Mole removal

Mole removal can be done for aesthetic or medical reasons. Both reasons are justified and completely safe if the intervention is properly performed.

Depending on the clinical and dermoscopic picture, it is possible to remove the mole with radio waves or with classical surgery, and the decision is up to the dermatologist. Every removed mole must be sent to the pathohistological analysis for confirmation of the diagnosis. The procedure of removing mole with a laser doesn’t enable sending the change to the pathohistological analysis and is not recommended. In the place where the mole was, and where the intervention was done, there is always a kind of scar. How a scar will look depends on the region where the mole was removed from and the method used.

With every mole removal we are getting safer and safer because the removed change can no longer become malignant. It is necessary to report to a dermatologist if you notice the appearance of a new mole or if following symptoms occur on the existing one: itching, redness, pain, change in shape, change in pigment, irregularly shaped disappearance of the mole, appearance of a scab, or bleeding.

If the mole is at a place of constant irritation such as feet, nail plates, mustache, beard, waist, it is desirable to follow the mole dermoscopically on a yearly level or remove it preventively.

What does a mole removal look like?

Removing moles is done under local anesthesia, it lasts for 20 minutes and is followed by mild unpleasantness during the first day of intervention. The stitches are removed 7 to 14 days later depending on the place where the mole was removed. If the mole has changed and become a melanoma, the intervention is done under general anesthesia and the whole thickness of the skin is removed in the place of existing change as well as the fatty tissue under the skin, all the way to the muscle fascia. The sample must be sent to a pathohistological analysis.

What is a pathohistological analysis?

A pathohistological mole analysis is the observation of a removed mole under the microscope and determining if the mole contains malignant cells and if it does, how deep down they have spread.

Possible ways for mole removal

Surgical removal of moles

Surgical removal of moles is indicated in the following cases:

  • If the mole is dysplastic – dermoscopy is used to observe the irregular structure, but the mole is still healthy.
  • If the mole has changed and dermoscopy states that there are criteria for melanoma.
  • If the mole is innate – congenital. These mole carry a 15% greater risk of becoming malignant in one’s lifetime.
  • If the mole is blue, blue naevus. Bluish gray color of the mole points to the pigment cells in the last, deepest part of the skin. Also, it carries a greater risk for change during lifetime.
  • If the mole is removed for aesthetic reason or is in a place of frequent irritation and is larger the 7 mm.

Removing moles with radio waves

This method consists of removing a mole with radiofrequency power and practically evaporating the skin in the place of radio wave passing. A big advantage of this method is that it is comfortable and fast for the patient – it lasts up to five minutes, without having stitches, blood or pain after the intervention. After removing the mole, the scar is often more acceptable than surgical intervention.

A drawback of this method is that there is a 10% higher chance that some mole cell will remain in the skin then when this procedure is done surgically. A removed mole can be sent to a pathohistological analysis and if the mole cells have begun to change this will be shown under the microscope.

Radio waves can be used to remove the following moles:

  • Moles up to 7 mm in diameter with regular structure.
  • Moles that are removed for aesthetic reasons.
  • Moles that are in the place of constant irritation but still haven’t changed.

Removing moles with a laser

Removing moles with a laser is a procedure called “shave” or shaving the mole. A laser beam melts the mole down to the skin level or a little deeper. This method removes the moles that are colorless. A mole can’t be sent to a pathohistological analysis because it evaporates under the laser beam. A patient must be warned that there is still a mole in that spot, but it is less visible. The procedure is done purely for aesthetic reasons.

Spec. Dr. Svetlana Djurisic, dermatologist
Dermatological clinic DERMATIM, Belgrade