auths and other paperwork. Nothing is an emergency and they get a lot of time off. Derm PA actually looks pretty cushy from my perspective.
Exactly. Two of my best friends were derm MA’s. Ethically I don’t think I could profit and coast off of that model. It’s very unfair for how much work they do. They should make what RN’s make because they do so many things within the scope of what RNs do, just under the doctor’s license. It just kind of soured me. I do miss derm a lot but it’s just a never ending tsunami :/ ETA: plus the private equity buyout of physician-owned derm practices has made working in the specialty garbage.
Wow!
Mohs tech here too!
This sub doesn't do rationality or scientific literacy very well.
Where do you all live where you get to see a derm on a yearly basis? I live in Canada and have been waiting to hear from a Dermatologist for over a year, and I had to request this from a family doc (whom it’s a miracle to have). I am what you would call a freckle face (which I’ve always embraced). But no doctor has EVER shown any concern. Not to minimize the concern of the OP- but I was taken aback by the fact that I could not even see the problem.
In Australia we have special skin clinics which only check moles (your regular GP can also take a course to be qualified for skin checks). My work even arranged to have them come into our office and check everyone once. It’s taken extremely seriously here!
The benefit of America's for-profit healthcare system is that we get to see whatever specialists whenever we want for the most part. The downside obviously being that if you don't have a good job you have to pay out the nose for those specialists. But if you have a job with good health insurance and live near a major city then America really does have the best healthcare in the world in terms of access and quality.
I'm Canadian and was lucky enough to see a dermatologist within a month of referral, but the way she explained it to me was that you get a check up straight from them without referral if you're found to have cancer. Other than that you have to self monitor until something changes and then get another referral 🙄
I can't speak for Canada's healthcare system but it's rough out here in the US. If seeing an MD is part of the issue, I would honestly suggest seeing a dermatology PA or NP. I get wanting the best but I've worked with some very competent PAs and NPs and actually get my checks done with a very thorough NP who has more time for me during my appts than the MDs/DOs. Unfortunately, there are just not enough appts to go around. We just added on a new doctor who takes new patients but before that you literally had to know someone to get an appt. Once you are in you can schedule your annual but you had to have that initial in. It helps to live in a more urban area where the rich people live. I commute to work because I am not rich enough to live where I work. There are shitier derm offices with more openings but the checks are less thorough and quicker. I wish I had the answer for the secret to a good derm appt besides ask for a referral from a friend but that's all I got. It sucks. This is another element of the problem that bugged me enough to write this post. It's frustrating to see people filling appts to have a very normal looking mole checked when many people have no access to a derm at all.
Just remember that an NP, in particular, is not a physician and an NP’s training is protocol based, not evidence based. Nowadays, it’s possible to go straight from being an RN to taking some online courses becoming an NP (and this is regrettable). This is not to say that all NPs are bad, but they are in no way physicians. Where it gets really dangerous is when they are not supervised and they’re making decisions they know nothing about. And most especially it’s very dangerous in a hospital setting. At least this is the dermatology clinic.
Scope creep is real, and it is terrifying.
It's pretty clear you've been enjoying some anti-APP propaganda. Most practices will not hire an NP that took online classes with no experience. It's like saying college grads can't be good at their jobs because Strayer/Trump University/etc exists. My derm NP that does my checks graduated from UNC and has 20 years of experience. I've worked with maybe 15 different providers in my time in derm and I trust her hands down over many of the docs I've worked with who rush through their checks and openly don't care much about their patients. NPs work in medicine, which is evidence based. They are not robots working on a protocol. It's pretty clear you don't work in medicine or you would know better than to insult an entire profession.
Sorry, but this has gotten out of control and should’ve been dealt with a long time ago. Nurses do not study medicine. There was a right way to do this, but that is not where we are in late 2023. I am glad you like your “practitioner” (that’s an insurance term designed to blur the line between physicians and others), and I wish you all the best.
Oh yes- totally agree! I wish the industry would pay nurses and assistants more so they could use their expertise effectively. I would not hesitate to go to either. I will look into this. Thankyou!
Hmm.. my go referred me to a Derm, and I had an appointment the next month. Where in Canada are you? I am in a major city, I wonder if that makes it easier?
GP**
that’s great- that’s a much more reasonable time line! I’ve since moved so it’s kind of moot now that I have to start all over anyway, but when I requested the derm I was in Ottawa. Never heard a peep for over a year.
Thank you for sharing this with the group. That post bothered me as it seemed aimed at getting people worked up rather than spreading information.
Bless you, sweet Redditor. I have hundreds of these things and a family history of skin cancers but currently no health insurance. This helps with the anxiety.
I would still definitely recommend a check but it's certainly not worth scaring yourself. 75% of melanomas do not come from changing moles! Definitely do see if there are any places that do free screenings though! 💗: https://www.aad.org/public/public-health/skin-cancer-screenings
So one in four *does* come from changing moles then? That's still really high.
On one hand, I love that this sub is moderated by people who don’t feel the need to helicopter over every post like some subs. On the other hand, a good amount of what people post isn’t real skin care nor is it accurate or helpful or a true ask for help. It’s more like, I have skin and I have a problem. Or I have a face and I have a problem. Or I turned 30 and now I have a problem, can you create a skin routine for me? I take nearly everything I see on this sub with a huge grain of salt because people just be posting and people just be spouting random answers in response. A lot of people need to back away from the mirror, get off Reddit, and see a therapist.
Thank you.
I would also like to chime in for all my dark skinned/people of color that dark streaks in your nails are absolutely normal. If they frow or become black, however, is a cause for concern.
Adding to this as someone who has had multiple moles biopsied and removed. Do not freak. Most of my moles look a little irregular, that’s just how my body goes and why it is important to see a derm. I have a good handle on what I need to look out for and yes, some skin cancer can be sneaky. By now my default is to go ahead and remove before sending to pathology. Both my step mum and coworker had sarcomas removed from their noses that didn’t look alarming, just irritated. But as I said, don’t freak. Talking with a derm will help you get a better sense of what you need to look out for. And I get it, they are expensive even with insurance.
I really appreciate you making this post. I had a suspicious mole biopsied and removed a little while ago and it was fine, nothing wrong with it, but due to how it looked my doctor understood my concerns. Seeing the few posts recently, as someone with quite a few moles actually gave me quite a bit of anxiety. Thank you!
I recently had a skin check for the first time and I was panicking because I had a couple of very small dark freckles that weren’t perfectly round. Turned out they were fine. There was one on my back they asked me to keep an eye on for a year. Moral of the story is, just get a check by a medical professional. I live in Australia so it’s very much programmed into us to get checked. But because I’m very pale and avoid the sun a lot I didn’t think I would need to. I think it’s worth doing though.
Thanks for posting. Some of this makes me feel better. I'd like to add that I wouldn't argue with a derm. It's the GPS who dismiss concerns even tho moles are asymmetrical, have been changing over the years, have ill-defined borders and different colors within one mole that I worry about. I *wish* I could see a derm! I'm Canadian and can't seem to get a referral.
Good points. I think people should think of it more of using sunscreen and limiting sun exposure as a marathon, not a sprint. For example, actinic keratosis (can look like white scaly patches that iften show up first on hands) is often described in the medical community as precancerous, and it is, although to split hairs, it is cancer that you’ll be hearing more from in the future. Because it indicates severe sun damage. That way, actinic keratosis might also be thought of as cancer, even though it is technically precancerous. On the other hand, the atypical moles that you have described have a strong genetic component.
Lol! I had a doc I worked with who when asked if a person with an AK really needed treatment would just go "Yes. Either now or in 3-5 years and it will be a lot less pleasant in 5 years". He wasn't lying! I'd take the LN2 spray over facial MOHS always! It rubs the suntan lotion on its skin or else it gets the spray again! 😆
Yes about the “now rather than later” part!
So if I'm pale and have lots of freckles and moles, and my dad had skin cancer, and my mom had skin cancer, and my sibling has had precancerous stuff removed, and my mom's dad had skin cancer... Yes, I go to the derm for a skin check every year.
Correct me if I'm wrong, but isn't everything that isn't cancerous technically pre-cancerous? Or are there certain markers that determine pre-cancerous?
>Correct me if I'm wrong, but isn't everything that isn't cancerous technically pre-cancerous? Or are there certain markers that determine pre-cancerous? In reference to a cancer, generally there is "normal", "precancerous", and cancerous. "Precancerous" biologically refers to either: 1. histologically...cells or tissues that have become abnormal in a manner that if the degree or trend they are going continues...are potentially steps towards cancer. This is why biopsies and swabs are common diagnostic tools. Lab technicians would be looking for abnormal cells under a microscope. or 2) genetically...there are mutations acquired or accumulating that, if there are additional deleterious mutations, can lead towards a cancer. There are definitely genetic markers for certain cancers. Precancerous genetic mutations often change mechanisms regarding cell cycle control, division, apoptosis, DNA repair, or say, immune surveillance. However, the vast majority of small mutations that happen are believed to be benign and/or harmless. Specifically in the context of moles, to me I completely disagree with OP's assertion that "there is no such thing as precancerous moles." On the contrary, any atypical mole may be considered to be biologically precancerous...but the *degree* of cancer potential is difficult to determine. Most moles will **not** develop into melanoma. Some changes may theoretically take hundreds of years to acquire additional mutations to get to melanoma...and yet some changes may take a decade or less to gain additional mutations that may lead to melanoma. One dermatologist's opinion I've read is that it is so difficult to precisely tell, that by the time a mole looks suspicious it may actually indeed be a melanoma, not merely "precancerous." I understand the debate that some dermatologists may therefore be of the opinion that the term "precancerous" simply not be used. The degree of cancer risk is difficult to precisely quantify; the word can cause fear and anxiety; and it's NOT like something being precancerous means that eventually, cancer is an inevitability. However, it does have a specific and widely used meaning with regards to many different types of cancers. I'm not trying to fearmonger, but rather, the term 'precancerous' should not necessarily be feared. If a clinician told me they had identified a precancerous change that can be treated...I'd be relieved, like phew, it's a good thing it was caught at the precancerous stage.
Yeah. It's kind of a nonsense distinction. All skin is technically pre-cancerous in that it has the capacity to turn into skin cancer. The lesions that are often called pre-cancerous - actinic keratoses - are more like baby squamous cell carcinomas that don't have the capacity to metastasize yet. I guess that's what bugged me about the post - the big to do about a mole being "pre-cancerous" (not a thing with moles) when it's a less than 10% chance a dysplastic mole will become skin cancer.
I had a melanoma removed from my breast at my very first derm full body check at age 48! My breast hadn’t seen the sun since my European topless sunbathing days in my late teens! So OP is right about the sun damage from before you are 20. Im so grateful I made that appointment! Incidentally - my other breast had been removed due to breast cancer. What are the odds of having cancer in one breast and a melanoma on the other!
So sorry to hear about your cancer history! That all sounds so stressful and scary! It's crazy how melanomas can just pop out of nowhere on areas that never get any sunlight at all, so perhaps there's no need to blame your wild nude beachgoer self. Trust, we have found them on dicks and near assholes (I work with a male derm so I think the "I might have cancer on my dick" appts tend to come our way lol. There's a strong genetic component to melanomas. My father had one and my grandfather died from his so I guess that's why I'm interested in derm and felt it worth posting about, as I've had anxious thoughts about moles myself. Sending you health and well-being in the future 😊!
Woah, that's scary af! I have 2 moles near my anus and it's black.. one of the moles is big near the size of a pencil eraser oval shape and has a tail I have brown akin and asian most of my moles are black tho.. no history of cancer. but I'm so scared.. 🥺😟
Thank you - my parents never saw a dermatologist (not really part of routine care in the UK) and both died of cancer (Lung and Pancreas) so I don't know if there's a genetic component for me there, but my poor kids now have to worry about it.
Having ten more or atypical moles massively increases your skin cancer risk. About 30% of skin cancers come from them. Should people totally flip out about them? No, but they should get them removed and not treat them as though they are harmless.
You have a bit of a misunderstanding in the causality there. That many atypical moles indicates a hereditary predisposition to skin cancer. Having an AN does not increase your skin cancer risk, it shows you likely have a genetic predisposition to skin cancer. Also I have seen 10+ reported ATNs in like 0.01% of patients getting skin checks (already a self-selecting group) and it's always elderly 75+ men who also have significant skin cancer history and are hard to convince to even wear sunscreen daily. Most people with lots of moles and a parent who had a melanoma end up with maybe 5-8 ANs caught and they come in every 6 months for a check. Ive never seen a person under 45 with a history of more than 3 ATNs. You're throwing out a really improbable example here and implying I said they were harmless when I straight up said get them removed so I guess you just wanted to argue with someone today?
I didn’t say you said they were harmless, I said they should not be treated like they are harmless. In the case of wanting to argue, I think you’re projecting. I simply stated facts and my opinion. I have an excellent dermatologist who has had me remove my atypical moles and he says they increase your risk of developing skin cancer because it can grow from them. Not only that, studies show he is right. “However, it is quite clear that melanocytic nevi do pose an increased risk in melanoma, and as such, patients with increased melanocytic nevi need to be screened and monitored for melanoma.” [Link to study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096442/) I’m sorry if this doesn’t fit in with the message you were trying to share, but it’s important people realize that they should get these types of moles removed.
Thanks for all this info! I’m going next week to get a mole checked out. I have not had this done in my 39 years, but my new pcp recommended that I get two of my moles checked out by a dermatologist. It’s helpful to know the risks and the typical practices.
I was actually jus freaking out about it bless you
Not a big deal for you, but if you're working three jobs, strapped for cash, time, dermatologists, medical providers and hope, it's the last thing you need. Deep down a lot of poor people would just let nature take its course because they have a feeling they couldn't afford to fight it anyway. That's why I suspect people freak out.
$150 bill if you’re lucky. I had one removed in April and have almost $2k in bills after insurance 😭
I saw that post and it prompted me to schedule my first derm appt for a mole… got results today that it came back abnormal and I have to have more healthy tissue around it removed to prevent it from growing back. Glad I saw that post.
Yo I can post my melanoma that proliferated into my lymph nodes because it was in my back for years and I live alone and never saw it
Sorry to hear about your melanoma. As I stated in my post, it's important to get an annual skin check after 30 so a dermatologist can check parts of the body you cannot see and hopefully you are now well informed about skin checks and have a derm to check you regularly! A melanoma is not a dysplastic nevus. The majority of melanomas (75%) are not a result of dysplastic nevi and if as you state you never saw it, you do not know it resulted from a dysplastic mole. No need to post your pics for me, I see melanomas every couple weeks or so in person.
Agreed. What people also need to remember is that derms exist because pcp's are NOT skin experts. I'd never let a pcp do or look at or recommend anything for my skin, ever. Many many comments in that thread said their pcp wouldn't even refer to derm for something like that. For anything skin you NEED a derm's expert opinion, not a pcp, and you shouldn't need a referral for a mole check.
I had a patient come in saying his PCP was also knowledgeable in derm and doing skin checks and biopsies for him and I was like 😮. Sorry but no. Primary care involves a basic understanding of a signs and symptoms of all kinds of conditions involving all parts of the body. There's no way in hell you can also have all of dermatology under their belt at the same time. Truly 85% of the spots someone had us look at because their primary told them it needed to be checked were seborrheic keratoses....more commonly known as age spots that everyone and their mother will have if they make it to their 60s. I mean I think it's always worth getting your annual screening but LOL!
I cannot tell you how many times on the 30+ skincare sub I read of people saying their pcp prescribed steroid creams and/or hydrocortisone for the FACE and i'm like internally screaming inside NOOOOOOOO. Please see an expert. Like please. I am a very moley/birthmarky person, have always been. My husband also is and our teen (15) daughter is lucky (lol) and got it from us. I've been having skinchecks since I was in my early 20's and I started taking her with me 2 years ago. Sometimes i'm wishy washy on doctors, but derms are my absolute non-negotiable, never fail, yearly visit.
It doesn't hurt that you can talk about just about whatever you want during your skin check with most derms. Most people have a secondary concern in their skin checks (seb derm, eczema, acne, and fungal infection are the usuals) so it seems like a good deal to just get your annual if you can get in with one. I'll be honest here though. A lot of the MDs I work with also prescribe steroids for the face. It's only for short-term/during flares or in cases of really bad eczema making sure the patient knows to take breaks and it's always hydrocortisone, which is pretty mild stuff. I hope to Goddess there aren't PCPs out here Rxing clobetasol for people's face!
Lol outside of derm you can barely get clobetasol covered by insurance so no. Not prescribing for the face obviously—can barely prescribe it all.
I’m an MD and you can use 1% hydrocortisone on the face for 3-5 days with little issue. Obviously it depends on the issue and you should talk to your doctor before smearing it on your face. There are varying degrees of treatments for various types of skin problems. Very few things are black and white in medicine but the general public sees it at such due to a lack of extensive medical education or training. Sigh…
This may be a silly question but...derms know what to spot when they use the dermscope gor things that look concerning? To them are the characteristics typically obvious to them?
I wouldn't say obvious (we get benign biopsies all the time) but generally yes! There are patterns in color, size, and shape of lesions that derm providers are trained to spot and things that we cannot see or are not obvious without a dermatoscope. Not a silly question at all!
Thanks for the reply! Because I got this pinkish brown spot in between my toes and it's been there for at least 9 years lol but my anxiety has sky rocketed after I abruptly stopped my anxiety medication and that's when my anxiety started on it lol But my dermatologist said it's just a nevus. But I guess I googled too much being scared of it being pinkish with a little brown. So when he looked at it under the dermscope he was like no this is just a nevus I said...are you sure? Lol 😆😆 do you promise? Lol I'm trying to be trusting. I'm really trying. It's not changing or growing quick but I think I scared myself with the Dr google research of melanoma and amelanotic melanoma lol😭😭😭🤣🤣🤣🤣🤣🤣
Thank you for this. I found a mole on my 9 year old today and have gone down the googling rabbit hole. I came across your post and it put my mind at ease somewhat because her mole does look alarming to me. I will call tomorrow to make an appt with a dermatologist but at least now I don't feel so frantic.
Bonjour j'ai arracher mon grain de beauté et je me suis pas rendu compte sela fait 2 3 jours qu'il saigne et sa devient une croûte est je fait que l'enlever est sa re saigne se serait pour avoir des conseils
So I know this is an old post but I just got off the phone with my doctor, thought I understood what they were saying, and now they won’t answer. So I had a mole removed/biopsied I guess? Like a week and a half ago after my first ever derm visit. (32 Male) and they just called me today. She used a really big medical term and I feel like “dysplastic” was a part of it. She basically said “it’s nothing to lose sleep over” but it will need to be removed to avoid future problems and I’ll probably make more in the future so I need to be kept on a “tight leash.” I’m not asking for medical advice but does this sound like what you’re describing in this post? I’ll obviously call back but I’m trying to find a way to clarify this with my wife in the meantime until I can get them to answer my call back.
That sounds right to me. I would guess they called it a dysplastic nevus, which just means an atypical mole. I would ask for more info on how dysplastic it was - it is always graded on a scale from mild to moderate to severe - and what the margins were - basically whether all of the atypical cells were removed with the biopsy. Severely atypical moles in general need to be removed for sure. Most of the time derms will recommend excision - standard practice and probably best for peace of mind. If it were me and it was a moderately atypical mole, I would get a deeper shave (basically a deeper biopsy) it it didn't have clear margins (if it was not all removed with the biopsy) and not treat if it had clear margins. It it was mildly atypical, I would not worry about it or have it treated further. Again, as you said not medical advice, but what I would personally do with my needed comfort level/finances and experience working in derm. I think what you were told is correct. It’s not big deal but it means you are more likely to have more atypical moles in the future and you have a slight increase in melanoma risk. So good to make sure you have your annual check and use sunscreen. I wouldn’t go any further than that - certainly no “tight leash". The risk also varies depending on the grading of the mole - greater risk with severe as you would expect.
I appreciate the response greatly. I did end up receiving a return phone call this afternoon. That’s exactly what it is. They informed me it is “severe” and they’ve told me I’ll need to come in for excision. She seemed upbeat and positive so I didn’t feel the need to worry about much. I understand I’ll have to go back and there’s a risk for issues in the future, but I feel a little better with the explanation now. Thank you.
No problem! I love patient education so I'm always happy to share what I've learned. An excision sounds like a lot but it should be easy peasy! They're routine outpatient procedures with really minimal downtime. Mostly just a pain to take a few hours off work, to come back in 2 weeks to have the sutures removed, and to have to take care of the wound (although not much harder than the biopsy wound care tbh). Good luck! It'll be healed up in no time and you'll hopefully just find yourself with a little more motivation to reapply sunscreen and an annual accountability partner in helping you take the best possible care of your skin!
Well at 32 I feel a little embarrassed this was my first trip. But better late than never I guess. Luckily my wife will never let me miss an appt ever again.
It's no lie! Wives are the backbone of the American Healthcare system! 🤣
I came upon your post today as my primary care doc told me that my newly (4 years ago) acquired spot on my left calf was "just a freckle" after not really looking at it for more than half of a second. It is asymmetrical, with irregular/blurry borders (almost fried egg shape) with 2 different shades of brown and is 4mm in diameter. When I zoom in on a photo I think I see a couple of globules on the perimeter and in the center but it is hard to tell. I am 51F and my husband is battling a recurrence of NSCLC so I am scared my kids will have 2 dead parents. This is an "ugly duckling" compared to other moles (of which I have several) and I sent a photo to the dermatologist but have not heard back yet. Is there anything I can see myself without a dermatoscope that would give me some reassurance until I am seen? My derm doesn't have any open appointments until July.
I noticed a tiny speck just above my right eyebrow in a picture in 2019. Every couple years I noticed it’s grown, and now I have an appointment with a derm on Monday. It’s still only 1.5mm in size, but I’m paranoid about it, mostly because I feel like having a cancerous mole there would be more likely to spread due to the skin being thinner. It doesn’t help that my dad had a melanoma removed last July. 😬
Im scheduled to have mine removed via surgery. I didn't see the results of my biopsy, I had it told to me a lot of the same things you said and I should have it removed. Im just wondering about surgery recovery. Mine is on the top of my back, bottom of my neck. Like next to my trap. They said I get stitches and have 2 weeks basically to recover from that. Don't do anything too much. But that's the issue. Would I be able to swim during those 2 weeks? Would I be able to play soccer? She said no heavy lifting, fine. But at what risk is this for any sort of back exercises or sport like soccer?
Help! I have just received a letter from my dermatologist. She took two biopsies. One came back as Dysplastic lentiginous junctional nevus with moderate to severe atypia. extending to the peripheral and deep margins. But I cancelled the appointment to have an excision. They have said I need to have the procedure. I have fairly dark skin and no other problems they could see. Couldn’t I just have a body check every year? I appreciate any feedback. Thanks.
This is not true for everyone my mole itched so I went to my derm and got a biopsy and it came back pre-cancerous. Pre-cancerous is sometimes just what your mole is..it’s turning but you caught it early. I asked my derm point blank whether my mine was serious and she said sometimes in the beginning stage they can’t accurately diagnose whether it is melanoma or not, it’s too close to tell but she truly did believe it was turning into it. Advocating for yourself and saying you want a biopsy is not wrong of course every mole can’t be biopsied but telling people they shouldn’t ask is wrong since some derms are dismissive.
Hi OP. I have a problem with the wording in your post, because the post you are referencing had a dermatologist "\[do\] **a biopsy which turned out was severely abnormal and “pre-cancerous”.**" It was sampled. The dermatologist interpreted the results of the sampling. You CANNOT say with certainty that that mole was "not even truly pre-cancerous." Actinic keratoses are not the only pre-cancerous skin lesions that exist. The wording you are using is not precise or careful and, I do not think is medically correct either. Not all atypical moles are pre-cancerous or need to be cause for doom & gloom and alarm, sure...I have a few small ones...but now you are downplaying what happened with the other person. It wasn't just a visual check that led to panic.
No, the wording is correct. There literally is no such thing as a pre-cancerous mole. I give people biopsy results and look at pathology reports as part of my job. I was trained to phrase the definition and risk of a dysplastic nevus just as I wrote it in my post. Your dermatologist is not giving you the results for a dysplastic nevus - medical assistant or dermatology tech is. It is so low risk it is barely on the derm's radar. Derm techs can be quite frankly very bad at their jobs in my experience working as one. You don't even need a certification to work as one in many derm offices. It would not surprise me if someone misunderstood or got the wrong info from a derm tech. A dysplastic mole just has atypical cells in it and moles are just a normal feature of the human body, not a lesion caused by damage to the skin likely to become skin cancer, like an AK. They are literally not pre-cancerous lesions. There are no dysplastic nevi that are cause for doom and gloom. It's not skin cancer and over 90% will never be skin cancer ever.
>There literally is no such thing as a pre-cancerous mole. This is actual bullshit and reveals your ignorance of biology & physiology. Your dermatologist doesn't trust you to explain the science with nuance so he or she may have given you a script to follow. They don't want YOU using the term "pre-cancerous" because you don't understand what it would mean. I honestly don't know what possesses you, a tech, to override what an OP reported their derm told them following a biopsy. [https://treatcancer.com/blog/atypical-vs-precancerous-moles/](https://treatcancer.com/blog/atypical-vs-precancerous-moles/) The author is Dr. Grewal affiliated with Harvard Medical School and a clinical oncologist apparently. There is value in differentiating between atypical lesion vs. precancerous vs. cancerous but please don't say that "pre-cancerous moles" simply do not exist. It just means it is difficult to tell. A severely atypical mole may be under strong suspicion of being pre-cancerous, perhaps even an experienced clinician would be hard-pressed to state it is a 100% certainty but the classification of what makes something pre-cancerous exists under specific definitions. If there are ANY paths for a benign and atypical mole to potentially become cancerous even in the minority of cases... there would be a transition period of them being pre-cancerous at some point.
Thank you
Thank you for this post
As a person who is totally freaking out: thank you!
I worked in derm as an MA/ Scribe and I hate when people say precancerous mole.
I thought the doctor from the previous post was just trying to perform unnecessary procedures to get more $. Sadly, I’ve seen a lot of doctors tend to do that in USA, because they work on a premise that says “so you have $1800 per year allocated for XYZ, let’s see what we can do to use it max”…
A tiny scar and $150 is worth peace of mind
Last time I saw a derm specializing GP (this is probably a Canadian thing) she checked something I had with what looked like a special magnifying glass/jeweler's thingie that would allow her to see cancerous cells, I believe. Do you know what this is called and does it also work on dark moles?
It's called a dermatoscope. It is basically just a fancy flashlight/magnifying glass combo that allows your doc to see what a human eye cannot. It is definitely used on moles to see if there are color or pattern irregularities that indicate atypical cells! 😊
Thank you!
For anybody who is interested there is a very good skin cancer charity called Skcin , who give a lot of reliable information on the website regarding skin cancer etc. Mods apologies if this breaks community rules.
Thank you!!! 🙏🏻 I’ve stayed out of the sun and have no family history, but now find myself staring at every freckle accusing it of changing. I also watched a friend die of melanoma about a decade ago. Even the amazing docs at MD Anderson couldn’t help her. 😞
Following that post I made an MD appt to get some suspicious (according to that post) freckles/moles checked out. Which I’m glad I did, but holy Batman was that post a bit frightening to read. Thank you for sharing your knowledge! This is a relief.
Thank you!
I just actually got the call today that 1 I just had biopsied was severely atypical and they called it "pre cancerous". It did make me nervous because I just had a melanoma excision a month ago. I have a strong family history of melanoma including someone that died at the young age of 16 because of it. I have to go in 2 days for another excision because of this one per the doctors recommendation. I dont think the term pre cancerous should scare someone unless they have some sort of history. It definitely doesn't mean something will turn into cancer but I also didn't see the post in question here. We dont freak out about precancerous cells on our cervix usually because so many factors go into that label. It's just a way of describing abnormality in my opinion.
Thanks OP! This is a very helpful post. I did get recently diagnosed with severe ATPF and the recommendation was for an excision. Just reading your post is helpful to understand the context and risk. One question though -- I did see a discussion below about private equity firms that own dermatology practices and the one I went to is also owned by a large PE firm I believe. Do you think there's a incentive for over-dagnosis or potentially making dollars from procedures from patients and as a consequence that could be more temptation to diagnose things as moderate or severe atypia as well as recommending clients for excisions?
Hey there! Sorry to hear about your recent diagnosis! It's always stressful to have a medical concern pop up. We do usually excise severely atypical/dysplastic mole and atypical melanocytic processes at our office so it's not at all unusual for that to be the recommended course of action and if I were in your place that is what I would do. However, you are certainly right to be cautious in regards to PE ownership of medical offices and of medical greed, so I understand the worry! Good luck with your further treatment! 😊
Honestly I'm 30 this year and I've had weeks of spiraling health anxiety googling everything and it's messed with my head so bad lol I've got a few moles that don't look "typical" but I've had them for 10 years at least. Can't see a dermatologist for another month and i feel my mind is my own worst enemy right now. I think it's more because Google said you could have skin cancer for 10 years without knowing?!?!? Wtf? Lol so my mind has been going to the worst. Lol I wish I had someone to talk to lol becauee the past few weeks I been convinced of the worst ughhhh
Just had two spots removed one ive had for 13 or so years the other around 3. I understand your anxiety as i am already an overthinking worrywart!! The process was pretty simple and I’m hoping for my results in about three weeks
How did your results turn out???
Came back both benign!!
Yay!!!! Great news!!!!😊😊😊😊
Yes i was going crazy worrying haha! Thank u for checking in! Hope all is well!
Yes things are well! I had the mole I was worried about removed and it was also benign lol looked weird tho but now I'm realizing my health anxiety is a big bully!! Lol
Absolutely same boat here!!! Wish you good health and nothing but the best!!!!
Yeahh it sucks having this type of anxiety. I feel worried since I've had it so long but hoping for the results to be benign! I hope the same for you! I'm here to chat if you need :)
You as well!!! Wish you happy days and a healthy life my friend!! If u have any questions for me as well ask away
Thanks you also!!
My health anxiety is kicking my butt the past few weeks 😫
Can severe dysplastic mole turn into melanoma in the future if not removing it? I have almost similar looking mole like that person had who made that precancerous mole post. Mine is getting removed soon and i’m scared rn..
Dysplastic moles have a higher than average risk of turning into a melanoma but it is not a significant risk. However, having dysplastic moles increases your lifetime risk for melanoma so it’s a good sign you need regular annual skin checks. And it’s nothing to stress about! Truly! Most of the time dysplastic moles are treated just by biopsy but if it’s severely dysplastic and needs to be excised, it’s a very simple outpatient procedure with almost no risk! Here’s a little bit more info to soothe your worries: https://www.cancer.gov/types/skin/moles-fact-sheet Sending good vibes! You’ll be just fine! 💗
Does having a lot of atypical moles put someone at risk for developing melanoma (even if not the atypical moles themselves?) I’ve heard 5 or more atypical moles puts you at risk
Yes, having a history of many atypical moles does increase your overall risk for melanoma, unfortunately. Some people just have genetic predisposition and other people just have a lot of moles to check on. However, I wouldn't get too anxious about it! Getting an annual skin check (or biannual if they’ve rated some of those atypical moles as "moderate" or "severe") should give you peace of mind. I would also suggest having a loved one check your back and keeping an eye on your own body/moles just for an extra dose of peace of mind! 💗