Contrary to what you might think, moles are not the most likely place for a deadly melanoma to develop, a new analysis shows.

In fact, a review of 38 previously published medical studies involving more than 20,000 melanomas showed that only 29 percent of the skin cancers started in moles patients already had, while 71 percent arose as new lesions on the skin.

“Patients and physicians should be aware that skin without moles is more at risk than moles to develop a melanoma,” said lead researcher Dr. Riccardo Pampena. He is with the dermatology and skin cancer unit at Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico at Reggio Emilia in Italy.

Melanomas that arise on their own also tend to be more aggressive than melanomas associated with moles, suggesting the two types of malignancies might be different, Pampena added.

Regardless, dermatologists should always do complete skin examinations and follow up any atypical moles, Pampena stressed.

“Not only moles, but the whole-body surface should be monitored by patients and physicians,” he said.

The report was published Aug. 29 in the Journal of the American Academy of Dermatology.