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What is the Risk of my Child’s Mole or Birthmark Becoming a Skin Cancer?

“It can be quite scary,” says Dr. Adam Mamelak, dermatologist and skin cancer expert in Austin, Texas. “As a parent, we put our children before ourselves. And at the forefront of this, is our child’s health.”

Parents are naturally concerned about their children’s health and wellbeing, and become concerned when anything seems out of the ordinary. Birthmarks of some kind are very common, occurring on over 80% of babies.

Dr. Mamelak meets parents on a daily basis bringing their children in to have their birthmarks and moles evaluated. “With the rates of skin cancer soaring, parents are being more and more diligent about checking their children’s skin. It becomes natural for parents to wondering what the risk is of their child’s birthmark becoming a melanoma skin cancer.”

While some birthmarks last for life, others eventually fade away. “Not all birthmarks are the same. Birthmarks differ is shape, size and composition,” explains Dr. Miriam Hanson, board-certified dermatologist with a special interest in pediatric skin conditions at Sanova Dermatology. “Some are made up of blood vessels and form vascular lesions like port wine stains, spider angiomas or hemangiomas on the skin. Others are more consistent with pigmented lesions and give us darker discolorations such as Mongolian spots, café-au-lait macules or moles.”

The term “birthmark” general refers to a colored spot or patch on the skin, which can be present either at birth or shortly afterward. Most birthmarks are not generally considered a health hazard.

Congenital Moles

Congenital (meaning present from birth) nevi, or moles, are a type of birthmark which nearly everyone has. Large congenital moles have a slight risk of eventually becoming cancerous. Larger moles have a greater risk of becoming cancerous than do smaller ones. Congenital birthmarks should be examined by your dermatologist, who in most cases can diagnose them based on the skin’s appearance.

Cancer Risk for Congenital Moles

A long term study published by the U.S. National Library of Medicine followed 265 patients who were first treated for congenital nevi from 1950 to 1984, shows how cancer risk is related to the size of congenital moles. The patients were studied for cancer incidence from 1971 to 1989, and for mortality until mid-1993. There were 164 patients who had congenital moles covering less than 1% of the body, and 68 patients who had moles covering 1% to 4% of their bodies. None of the moles in these patients developed melanoma. Of 33 the patients who had congenital moles covering 5% or more of the body, two developed melanoma, and both cases were fatal.

“Size tends to be an important consideration,” notes Dr. Hanson. “Most studies divide congenital moles into small, medium and large, large being over 20 cm in diameter. These appear to have the greatest risk.”

In a 2012 publication in the Journal of the American Academy of Dermatology, the risk of small- and medium-sized moles was reported to be likely less than 1%. In large-sized mole, the risk varied widely but on average was still likely less than 5%.

What to Look for in Children

It is important to look at your child’s moles and remember what they look like so you will notice changes early.

“To some degree, a child’s mole will grow with them,” says Dr. Mamelak, “it’s therefore not uncommon to see a mole get slightly bigger over time, in proportion with the child’s growth.”

“It’s when the mole grows out of proportion with the child, or begins to exhibit atypical or suspicious characteristics that it should be promptly evaluated,” says Dr. Mamelak.

Regular skin examinations to check for unusual changes are recommended for people who have more than 50 moles on their bodies. If there are any questions about whether a mole poses a health risk, your dermatologist will either remove it surgically or take a small tissue sample to look for changes in the skin which are signs of cancer. Your doctor may also take photographs of birthmarks to look for changes over time.


Since most birthmarks do not present a health risk, they do not usually require treatment. Moles that have an increased risk of cancer can be surgically removed. Visible birthmarks which cause you to be self-conscious or uncomfortable about your appearance can often be hidden with cosmetics. If a birthmark cannot be easily covered, your dermatologist may be able to remove it. There are a variety of ways in which a dermatologist can remove birthmarks, including laser therapy, surgery and other skin treatments.


At Sanova Dermatology, we use state of the art technology and techniques to provide the best care possible. Contact us if you would like to know more about diagnosis and treatment options for birthmarks or any other skin condition.

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