WHAT IS A MOLE ?
A mole is a flat or raised coloured spot found on the skin that consists of melanocytes. Melanocytes are cells that produce the pigment which give our skin their natural colour. Moles can vary in size, shape and colour from skin colour to brown or black. They may also have different textures ranging from smooth to rough, and occasionally may have a hair growing from them. Throughout your lifetime, your moles will change in appearance with some fading over time and some getting darker. The number of moles that you have will also vary dependent on your age. During the first 30 years of life, the number of moles that you have will increase. As you approach the 4th and 5th decades of life, some of your moles may disappear. The circulating hormones in your body may also have an influence, with some moles appearing to get darker during pregnancy. Mole removal can be undertaken for any mole that is unsightly or troublesome.
WHAT TYPE OF MOLES ARE THERE ?
There are many types of benign or harmless moles. The common ones usually encountered are :
Compound melanocytic naevi – usually raised and light brown in colour with some having hairs growing from them
Junctional melanocytic naevi – usually flat, round and brown in colour
Dermal melanocytic naevi – usually raised, hairy and pale in colour
Dysplastic or atypical naevi – flat or raised moles that have an irregular shape or larger than usual with a range of different colours within them
WHAT SHOULD I LOOK FOR ?
The majority of moles are benign or harmless and can be left alone. Occasionally moles can arise in prominent areas and become a nuisance if you regularly catch them on clothing or by shaving. Moles can also appear in areas that are cosmetically sensitive and you may feel self conscious about them. Mole removal can be undertaken for such moles. Although the majority of moles are harmless, it is important to be aware that changing moles can be a sign of skin cancer. In such cases, it is also beneficial to undertake mole removal so it can be analysed histologically to confirm the diagnosis.
WHAT ARE THE AVAILABLE TREATMENT OPTIONS ?
Surgical excision is a procedure where mole removal is performed, and the wound is closed with stitches. This can usually be performed under local anaesthetic where the skin is numbed with an injection. The mole can then be sent away for histological analysis where a definite diagnosis of the type of mole can be achieved. The procedure will result in a scar that is usually twice as long as the mole itself, however such scars tend to settle and mature well over time.
A punch excision is another method of mole removal that is similar to surgical excision. The procedure is performed with a punch biopsy which come in varying sizes. In large moles, a punch biopsy can be used to obtain a histological diagnosis without removing the entire mole. In smaller moles, mole removal with this technique usually results in a shorter scar. This is a useful technique for small moles on the face where cosmetic outcome is important.
A shave excision is a mole removal procedure where a raised mole is shaved off its base under local anaesthesia. As moles arise from beneath the skin surface, a shave excision results in some of the mole being left behind beneath the skin. The base of the mole is then cauterised or burnt. The area is allowed to heal by itself over a period of 1-2 weeks. The advantage of this technique is that it usually leaves an inconspicuous scar that is the shape of the initial mole. The disadvantage is that because a portion of the mole is left behind, there is a chance that the mole may recur.
Laser mole removal
Laser mole removal is a technique that involves the use of a laser to accurately “burn” away the mole. It is similar to a shave excision in that it leaves an inconspicuous scar in the shape of the initial mole. As a portion of the mole is left behind, there is a possibility the mole could return in the future.
WHAT ARE THE RISKS & COMPLICATIONS ASSOCIATED WITH MOLE REMOVAL ?
Scarring : Surgical excision will always result in a scar however by careful planning and design, the scar can often be hidden in natural skin creases. It is important to be aware that scars may be red and raised for 6-12 months before settling down to usually become a thin white line
Recurrence : Moles can occasionally come back particularly if a shave excision is performed as part of the mole is usually left behind. The chance of a recurrence is rare if surgical excision is performed
Infection : All surgical procedures may result in infection. If you develop an infection, you will require antibiotics
WHAT SHOULD I EXPECT ON THE DAY ?
During mole removal, the area to be treated is numbed with a local anaesthetic injection. Once the area is numbed, the mole is removed. The area is then stitched closed. If a shave excision or laser removal was performed, a dressing is applied. Stitches are usually removed after 7 days. If a dressing is applied following a shave excision or laser removal, then the wound is checked at one week to ensure that the area is healing well.