Moles of special sites

Moles can arise anywhere on the skin and sometimes appear in areas that need particular care when assessing risk. These include the lips, the skin under or around the nails, and the palms of the hands and soles of the feet. Changes in these locations may be more difficult to spot, so early specialist review is important.

Moles on the lips

Pigmented areas on the lips may represent harmless freckles, moles or other pigment changes. A benign lip mole is usually:

• Small and well defined
• Uniform in colour
• Stable over time

Concerning features include rapid growth, irregular edges, very dark or uneven colour, or any area that bleeds or does not heal. Because the lips are exposed to sunlight, it is important to protect them with lip products containing high factor sunscreen and to seek early assessment of new or changing pigmented areas.

Moles around or under the nails

Pigment in or around the nail can have many causes, including harmless streaks due to increased melanin, bruising after injury, certain medications or, less commonly, melanoma arising from the nail unit. Nail changes of concern can include:

• A dark band or streak within a single nail that widens or becomes more irregular
• New pigment extending onto the surrounding skin at the base or sides of the nail
• Persistent nail splitting, distortion or a lump under the nail without clear injury

Any new, persistent or changing pigmented streak in one nail should be assessed promptly by a dermatologist. A dermatoscopic examination is particularly valuable for assessing nail pigmentation in more detail.

Moles on hands and feet

Moles on the palms and soles are common and are often benign. However, melanoma can also occur in these areas, sometimes looking like a dark patch or irregular area of pigmentation. Because the skin is thicker, changes may be subtle at first.

You should seek advice if a mole on the palm of the hand or sole of the foot:

• Develops or changes in adult life
• Becomes larger or changes shape
• Shows multiple or uneven colours
• Starts to bleed, crust or remain sore

Assessment and management

Moles at special sites are often more challenging to interpret. During an appointment the dermatologist will:

• Take a detailed history of how long the lesion has been present and any changes
• Examine the area closely, often with dermatoscopy
• Review the rest of your skin and other moles for comparison

If there is concern that a mole could represent melanoma or another serious condition, a biopsy or complete excision under local anaesthetic may be recommended so that the tissue can be examined under the microscope.

If you have noticed a new or changing mole on your lips, nails, hands or feet, please arrange a specialist mole check or contact us via the contact page.