Dear Alice,

I’m sure I’m going to get a lot of flack for even asking, but after five years in Japan I can’t sit on this question any longer. What the heck are those huge moles so many Japanese have on their faces? I don’t mean the occasional freckle or demure beauty mark — I’m talking about enormous, protruding monster moles! I can’t begin to tell you how many Japanese I know, both men and women, who have big black moles on their faces. Are these kinds of moles specific to Japanese skin? Doesn’t it bother people to have moles in such a visible place? Why don’t they have them taken off?

Jim W., Fukuoka

Dear Jim,

You won’t catch any flack from me. I’ve wondered about that myself, and judging from my mailbox, so have quite a few other foreigners living in Japan. And it’s not like you can just go up and ask your friend with a whopper of an eye-stopper why the heck she doesn’t get that thing removed.

Let’s start with the basics. The Japanese word for mole is hokuro, but if you hang out with doctors you might want to learn the medical term: shikiso saibo bohan (literally, “pigmented cell mark,” and properly translated as “melanocytic nevus”). A mole is a growth on the skin formed by clusters of melanocytes, which are the skin cells that produce melanin, the pigment that gives skin its color. I looked all this up, and more, in preparation for an interview with Chieko Mori, a dermatologist at the Shirono Laser Clinic near Ebisu Station in Tokyo.

The first thing I learned is that Japanese are not molier than thou.

“The density of melanocytes is quite similar among all racial and ethnic groups,” Mori explained, “but in more darkly pigmented individuals these cells produce more melanin, which makes the nevus appear darker.”

We were speaking in Japanese, and the doctor must have noticed I was having trouble with all that unfamiliar vocabulary because she rephrased. “In other words, Japanese don’t get more moles than other people, but since our skin produces more melanin than that of Caucasians, the moles we do get tend to be dark brown or black and are quite noticeable against our relatively light skin. And, for various reasons,” she continued, “Japanese are less inclined to have moles removed.”

Most Japanese live with their moles, even if they don’t like them, because they’re afraid it will be painful and expensive to have them removed, according to Mori. Until about 10 years ago, when laser technology was introduced from the United States, the only way to get a mole removed in Japan was to have it cut out with a scalpel. That’s a scary procedure that requires stitches and leaves an obvious wound.

Laser removal heals faster, and involves little or no pain, but it’s still pricey because Japanese national health insurance doesn’t cover removal, by any method, unless the mole poses a health risk. Charges at the Shirono Laser Clinic are typical: ¥10,000 per millimeter of mole, thus removing a mole the size of a pencil eraser would cost about ¥50,000. That’s a fair chunk of change.

There are also a number of superstitions that discourage people from removing moles, the most common of which is that messing with a mole will cause it to turn cancerous (hokuro o ijiru to gan ni naru).

“That’s simply not true,” Mori assured me. “If a mole has been there a long time, and hasn’t changed in shape or color, there’s virtually no risk of it turning cancerous whether you finger it or remove it or just leave it alone.”

Some people also believe that facial moles, particularly those located in the center of the face, are somehow connected to the brain.

“Once we reassure them that the mole is not cancerous, they want to leave it where it is,” Mori said. “They don’t want to risk disturbing the brain.”

Another popular belief is that removing a mole will cause one’s luck to change (hokuro o toru to unsei ga kawaru), and they don’t mean a change for the better. There’s a whole branch of fortunetelling called hokuro uranai in which character and fortune is divined according to the placement of moles on the face or body.

A mole on the stomach means you’ll be lucky in love, while a mole in the middle of the nose forewarns a predisposition to marital troubles. But more often than not, facial moles seem to be taken as signs of good fortune. For example, a mole near the mouth is said to mean that you’ll never go hungry. A mole on the ear means you’ll have plenty of money.

These cultural beliefs certainly help explain what seems to be a general tolerance of moles in Japan. And plenty of Japanese people like moles, on themselves or others, as evidenced by the term hokuro bijin (a beautiful woman with a mole). There are a number of well-known actresses who sport prominent facial moles, although having looked at the photos, I’d classify their little friends more as “demure beauty marks” than “monster moles.” Examples include Rie Miyazawa, who has a mole near her nose; Yuko Takeuchi and Otoha, who have dark spots on their chins; and Asuka Seto and Miki Nakaya, who have beauty marks by their mouths. There are even attractive manga characters with moles, and that’s obviously not an accident of nature but a deliberate decision by their creators.

My favorite defense of moliness was offered by my friend Yasuko, who’s got quite a biggie under her left eye. She was horrified when I asked, gingerly, if she’d ever thought of having it removed.

“Gracious, no!” she cried. “I’ve had this mole so long it’s become my shirushi (the mark by which one is known). If I died without it, when I get to heaven my old friends wouldn’t know me, and I’d have to spend all eternity alone!”

In Japan, black moles on the palms of the hand and the soles of the feet have been found to turn cancerous at a higher rate than moles in other locations. If you or someone you know has a dark spot in either of those locations, please consult a doctor.

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