Spitz Nevus (Mole): How It Looks and When to Remove One

A Spitz nevus is an uncommon type of mole that is usually raised, dome-shaped, and pigmented.1 Anyone can have a Spitz nevus, or multiple, but they’re more common in children and people with fair skin.2

A Spitz nevus isn’t cancerous. However, some Spitz nevi (the plural of Spitz nevus) have atypical characteristics that make them look suspiciously like melanoma, a type of skin cancer, and are therefore often removed as a precaution.1 

What Spitz Nevus Typically Looks Like

A Spitz nevus is a noncancerous mole that often appears on the legs, face, or neck but can also occur on the trunk or arms. Spitz nevi usually appear as only one lesion, but they can also develop as multiple lesions.

Although they can appear at any age, Spitz nevi often appear in childhood,3 usually within the first 20 years of life.4 They tend to appear suddenly, grow quickly in a few months, then stop growing and may even disappear after a period of time.1

A Spitz nevus typically has the following characteristics:2

• Symmetrical
• Circular
• Firm
• Smooth or warty surface
• Up to 1 centimeter in diameter
• Dome-shaped 
• Red, red-brown, pink, blue-black, tan in color or the same color as the skin

Some Spitz nevi may bleed, ooze, or itch.42 However, most people with a Spitz nevus don’t have symptoms.2

A Spitz nevus can look a lot like melanoma,2 a serious type of skin cancer, and a dermatologist may need to look at it using a dermoscope (or dermatoscope), a noninvasive magnifying tool for skin lesions, and take a skin biopsy (removing a sample of tissue for analysis in a lab) to make sure it isn’t melanoma.

Characteristics of Atypical Spitz Nevus

Atypical Spitz nevi are different from most Spitz nevi and have the following characteristics:12

• Asymmetry
• Larger than 1 cm in diameter
• Broken on the surface (ulcerated)
• Different colors or patterns

It's important to see a primary care provider or a dermatologist (specialist in conditions of the skin, hair, and nails) if you see atypical features of a Spitz nevus or mole. A provider can determine whether ongoing monitoring or treatment such as surgical removal is necessary.1

Spitz Nevus and Cancer: What's the Connection?

Spitz Nevus and Melanoma: Overlaps and Differences

An atypical Spitz nevus may also be referred to as an atypical Spitz tumor. While “tumor” is in the name, it doesn’t necessarily mean it’s cancerous. Atypical Spitz tumors share characteristics with a Spitz nevus but have some microscopic features that are associated with melanoma.5 

The potential of atypical Spitz nevi to be malignant (cancerous) is controversial.5 It can be hard to tell an atypical Spitz tumor apart from spitzoid melanoma, even under a microscope, which has led experts to recommend that they be removed as a precaution.1

When to Consider Spitz Nevus Removal

The first step in considering whether to remove a Spitz nevus is having it looked at by a dermatologist. They may use a dermoscope to examine the Spitz nevus and take a biopsy if it looks suspicious. A biopsy can help determine if it’s benign (noncancerous) or malignant. 

Even if your Spitz nevus is benign, you may still want it removed for cosmetic reasons. Talk to a health care provider or dermatologist if you have questions about Spitz nevus removal.

Purpose of Dermoscopy

like Spitz nevi, up close. Under the dermoscope, they can evaluate the color, structure, and patterns of skin lesions to help diagnose certain skin conditions, like atypical moles and melanoma.6 

Dermoscopy may also be used to monitor a Spitz nevus and see if and how it changes over time.1 Dermoscopy is a useful technique to inform dermatologists whether a skin biopsy is necessary.

Healing After Spitz Nevus Removal

If your Spitz nevus is removed, your dermatologist will provide you with aftercare instructions. Make sure to follow these instructions to give your skin the best chance at successful and speedy healing. If you have stitches, your provider will let you know when you need to return to get them removed. 

Generally speaking, taking care of your skin after removal of a skin lesion includes:7

• Making sure your hands are clean when you care for the affected area of skin
• Keeping the wound from reopening 
• Using ointments, if directed by your dermatologist

Be sure to tell your healthcare provider if the skin lesion returns after the wound has healed.

Summary

A Spitz nevus is an uncommon type of mole that is fast-growing. It’s more common in children and people with fair skin but can develop on anybody. Spitz nevi are not cancerous, but some have atypical features that make them look like melanoma and are often removed as a precaution. A dermatologist will use a dermoscope to examine a Spitz nevus and take a biopsy if they see something suspicious.