Melanoma; Causes, Symptoms, Diagnosis, Treatment

Melanoma; Causes, Symptoms, Diagnosis, Treatment

Melanoma is a growth on the skin that develops when pigment cells (melanocytes) grow in clusters. Most adults have between 10 and 40 common moles. These growths are usually found above the waist on areas exposed to the sun. They are seldom found on the scalp, breast, or buttocks. Although common moles may be present at birth, they usually appear later in childhood. Most people continue to develop new moles until about age 40. In older people, common moles tend to fade away.

melanocytic nevus (also known as endocytic nevusnevus-cell nevus and commonly as a mole)is a type of melanocytic tumor that contains nevus cells.[rx] The majority of moles appear during the first two decades of a person’s life, with about one in every 100 babies being born with moles.[rx] Acquired moles are a form of benign neoplasm, while congenital moles, or congenital nevi, are considered a minor malformation or hamartoma and may be at a higher risk for melanoma.[rx] A mole can be either subdermal (under the skin) or a pigmented growth on the skin, formed mostly of a type of cell known as a melanocyte. The high concentration of the body’s pigmenting agent, melanin, is responsible for their dark color.

Familial atypical multiple mole melanoma (FAMMM) syndrome is an autosomal dominant genodermatosis characterized by multiple melanocytic nevi, usually more than 50, and a family history of melanoma [rx]. It is associated with mutations in the CDKN2A gene and shows reduced penetrance and variable expressivity. Some FAMMM kindreds show an increased risk for the development of pancreatic cancer and possibly other malignancies [.

Melanoma

Types of Skin Mole/Melanoma

According to The Physical appearance type of mole are

  • Common moles – Non-cancerous moles are typically pink, tan or brown. They are one color. They can be flat or raised, round or oval, and are typically smaller than a pencil eraser. If you have 50 or more common roles, you are at increased risk for skin cancer and should consult your doctor.
  • Atypical moles (dysplastic) – See your doctor if you have any large, unusually shaped, or multi-colored moles, as these may be more likely to develop into skin cancer.
  • Congenital moles (birthmarks) – These are moles that you are born with. Very large congenital moles put you at greater risk for melanoma, so you should consult your doctor regularly to check for signs of skin cancer.
  • Spitz nevi – These moles look like melanoma (skin cancer). They are usually pink or multicolored, raised, and domed shaped. They may bleed or ooze. You will need a biopsy to ensure such a mole is not cancerous. Spitz nevi are more common in children and young adults.
  • Melanoma – A melanoma is a cancerous mole. It will need to be removed. See your doctor immediately if you suspect you have a melanoma.

According to the location of the mole Types

  • Junctional nevus – the nevus cells are located along the junction of the epidermis and the underlying dermis. A junctional nevus may be colored and slightly raised.[rx]
  • Compound nevus – A type of mole formed by groups of nevus cells found in the epidermis and dermis.[rx]
  • Intradermal nevus – A classic mole or birthmark. It typically appears as an elevated, dome-shaped bump on the surface of the skin.[rx]
  • Dysplastic nevus (nevus of Clark) – usually a compound nevus with cellular and architectural dysplasia. Like typical moles, dysplastic nevi can be flat or raised. While they vary in size, dysplastic nevi are typically larger than normal moles and tend to have irregular borders and irregular coloration. Hence, they resemble melanoma, appear worrisome, and are often removed to clarify the diagnosis. Dysplastic nevi are markers of risk when they are numerous (atypical mole syndrome). According to the National Cancer Institute (NIH), doctors believe that when part of a series or syndrome of multiple moles, dysplastic nevi are more likely than ordinary moles to develop into the most virulent type of skin cancer called melanoma.[rx]
  • Blue nevus – It is blue in color as its melanocytes are very deep in the skin. The nevus cells are spindle-shaped and scattered in deep layers of the dermis. The covering epidermis is normal.
  • Spitz nevus – a distinct variant of intradermal nevus, usually in a child. They are raised and reddish (non-pigmented). A pigmented variant, called the ‘nevus of Reed’, typically appears on the leg of young women.
  • Acquired nevus – Any melanocytic nevus that is not a congenital nevus or not present at birth or near birth. This includes junctional, compound and intradermal nevus.
  • Congenital nevus – Small to large nevus present at or near the time of birth. Small ones have a low potential for forming melanomas, however, the risk increases with size, as in the giant pigmented nevus.
  • Giant pigmented nevus – these large, pigmented, often hairy congenital nevi. They are important because melanoma may occasionally (10 to 15%) appear in them.
  • Intramucosal nevus – junctional nevus of the mucosa of the mouth or genital areas. In the mouth, they are found most frequently on the hard palate. They are typically light brown and dome-shaped.
  • Nevus of Ito and nevus of Ota – congenital, flat brownish lesions on the face or shoulder.[rx]
  • Mongolian spot – congenital large, deep, bluish discoloration which generally disappears by puberty. It is named for its association with East Asian ethnic groups but is not limited to them.[rx]
  • Recurrent nevus – Any incompletely removed nevus with residual melanocytes left in the surgical wound. It creates a dilemma for the patient and physician, as these scars cannot be distinguished from a melanoma.[rx]


Causes of Skin Mole/Melanoma

Although anyone can develop melanoma, people with the following risk factors have an increased chance of melanoma [rx]:

  • Having a dysplastic nevus
  • Having more than 50 common moles
  • Sunlight – Sunlight is a source of UV radiation, which causes skin damage that can lead to melanoma and other skin cancers. Sunlight can be reflected by sand, water, snow, ice, and pavement. The sun’s rays can get through clouds, windshields, windows, and light clothing.
  • Tanning – Although having skin that tans well lowers the risk of sunburn, even people who tan well without sunburning increase their chance of melanoma by spending time in the sun without protection.
  • Lifetime sun exposure – The greater the total amount of sun exposure over a lifetime, the greater the chance of melanoma.
  • Severe, blistering sunburns – People who have had at least one severe, blistering sunburn have an increased chance of melanoma. Although people who burn easily are more likely to have had sunburns as a child, sunburns during adulthood also increase the chance of melanoma.
  • Sunlamps and tanning booths – UV radiation from artificial sources, such as sunlamps and tanning booths, can cause skin damage and melanoma. Health care providers strongly encourage people, especially young people, to avoid using sunlamps and tanning booths. The risk of skin cancer is greatly increased by using sunlamps and tanning booths before age 30.
  • Personal history – People who have had melanoma have an increased risk of developing other melanomas.
  • Family history – Melanoma sometimes runs in families. People who have two or more close relatives (mother, father, sister, brother, or child) with melanoma have an increased chance of melanoma. In rare cases, members of a family will have an inherited disorder, such as xeroderma pigmentosum, that makes the skin extremely sensitive to the sun and greatly increases the chance of melanoma.
  • Skin that burns easily – People who have fair (pale) skin that burns easily in the sun, blue or gray eyes, red or blond hair, or many freckles have an increased chance of melanoma.
  • Certain medical conditions or medicines – Medical conditions or medicines (such as some antibiotics, hormones, or antidepressants) that make the skin more sensitive to the sun or that suppress the immune system increase the chance of melanoma.

Symptoms of Skin Mole/Melanoma

Melanoma

According to the American Academy of Dermatology[rx], the most common types of moles are skin tags, raised moles and flat moles. Benign moles are usually brown, tan, pink or black (especially on dark-colored skin). They are circular or oval and are usually small (commonly between 1–3 mm), though some can be larger than the size of a typical pencil eraser (>5 mm). Some moles produce dark, coarse hair. Common mole hair removal procedures include plucking, cosmetic waxing, electrolysis, threading, and cauterization.

  • The Ugly Duckling Sign New Growths, Moles, Spots or Lesions – The most significant sign is a mark, mole or any new growth on the skin that looks different from the other spots on your skin. (An Ugly Duckling – A lesion looking a bit different from the other spots on your skin). With the uniqueness of each person comes the uniqueness of our skin and its moles and marks. But if a mole or mark stands out from the other lesions on your skin you should pay closer attention.
  • New Moles or Lesions When You’re Older Than 35 – Below the age of 35 years, it is completely normal to develop new moles. After that age, it becomes less common. In adults, 71% of melanomas show up as new moles or marks on the skin.[rx] Be extra attentive to new mole looking lesions if you are over 35 and remember to check areas you don’t look at often, such as your back. Taking a photo of these difficult areas is recommended to discover any new lesions early.
  • Sores that do not heal
  • Pigment, redness or swelling that spreads outside the border of a spot to the surrounding skin
  • Itchiness, tenderness or pain
  • Changes in texture, or scales, oozing or bleeding from an existing mole
  • Blurry vision or partial loss of sight, or dark spots in the iris


Diagnosis of Skin Mole/Melanoma

Healthy moles are usually round or oval in shape and tend to be only one color. They normally aren’t very big (less than 6 mm in diameter).

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The following ABCDE checklist can be used to tell melanoma apart from a normal mole

Asymmetry: The mole has an uneven (asymmetrical) shape. It often has one or more raised areas and is flatter elsewhere.
Border: The mole has an irregular border (edge), and may appear ragged, blurred or notched.
Color: The mole changes color. It may be several different colors, or an unusual color such as white, blue or red.
Diameter: The diameter is greater than 6 mm (wider than an average-sized pencil).
Evolving: The mole is changing: It might bleed, leak fluid, itch or crust over. Changes in size, shape, color or the surface are possible, and the mole may become raised.

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The ABCDE rule helps to recognize melanoma. But not all criteria apply to every melanoma: For instance, if it starts growing on normal skin (not in an existing mole), it often has a smaller diameter than 6 mm. Additionally, the most dangerous form of melanoma, nodular melanoma, has its own criteria:

  • Elevated – Raised moles are especially likely to develop into melanoma.
  • Firm – Cancerous moles often become firm or hard to the touch.
  • Growing – Moles that are growing are special causes for concern.

If you have a lot of moles and aren’t sure how to best keep track of them all, it might help to use the “ugly duckling” method. “Ugly ducklings” are moles that stand out from the crowd. This can make it easier to spot abnormal changes in the skin.

  • Skin Cancer Screening – In February 2009, the US Preventive Services Task Force published an update stating that there is insufficient evidence available to recommend for or against skin cancer screening. Furthermore, there has never been a randomized, controlled trial examining the efficacy of skin cancer screening. Thus, no data exist to demonstrate the effectiveness of early detection of skin cancer or the benefits on morbidity and mortality, including a reasonable calculation of the benefits of screening in the general population.
  • Role of Total Body Photography and Dermoscopy – Total body photography (TBP) is used to sequentially document the stability of skin lesions, detect subtle changes in existing lesions, and to recognize new lesions. Additionally, TBP was shown to help identify melanoma in its earlier stages and promote continued surveillance of skin lesions via the patient performing SSE.
  • Dermoscopy – is a simple and inexpensive technique that permits the visualization of morphologic characteristics that are not readily detectable with the naked eye. It is a real-time, in vivo method for the early detection of melanoma and other pigmented skin lesions. It has been shown to improve diagnostic sensitivity for melanoma by 10% to 27%.
  • Clinical Significance of Dysplastic Nevi – BK moles, Clark’s nevi, and atypical nevi are terms that refer to lesions with specific clinical and pathologic characteristics associated with an increased risk for the development of melanoma. These typically become clinically apparent at puberty or adolescence and continue to appear throughout life. Some clinicians have described patients having many nevi as having “dysplastic nevus syndrome,” although the classic definition refers to a patient with a triad of >100 nevi, at least 1 nevus that is ≥8 mm in diameter, and at least 1 nevus with clinically atypical features. The clinical significance of dysplastic nevi is in their association with the development of melanoma, with an age-adjusted incidence of melanoma ∼15 times higher in those patients with dysplastic nevi versus the general population (154 vs 10 per 100,000 person-years).

Melanoma stages – Healthcare professionals use a staging system called the AJCC system to describe how far melanoma has grown into the skin (the thickness) and whether it has spread. The type of treatment you receive will depend on what stage the melanoma has reached.

The melanoma stages can be described as

  • Stage 0 – the melanoma is on the surface of the skin
  • Stage 1A – the melanoma is less than 1mm thick
  • Stage 1B – the melanoma is 1-2mm thick, or less than 1mm thick and the surface of the skin is broken (ulcerated) or its cells are dividing faster than usual
  • Stage 2A – the melanoma is 2-4mm thick, or it’s 1-2mm thick and ulcerated
  • Stage 2B – the melanoma is thicker than 4mm, or it’s 2-4mm thick and ulcerated
  • Stage 2C – the melanoma is thicker than 4mm and ulcerated
  • Stage 3A – the melanoma has spread into 1 to 3 nearby lymph nodes, but they’re not enlarged; the melanoma isn’t ulcerated and hasn’t spread further
  • Stage 3B – the melanoma is ulcerated and has spread into 1 to 3 nearby lymph nodes but they’re not enlarged, or the melanoma isn’t ulcerated and has spread into 1 to 3 nearby lymph nodes and they are enlarged, or the melanoma has spread to small areas of skin or lymphatic channels, but not to nearby lymph nodes
  • Stage 3C – the melanoma is ulcerated and has spread into 1 to 3 nearby lymph nodes and they’re enlarged, or it’s spread into 4 or more lymph nodes nearby
  • Stage 4 – the melanoma cells have spread to other parts of the body, such as the lungs, brain or other areas of the skin;
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Treatment of Skin Mole/Melanoma


If you have melanoma skin cancer you’ll be cared for by a team of specialists that should include a dermatologist, a plastic surgeon, an oncologist (a radiotherapy and chemotherapy specialist), a pathologist and a specialist nurse.When helping you decide on your treatment, the team will consider:

  • the type of cancer you have
  • the stage of your cancer (its size and how far it has spread)
  • your general health

Whether it’s during 1 or 2 visits, a dermatologist can safely and easily remove a mole. A dermatologist will use one of these procedures:

  • Surgical excision –  The dermatologist cuts out the entire mole and stitches the skin closed if necessary. Your mole will also be looked at under a microscope by a specially trained doctor. This is done to check for cancer cells. If cancer cells are found, your dermatologist will let you know.
  • Surgical shave – The dermatologist uses a surgical blade to remove the mole. In most cases, a specially trained doctor will examine your mole under a microscope. If cancer cells are found, your dermatologist will let you know.

Your treatment team will recommend what they believe to be the best treatment option, but the final decision will be yours. Before going to the hospital to discuss your treatment options, you may find it useful to write a list of questions to ask the specialist. For example, you may want to find out about the advantages and disadvantages of particular treatments.

Treating stage 1 to 2 melanoma

Treating stage 1 melanoma involves surgery to remove the melanoma and a small area of skin around it. This is known as surgical excision.

  • Surgical excision is usually carried out under local anesthetic [rx], which means you’ll be conscious but the area around the melanoma will be numbed, so you won’t feel pain. In some cases, general anesthetic [rx] is used, which means you’ll be unconscious during the procedure.
  • If surgical excision is likely to leave a significant scar, it may be carried out in combination with a skin graft[rx]. However, skin flaps are now more commonly used because the scars are usually much better than those resulting from a skin graft.
  • In most cases, once the melanoma has been removed there’s little possibility of it returning and no further treatment should be needed. Most people (80-90%) are monitored in the clinic for 1 to 5 years and are discharged with no further problems.

Sentinel lymph node biopsy

  • A sentinel lymph node biopsy[rx] is a procedure to test for the spread of cancer. It may be offered to people with stage 1B to 2C melanoma. It’s carried out at the same time as surgical excision. You’ll decide with your doctor whether to have a sentinel lymph node biopsy. If you decide to have the procedure and the results show no spread to nearby lymph nodes, it’s unlikely you’ll have further problems with this melanoma.
  • If the results confirm melanoma has spread to nearby nodes, your specialist will discuss with you whether further surgery is required.
  • Additional surgery involves removing the remaining nodes, which is known as a lymph node dissection or completion lymphadenectomy[rx].

Treating stage 3 melanoma

  • If the melanoma has spread to nearby lymph nodes (stage 3 melanoma), further surgery may be needed to remove them. Stage 3 melanoma may be diagnosed by sentinel node biopsy, or you or a member of your treatment team may have felt a lump in your lymph nodes. The diagnosis of melanoma is usually confirmed using a needle biopsy fine needle aspiration[rx].
  • Removing the affected lymph nodes is done under general anesthetic. The procedure, called a lymph node dissection, can disrupt the lymphatic system, leading to a build-up of fluids in your limbs. This is known as lymphoedema.[rx].

Treating stage 4 melanoma

  • If melanoma comes back or spreads to other organs it’s called stage 4 melanoma. In the past, cure from stage 4 melanoma was very rare but new treatments, such as immunotherapy and targeted treatments, show encouraging results.
  • Treatment for stage 4 melanoma is given in the hope that it can slow cancer’s growth, reduce symptoms, and extend life expectancy. You may be offered surgery to remove other melanomas that have occurred away from the original site.
  • You may also be able to have other treatments to help with your symptoms, such as radiotherapy[rx] and medication. If you have advanced melanoma, you may decide not to have treatment if it’s unlikely to significantly extend your life expectancy, or if you don’t have symptoms that cause pain or discomfort.
  • It’s entirely your decision and your treatment team will respect it. If you decide not to receive treatment, pain relief and nursing care will be made available when you need it. This is called palliative care.

Immunotherapy

  • Immunotherapy is used to treat advanced (stage 4) melanoma, and it’s sometimes offered to people with stage 3 melanoma as part of a clinical trial.
  • Immunotherapy uses medication to help the body’s immune system to find and kill melanoma cells. A number of different medications are available, some of which can be used on their own (monotherapy) or together (combination therapy).

Medications used include:

  • ipilimumab
  • nivolumab
  • pembrolizumab
  • talimogene laherparepvec

Ipilimumab

Ipilimumab is recommended by NICE as a treatment for people with previously treated or untreated advanced melanoma that’s spread or can’t be removed using surgery. It’s given by injection over a 90-minute period, every 3 weeks for a total of 4 doses. Common side effects include diarrhea, rash, itching, fatigue, nausea, vomiting, decreased appetite, and abdominal pain.

  • ipilimumab for previously treated advanced melanoma
  • ipilimumab for previously untreated advanced melanoma

Nivolumab

  • Nivolumab is recommended by NICE for treating advanced cases of melanoma in adults that have spread or can’t be removed using surgery. It’s given directly into a vein (intravenously) over a 60-minute period, every 2 weeks. Treatment is continued for as long as it has a positive effect or until it can no longer be tolerated. Nivolumab can be used either on its own or in combination with ipilimumab.

In clinical trials, the most common side effects were tiredness, rash, itching, diarrhea, and nausea.

  • nivolumab for treating advanced melanoma that has spread or can’t be treated with surgery
  • nivolumab in combination with ipilimumab for treating advanced melanoma[rx]

Pembrolizumab

Pembrolizumab is recommended by NICE to treat advanced melanoma in adults that are spread or can’t be treated with surgery. It’s given by injection for 30 minutes, every 3 weeks. In clinical trials, the most common side effects were diarrhea, nausea, itching, rash, joint pain, and fatigue.

  • pembrolizumab for treating advanced melanoma after disease progression with ipilimumab
  • pembrolizumab for advanced melanoma not previously treated with ipilimumab[rx]

Talimogene laherparepvec

  • Talimogene laherparepvec is recommended by NICE for treating melanoma that’s spread or can’t be removed with surgery, where treatment with other immunotherapies isn’t suitable. It’s injected directly into the skin, sometimes with the help of ultrasound guidance. In clinical trials, the most common side effects were flu-like symptoms, reactions at the injection site and cellulitis[rx] (infection of the deeper layers of skin and underlying tissue). Read the NICE guidance about talimogene laherparepvec for treating melanoma that’s spread and can’t be surgically removed[rx]
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Targeted Treatments

Around 40 to 50 in every 100 people with melanoma have changes (mutations) in certain genes, which cause cells to grow and divide too quickly. If gene mutations have been identified, medication can be used to specifically target these gene mutations to slow or stop cancer cells growing. Possible targeted treatments include:

  • vemurafenib
  • dabrafenib
  • trametinib

Vemurafenib

Vemurafenib is a medication that blocks the activity of a cancerous gene mutation known as BRAF V600. It’s recommended by NICE as a treatment for people who’ve tested positive for the mutation and have locally advanced melanoma or melanoma that’s spread. Common side effects include joint pain, tiredness, rash, sensitivity to light, nausea, hair loss[rx] and itching. Vemurafenib can also be used with another medication called cobimetinib for treating people with the BRAF V600 mutation melanoma that’s spread or can’t be removed with surgery.

  • vemurafenib for treating locally advanced or metastatic BRAF V600 mutation-positive melanoma
  • cobimetinib in combination with vemurafenib for treating BRAF V600 mutation-positive melanoma that’s spread or can’t be treated with surgery[rx]

Dabrafenib

  • Dabrafenib also blocks the activity of BRAF V600. It’s recommended by NICE for treating adults with the BRAF V600 mutation who have melanoma that’s spread or can’t be removed with surgery. Common side effects include decreased appetite, headache, cough, nausea, vomiting, diarrhea, rash, and hair loss. [rx[.

Trametinib

  • Trametinib blocks the activity of the abnormal BRAF protein, slowing the growth and spread of cancer. It’s recommended by NICE either for use on its own or with dabrafenib for treating people with melanoma with a BRAF V600 mutation that’s spread or can’t be removed with surgery.
  • Common side effects include tiredness, nausea, headache, chills, diarrhea, rash, join pain, high blood pressure[rx] and vomiting. Read the NICE guidance about trametinib in combination with dabrafenib for treating melanoma that’s spread or can’t be removed with surgery[rx].

Radiotherapy and Chemotherapy

  • You may have radiotherapy[rx] after an operation to remove your lymph nodes, and it can also be used to help relieve the symptoms of advanced melanoma.
  • Controlled doses of radiation are used to kill the cancerous cells. If you have advanced melanoma, you may have a single treatment or a few treatments. Radiotherapy after surgery usually consists of a course of 5 treatments a week (1 a day from Monday to Friday) for a number of weeks. There’s a rest period over the weekend.

Common side effects associated with radiotherapy include:

  • Tiredness
  • Nausea
  • Loss of appetite
  • Hair loss[rx]
  • Sore skin

Many side effects can be prevented or controlled with prescription medicines, so tell your treatment team if you experience any. The side effects of radiotherapy should gradually reduce once treatment has finished. Chemotherapy is now rarely used to treat melanoma. Targeted treatments and immunotherapy (as described above) are the preferred treatment options.

Melanoma vaccines

Research is underway to produce vaccines for melanoma, either to treat advanced melanoma or to be used after surgery in people with a high risk of the melanoma returning. Cancer Research UK has more information about melanoma vaccines[rx].

Home Remedies of Skin Mole/Melanoma



Removing Moles Yourself with Natural Remedies

  • Do not cut or shave off moles at home – While natural remedies for moles are mostly harmless, attempting to cut a mole off yourself can leave a permanent scar or cause a dangerous infection. If the mole contains cancer, some of the cancer cells may stay in the skin and spread. You should also see a doctor before you try any natural remedies for your mole to ensure that it is not cancerous.
  • Know that self-treatment of moles may lead to scarring – It is always best to see a dermatologist if you wish to remove a mole for cosmetic reasons. The treatments listed below have been used for decades, but they are not scientifically proven. Some may irritate your skin or even lead to scarring. If you experience irritation, stop the treatment immediately and call your doctor.
  • Use natural skin whiteners to fade out moles – There are a number of fruits and extracts that have been shown to whiten skin. Though each of these treatments will take several weeks to show an effect, they can be an effective, scar-free way to reduce the appearance of moles, particularly non-raised ones.
  • Lemon Juice – Citrus fruits contain vitamin C, which promotes collagen production (necessary for the creation of new skin cells), is a powerful antioxidant and has been shown to inhibit skin darkening due to UV exposure.  Combine lemon juice with honey and apply to the mole for 15 to 20 minutes, once a day. Wash off with water.

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Warning – Do not expose the mole to sunlight while treating it. The juice in citrus fruits can react with UV light to cause photodermatitis, a painful condition resulting in a rash, blisters or scaly skin.

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  • Asian Pears – Pears contain arbutin – a naturally occurring form of hydroquinone, which has been proven to be an effective tyrosinase inhibitor. Tyrosinase is an enzyme that helps to produce melanin, the pigment that darkens skin, so inhibiting will produce a skin-whitening effect.  The best pear varieties to use are Yaquang, Hongpi, Quingpi, or Guifei. Blend the peel and fruit together along with honey as a binding agent and apply for 15-20 minutes a day, washing off with warm water. Stop if you develop skin irritation.
  • Pineapple – Pineapple fruit contains compounds that act as tyrosinase inhibitors, thereby whitening skin. Blend four slice of pineapple in a food processor along with a half a tablespoon of honey. Apply for 15-20 minutes a day and wash off with warm water.
  • Gooseberry oil, bearberry extract or grapefruit seed extract – These all contain tyrosinase inhibitors that help to whiten skin, but you should be careful when using, as too much may cause an allergic reaction. Mix a few drops of the oil or extract with honey and apply to the mole for 15-20 minutes a day.
Apply garlic to the mole – Garlic contains sulfur-rich juices and enzymes that break down pigment-producing cells and lighten pigmentation. Garlic may help lighten a mole. Cut a clove of garlic in half, place the cut side in contact with the mole, and secure it overnight with a bandage. The mole should begin to disappear within 5 days.

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  • Warning: Garlic can irritate and redden your skin.
  • Apply petroleum jelly to the area around the mole to protect it from the garlic juice.

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Use apple cider vinegar – Clean the mole with warm water, then soak a cotton ball in apple cider vinegar and place it on the mole. You can secure it with a bandage overnight, but if you wish to irritate your skin less, consider placing it on the mole for only 10-15 minutes, four times a day. The mole may fall off after 10 days or so.

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  • Warning – Apple cider vinegar can make the mole worse at first.
  • Using apple cider vinegar may leave scars once the mole is removed.
  • Apply petroleum jelly to protect the skin around the mole.

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Try castor oil or flaxseed oil – Though evidence regarding their effectiveness is inconclusive, both of these oils have long been used to soften and dissolve moles. They may be particularly helpful with raised moles.

  • Castor Oil – Mix just a pinch of baking soda and a few drops of castor oil and apply to the mole twice a day. This method is unlikely to leave scars, but it may take a month or more before your mole starts to fade.
  • Flaxseed Oil – Mix finely ground flax seeds and honey to make a paste. Apply it to the mole for one hour, three times a day. It may take several weeks for the mole to fade.
Apply aloe vera – Use a cotton bandage to apply aloe vera to your mole and wait until it is completely absorbed, then apply more. After several weeks, your mole may fade.

References


Melanoma

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