Finding a spot or growth on the scrotum can understandably cause concern, but most moles (nevi) found in the genital area are entirely benign. A mole is a common skin growth that forms when melanocytes, the pigment-producing cells, cluster together. These lesions can appear anywhere on the body, including the scrotum, which is generally protected from sun exposure. The biological nature of a scrotal mole is usually the same as any other mole found elsewhere. While their presence does not automatically indicate a serious health issue, they do warrant careful observation.
Understanding Moles in the Genital Area
Moles located on the scrotum are considered a type of melanocytic nevus. Like other common moles, a benign scrotal nevus typically exhibits a symmetrical shape and a uniform color, often appearing flat or only slightly raised above the surrounding skin. The majority of pigmented lesions in this region are harmless, and they often maintain a stable size and appearance over many years. Melanocytic nevi are common in this area, demonstrated by the measurable percentage of male patients seeking consultation for genital lesions.
The skin of the genital area can sometimes cause moles to appear darker than those elsewhere on the body due to natural differences in pigmentation and blood flow. Besides simple moles, other common, non-cancerous growths, such as sebaceous hyperplasia or angiokeratomas, can also appear on the scrotum and might be mistaken for moles. These other growths reflect the specialized nature of the skin tissue in this region.
Identifying Signs of Concern
The primary concern regarding any mole, regardless of its location, is the potential for it to be or to become a melanoma, the most serious form of skin cancer. For lesions in the genital area, the standard warning signs for malignancy are organized into the modified ABCDE rule, which focuses on changes in appearance over time.
- Asymmetry (A): One half of the mole does not match the other half when divided down the middle.
- Border irregularity (B): The edges are uneven, notched, or blurred rather than smooth and sharply defined.
- Color variation (C): The mole contains multiple shades of brown, black, tan, or if shades of red, white, or blue begin to appear.
- Diameter (D): Any lesion larger than six millimeters (roughly the size of a pencil eraser) should raise suspicion, though melanomas can be smaller.
- Evolving (E): Any change in size, shape, color, elevation, or the development of new symptoms like itching, tenderness, or bleeding necessitates medical evaluation.
It is also important to be vigilant for the “Ugly Duckling” sign, which refers to a mole that looks noticeably different from all the other moles on your body.
What Causes Moles on the Scrotum
Moles are caused by a localized proliferation of melanocytes, the cells that produce the skin pigment melanin. The development of these clusters is influenced by a combination of genetics and hormonal factors, which dictate how and where these pigment cells aggregate. Genetic predisposition plays a substantial role in determining the total number of moles an individual will develop, as well as their distribution across the body.
Hormonal fluctuations, particularly during puberty, can also trigger the appearance of new moles or cause existing ones to darken or enlarge. This occurs because hormones can stimulate melanocyte activity, leading to increased pigmentation and growth. Unlike moles on sun-exposed areas like the face or arms, the development of moles on the scrotum is not primarily driven by ultraviolet radiation exposure. Moles in this area form mainly due to underlying genetic and endocrine influences.
The Process of Medical Examination
If a scrotal mole exhibits any of the ABCDE warning signs, or if it is frequently irritated, seeking examination from a dermatologist or urologist is the appropriate next step. The medical professional will typically begin with a thorough visual inspection of the lesion and the surrounding skin. This examination often involves the use of a specialized handheld microscope called a dermatoscope, which allows for a highly magnified view of the mole’s underlying structures and pigment patterns.
If the mole appears suspicious after this non-invasive inspection, the doctor will recommend a skin biopsy to determine the nature of the growth. This procedure is quick and is performed in the office using a local anesthetic to numb the area. Depending on the mole’s size and characteristics, the doctor may perform a shave biopsy, a punch biopsy to sample deeper layers of tissue, or an excisional biopsy to remove the entire lesion. The tissue sample is then sent to a pathologist for microscopic analysis, which provides a definitive diagnosis of whether the mole is benign, atypical, or malignant.