Hello, I’m Dr. Neal Schultz [pause] and welcome to DermTV. I hope you’re all doing a skin self exam
every month… and also having a complete skin screening exam for pre-cancers
and skin cancers… by a dermatologist every year. People ask whether
very small moles can turn into melanoma, but more importantly, if they can
already be melanoma. The simple answer to both unfortunately is yes but the
good news is that tiny melanomas are almost always 100% curable.
To help you while you’re checking your moles, use the ABCDE rule to give you
objective criteria to help you figure out if a mole’s suspicious, and if
you then should get that particular mole checked by a dermatologist.
I’ll explain all the very helpful ABCDE rules in another episode, but
the “D” stands for “diameter” which brings us back to the size of the moles.
The “D” rule says that if a mole is larger than a pencil eraser, which
is about 1/4 inch or 6mm, then it should be checked by a doctor. But, that
only tells you that moles bigger than ¼” are more apt to be abnormal;
It doesn’t help you with today’s subject, the tiny much smaller ones.
Well, how small is small? As small as 1mm which is 1/25th of an inch. On
the ruler, this black line is 1 inch, this black square is ¼ inch, and here’s
our pencil, about 1/4 inch or 6 mm. And of course a whole inch equals 25
MMs. Here’s the point: Moles as small as 1mm can already be an early melanoma.
So how small 1 mm? It’s the width of a lower case “o” or “e” in your newspaper,
and that’s really small. In the past 5 years I have diagnosed
more that 20 melanomas as small as 1 mm, but let me reassure you that if in
fact a tiny 1mm mole is a melanoma, it’s almost always completely
curable by a simple surgical procedure. So please don’t ignore your very
small moles or “birth marks”. And for perspective, when I trained in dermatology
in the mid-1970s, the ‘rule’ I was taught was that if a mole
was less than 4mm in diameter (which is one-sixth of an inch), then it couldn’t
be a melanoma. We’ve since learned that that’s wrong, and when it comes
to melanoma, size just doesn’t count.