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Mole removal

Wednesday, 18 February 2015 00:00

With the term moles (nevi) we mean skin lesions composed of more than expected melanocytes. Melanocytes are naturally occurring cells in the epidermis that protect us from UV with their colour (melanin). Some moles exist since our birth (congenital nevi) and some are acquired during our lifetime (acquired nevi).

We remove moles for esthetic and medical reasons, however for both occasions in our practice removal is surgical, without cauterizations, laser injury etc. This is a conscious choice since on the one hand, the aesthetic result is totally comparable and on the other hand and most importantly, we believe it is bad practice to burn a mole and remove only its top part (as it usually happens using a laser), leaving and essentially ‘burrying’ the now inflamed part that is deeper and often doesn’t even have melanin.

Often these moles recur and because of the laser induced injury, they look very atypical, making differential diagnosis from melanoma difficult. Moreover, it is unknown what the intense heat aggravation of the melanocytes causes in the remaining mole. The idea of creating an unlikely but potential medical issue from an aesthetic procedure seems totally absurd to us.

More superficial lesions or moles with a stalk can be removed with a simpler procedure called ‘shave’, which is much faster. It takes place under local anaesthesia as well, but does not require stitches and therefore costs less. However, in this procedure as well, we do not burn the mole and we aim for a removal in whole, assessed by histology (biopsy), which is possible exactly because the tissue is not burnt.

Mole removal for medical reasons is carried out most times because a mole looks ‘suspicious’ or because a mole is injured often because of its location (e.g. during shaving), in which case it is removed as means of prevention. On both occasions our goal is to act if possible before the occurrence of a melanoma or its spread.

Melanoma is a serious cancer that starts from melanocytes and may give metastases as it spreads. Most melanomas start from apparently healthy skin and less than 1/3 occur on a pre-existing mole. One of the main roles of a Dermatologist is to assess each individual lesion and to judge whether it is a possible melanoma that needs to be removed. In our practice with have a lot of experience in this field and a deep understanding of melanocytic lesions (see mole check).

We never remove moles without a reason, since it entails a small hassle and cost for the patient. In the same manner, regular mole checks should be carried out mainly in individuals with an increased risk in logical and established time intervals and not more often than needed from fear or uncertainty.

The surgical removal of a mole or suspicious lesion for medical reasons takes place in our practice, using local anaesthesia and requiring stitches since it is essential to have it removed in the required depth. The removal procedure depends on the size and location of the lesion and usually takes about 20 minutes. There is no pain during or after the procedure but it is better if the patient can rest or take it easy for a time period after the operation, especially if the mole is located in an area with a lot of tension (back, hands, feet etc) for an optimum aesthetic result. The histologic report from the biopsy is provided usually within 3 working days.

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