Cafe-au-lait spots with moles: how to tell them apart

Look at each mark separately. For a cafe-au-lait spot, note whether its colour is even and its edge is clearly defined. For a mole, note elevation, symmetry, colour variation, and surface changes. A photograph can help show evolution, but it cannot replace an examination. Several flat pigment marks, especially alongside other findings, may be worth discussing with a dermatologist even when the moles look unchanged.

Map the locations and photograph the spots and moles in consistent light. Avoid scratching, picking, or applying unprescribed pigment creams. Use sun protection on exposed areas to reduce tanning and make comparison easier. Cosmetic treatment of a cafe-au-lait spot is a separate decision from evaluating a mole; a dermatologist can explain whether [Picosecond Laser Treatment](/treatments/laser-and-energy/picosecond-laser-treatment/) is suitable without treating an uncertain mole.

Seek prompt assessment for a mole or pigment mark that changes in size, shape, colour, height, or surface, or that bleeds, crusts, becomes painful, or develops persistent itch. Arrange routine care when many new marks appear or when you cannot confidently identify which mark has changed. Urgent advice is needed for rapidly spreading skin changes with fever or significant illness.

Which marks appear flat cafe-au-lait spots and which are moles? Does any mole need a closer examination? How should I label and photograph them? If I want cosmetic treatment, which mark must be diagnosed first?