Melanocytic nevi (moles) are common. They usually look like light to dark brown spots on the skin. In children with very light or fair skin, they may appear more pink or red in color. While most melanocytic nevi are small, some may be quite large, especially those that are present at birth. Melanocytic nevi may be flat, or raised and bumpy. Some melanocytic nevi may have hairs growing from them; this is normal.

Melanocytic nevi that develop after the first year of life are called acquired melanocytic nevi. Acquired melanocytic nevi are usually small (less than the size of a pencil eraser), round or oval in shape, and the same shade of brown. They may be flat or raised. While most children have a few acquired melanocytic nevi, some children develop a large number of them. It is normal to continue to develop new moles over time, until about age 40.

Children with a large number nevi often have a parent who has many melanocytic nevi. Children who have had a lot of sun exposure, especially blistering sunburns, also tend to develop many acquired melanocytic nevi.

Do acquired melanocytic nevi increase the risk for skin cancer?

The risk of melanoma in an acquired melanocytic nevus is very, very small. Most melanomas do not arise within a pre-existing mole. Melanoma is very rare in children; the risk is higher in children who have one or more family members with melanoma or in children who have had many blistering sunburns and who are very fair-skinned. Other factors that increase the risk for skin cancer include a prior history of malignancy (e.g. lymphoma), underlying disorder of the immune system, and current or prior use of medications such as chemotherapy any other immune suppressant medications.

How can I protect my child from skin cancer?

·      Avoid getting too much sun. If you or your child develops a sunburn or even a suntan, they are getting to much sun exposure.

·      Use sunscreen regularly. Sunscreen should be at least SPF 30, labeled broad-spectrum, and water-resistant if used when swimming or sweating

·      Apply sunscreen at least every 2 hours while in the sun, more often if swimming or sweating.

·      Wear sun-protective clothing, including a hat, sunglasses, and a shirt. Special sun-protective clothing and swimwear is available.

You should try to examine your/your child’s skin every 2-3 months or as recommended by your provider. Before or during a bath or shower is a good time. If you notice any of the following when examining your child’s melanocytic nevi, call your doctor:

·      Change in color

·      Change in shape

·      Rapid increase in size

·      Itching or pain

·      Bleeding or crusting

·      New raised or bumpy areas

Most children and adults with acquired melanocytic nevi and small congenital melanocytic nevi can have these cared for by their primary care provider. If your have/your child has an unusual small congenital melanocytic nevus, an intermediate or large congenital melanocytic nevus, or a dysplastic nevus your dermatology provider may recommend skin checks every 3-12 months. Your provider may also take photographs of any concerning nevi to help to monitor changes during follow-up skin checks. The provider may suggest a skin biopsy if a melanocytic nevus changes significantly in the way that it looks.