Move removal

Removal of moles is a completely safe procedure if a physician chooses the most adequate mole removal method for the patient.

Surgical mole removal

Mole removal
Surgical mole removal involves the introduction of a local anaesthetic into the region underneath the mole. A patient feels a slight tingling sensation and the skin becomes completely numb. The incision is made directly around the mole if the mole is healthy. The sutures are removed after 7 to 14 days, depending on the region. A scar will form after removing the mole or any other skin lesion. It will be a fine line whose size will correspond to the mole diameter. Sometimes the scar is so discreet that it is barely visible, and in other cases it is noticeable. The scarring after the mole removal depends on: * the mole location * the mole size * the surgeon’s expertise * the body tendency to produce bad scarring, keloids or hypertrophic scars. Each scar can be treated with laser which can significantly improve its appearance. Surgical mole removal is the safest way to remove melanocytic lesions, because it is the only proven method to remove all mole cells. This procedure is always used if we are removing moles that are atypical, i.e. dysplastic or if there is a suspicion that the mole has changed to malignant melanoma. The entire excised tissue is sent for pathohistological verification.

Melanoma removal

Melanomas can be only surgically treated, when both the skin and subcutaneous tissue are removed to the fascia. Only in these cases, a patient will feel a mild pain after the intervention during the first 2 days.

Radiofrequency mole removal

Mole removal using radiofrequency is a newer method and it is suitable for all moles that have developed a small “stalk”, papillomatous naevi, with a base diameter of up to 5 mm. This method can also be used to remove flat moles, but the result in somewhat more pronounced scar consisting of a white dot of the mole base diameter. Using radiofrequency, the moles are removed while sparing healthy tissue not lo leave a rough scar, so the possibility that some mole cells remain is about 10%. The sample that is removed is sent for pathohistological analysis. After a local anaesthesia is introduced, the tissue under the mole is evaporated using radiofrequency wire. Then, the coagulation is performed and a scab forms. The scab falls off after 7 to 14 days. On the mole’s location, the skin will be pink for one to three months, and then will gradually fade. The whitish scar will remain because when removing the mole, all the pigment cells are also removed from the skin.

Deep shave biopsy

Deep shave biopsy is a mole removal procedure, which consists of deep shaving of moles followed by a wound coagulation using radiofrequency. This method is used when there is a dilemma whether the mole has started to change or whether it is still a healthy mole. Surgical knife removal allows the pathologist to have the correct cell arrangement at the incision site. Radiofrequency damages the base with high temperature, affecting the pathohistological findings. Deep shave biopsy is less frequently applied than surgery, because it is suitable only for the lesions up to 4 mm in diameter and it is comfortable only because there is no bandaging and suture removal.

Laser mole removal

Laser mole removal is indicated only in case of aesthetic reasons. This method is ungrateful because it does not allow for the mole samples to be sent for pathohistological analysis. The outcome of such removal is unpredictable because a dermatologist or surgeon never know to what extent the laser has evaporated the tissue and to what depth the moles are removed. The scar may be as discreet as when removed by radiofrequency, the pigment may reappear in the same place. Each mole removal leaves a small mark on the skin. Treatment of the resulting scars is desirable in the first two months, because if treated properly, the scar can become almost invisible. This especially applies for moles bigger than 1 cm.

Mole removal – Experiences

Mole removal is a proven and safe procedure if performed by a dermatologist or a plastic surgeon. It is necessary to break the myth that the medical removal of moles puts the patient in potential danger. Timely removal of suspicious mole enables complete healing. There are no natural treatments that will remove all mole cells, and such unprofessional treatment of the mole can lead to serious consequences for health. Moles can be removed surgically, using radiofrequency or laser. Laser removal of moles doesn’t give the opportunity to the physician to send the removed lesion to the pathohistological analysis, because the mole cells completely evaporate under the influence of a laser beam. Pathohistological analysis of moles is the only safe and reliable diagnosis of moles, so laser removal is recommended only in exceptional cases. Radiofrequency mole removal consists of mole cutting with a wire through which high-frequency current passes. The mole tissue remains intact for pathohistological analysis, but the lower edge is evaporated, so it is impossible to determine the limits of a lesion. With this method, we remove moles whose dermoscopic evaluation hasn’t shown any criteria for atypia, papillomatous dermal naevi and moles up to 4 mm in diameter of the base. Surgical method of mole removal is a completely safe procedure and is performed under local anaesthesia in smaller moles or in general anaesthesia in larger congenital ones. The sutures are usually removed in 7 to 14 days. In case of suspicion of melanoma, the intervention is performed in a wider and deeper area, with the removal of fatty tissue under the skin all the way to the fascia.

When is it necessary to remove a mole?

Dysplastic naevi

Dysplastic naevi are moles that have an atypical structure, which could evolve into malignant melanoma over time. Although a mole is still healthy, its irregular structure is revealed with dermoscopic examination. That is why it is important to have all moles checked up regularly.

Mole changes

If the mole has changed in size, colour, dermoscopic structures, it should be removed preventively.

Congenital naevi

They have a 15% higher risk of becoming malignant over time.

Blue naevus

The specific bluish grey colour of the mole indicates the presence of pigment cells in the last and deepest layer of the skin. Blue colour is one of the dermoscopic criteria for melanoma, so one should be especially careful with blue moles and sometimes even remove them preventively.

Aesthetic reasons

Moles can be removed for aesthetic reasons, regardless of whether they are flat or protrude from the skin. References:
Svetlana Đurišić specijalista dermatovenerologije

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