Mole is skin growths made up of cells that produce color (pigment). A mole can appear anywhere on the skin, alone or in groups. Most people get a few moles during their first 20 years of life. They are usually brown in color but can be blue, black, or flesh-colored. Most moles are harmless and don't cause pain or other symptoms unless you rub them or they bump against something. frequently removed for a variety of reasons. They can be removed by two surgical methods:
- Excision (cutting), with or without stitches
- Shave removal using a scalpel blade without stitches
Although laser excision has been tried for moles, it is not the method of choice for most deep moles because the laser light doesn't penetrate deeply enough, and there is no tissue remaining to examine pathologically. Typically, the dermatologist (a skin specialist) may choose excision with or without stitches, depending on the depth of the mole and the type of cosmetic outcome desired.
Types of Moles
Congenital nevi: These are moles that appear at birth. Congenital nevi occur in about one in 100 people. These moles, particularly giant nevi, may be more likely to develop into melanoma (cancer) than are moles that appear after birth.
Dysplastic (atypical) nevi: These are moles that are larger than average (larger than a pencil eraser) and irregular in shape, colour, and even border. People with dysplastic nevi may have more than 100 moles and have a greater chance of developing melanoma, a serious form of skin cancer.
Spitz nevi: These moles generally appear in juveniles and are typically under 1cm in diameter, firm, raised and pink or reddish-brown in colour. They may even bleed or ooze. Though they are not dangerous, they so closely resemble melanoma that they are difficult to differentiate and require an excisional biopsy to confirm diagnosis.
Acquired (common) nevi: These are moles that develop during a person’s lifetime, after birth. The common mole tends to be small, have uniform pigmentation, and defined edges. Though considered benign, people with more than 50 acquired moles have an increased risk of developing melanoma.
Skin tags: These are small, soft pieces of skin that stick out on a thin stem. They most often appear on the neck, armpits, upper trunk, and body folds. The cause of skin tags is not known. They are harmless.
What causes moles?
Some people are born with moles. Other moles appear later in life. Sun exposure seems to play a role in the development of moles and may even play a role in the development of atypical, or dysplastic, moles. The role of heredity cannot be underemphasized. Many families have a type of mole known as dysplastic (atypical), which can be associated with a higher frequency of melanoma.
How do doctors remove moles and skin tags?
Your doctor may remove a mole or skin tag in any of these ways:
- Cutting it off. Skin tags may be snipped off with a scalpel or surgical scissors. Some moles can be "shaved" off flush with the skin. Other moles may have cells that go underneath the skin, so your doctor might make a deeper cut to remove the entire mole and prevent it from growing back. This cut may require stitches.
- Freezing it with liquid nitrogen. Your doctor will swab or spray a small amount of super-cold liquid nitrogen on the mole or skin tag. You might have a small blister where the mole or skin tag was, but it will heal on its own.
- Burning it off. An electric current passes through a wire that becomes hot and is used to burn off the upper layers of the skin. You may need more than one treatment to remove a mole. Skin tags are removed by burning through the narrow stem that attaches them to the skin. The heat helps prevent bleeding.
The procedure may hurt a little, but your doctor will numb the area with an anesthetic before he or she begins. If the procedure causes any bleeding, your doctor may apply a medicine that helps stop the bleeding. Then he or she will put a bandage on it. These procedures usually leave no scars or marks.
- Removal with simple shaving without stitches
- The surgeon takes a scalpel and shaves the mole off flush or slightly below the level of skin.
- Then, either an electrical instrument will cauterize or burn the area or a solution will be placed on the area to stop any bleeding.
- The wound is then covered with a bandage.
- The doctor will give you instructions on how to take care of your wound. You are usually able to leave the office shortly after.
- Removal by excision with stitches
- Moles removed by excision (cutting) with stitches are usually in cosmetically sensitive areas where an optimal scar is desired.
- The surgeon maps out the mole and then sterilizes or cleans the area and numbs it.
- Then a scalpel is used to cut the mole and a border surrounding the mole. The border size depends on the concern of the surgeon for the mole being removed. If there is concern that the mole could be precancerous or cancerous, a larger border will be removed to ensure that the mole itself is completely excised.
- Depending on the depth of the mole (how deeply the mole penetrates into the skin), stitches are placed either deep (these are absorbed by the body and do not have to be removed) or on the upper surface of the skin (these don't absorb and will be removed later)
- Home care
- After the procedure, you need to keep a layer of petrolatum (Vaseline) and a bandage on the wound.
- Clean the wound once or twice daily with either water or diluted hydrogen peroxide.
- After cleaning the wound, apply the petrolatum and bandage.
- These steps are repeated until the wound is healed.
- Misconceptions about healing
- Some people think that woundsneed to be open to the air and that this helps healing. Several studies have disproved this and found significantly quicker healing with bandages and antibiotic salve.
- Similarly, vitamin E has been found to slow healing rather than accelerate it, and scars were shown to be worse with vitamin E placed directly on wounds than without it.
- There are several scar remedies on the market, including Kinerase Scar Healing Therapy, Skin Medica Scar Recovery Gel, MedermaSkin Care for Scars, Avene Cicalfate Restorative Skin Cream, Kelo-Cote Advanced Formula Scar Gel, and many others. These all have the common feature of covering a scar and providing a healing membrane during and after the initial procedure. These provide little or no benefit ove petrolatum alone.
Risks of mole removal methods vary from infection to anesthetic allergy and nerve damage. It is always prudent to choose a dermatologist or surgeon with appropriate skills and experience with these removals. This will decrease your risk associated with this procedure.
- Other risks vary depending on the area being treated and the method of removal.
- One of the most common difficulties after mole removal is a scar. Many people will attempt to remove moles for cosmetic reasons, not realizing that each and every removal will result in a scar. Many times your surgeon can give you an idea of the type and location of a scar after mole removal before you make your decision about removal.