Mole! What an interesting word. If you look up the definition of the word mole you get an incredibly diverse list of definitions. A mole can be a pigmented spot, mark, or small permanent protuberance on the human body. Or it can mean a burrowing insectivore with tiny eyes, a person who works in the dark, a machine for tunneling, and/or a spy! This is why I love the line in the Austin Powers movie when he meets ‘the mole’, but the guy actually has a huge mole on his face and he can’t stop noticing it and making all sorts of references to it. He says “Nice to mole you, I mean meet you. Nice to meet your mole. Moley, moley, moley!, I’d like to make some guacamoley!” The interesting thing is that most of the moles that look like the mole on ‘the mole’ in the movie are benign, unless it has only been there for only a few weeks. Once people know that a mole like that is benign often they are happy to keep it. What I try to make sure people understand is that protruding moles on the face are actually the easiest to remove and heal the fastest with almost no scar. If the mole has changed, bled, or become irritated in anyway, it needs to be biopsied and insurance will likely pay for the procedure. If the mole removal is purely cosmetic, a patient would have to pay for it out of pocket. Patients will often come in concerned about a large mole that is ugly and catches on clothing, bra straps, belts, and necklaces. Most of the time these moles are not even moles, they are skin tags, with can be related to blood sugar issues. The moles to be concerned about are anything that is black, bleeding, or new. The easy way to remember this is ABCDE. Assymetry, if a mole is unusually shaped like a piece of popcorn, it needs to be checked. Border, if a mole looks like it has a tumor growing out of it, or if it has the proflie of popcorn, it needs to be checked. Assymetry and border are similar. Color is the most important thing to look for in my opinion. Black is almost always a concern unless someone if dark complected. Many shades of brown with some red is also a potential red flag. Diameter is not as specific, the books recommend checking moles that are bigger than 6mm or about the diameter of a pencil eraser. I have seen pre-cancer moles that were as small as 2mm and huge moles that were fine. Finally E is for evolving. Any mole that has recently changed or is new needs to be checked. Most of the time I can look at a mole and tell if it is suspicious or not, but a biopsy will confirm how benign or not is actually is and tell us what we need to do. The vast majority of moles that I biopsy are pre-cancerous and a simple excision removes any worry of the mole turning into melanoma.