Have you ever found yourself anxiously monitoring a suspicious-looking mole? If so, you’re not alone – we’ve all looked closer at our skin occasionally, wondering if that odd-colored freckle could be something more serious. We deal with skin and moles daily but may not fully understand them. Removing moles is a standard dermatological procedure, but what is the process?

This article aims to provide a comprehensive overview of mole removal from a medical perspective. It will explore moles, common reasons for their surgical excision, types of excision procedures, and what you can expect from the pre-operative treatment through the post-operative healing timeline.

What Are Moles?

Moles, also known as nevi, are typically brown or skin-colored growths that can appear anywhere on the skin but are most common on the back, arms, legs, and face. Moles occur when extra skin pigment (melanin) develops in clusters of pigment-producing cells called melanocytes. Nearly everyone has between 10-40 moles by adulthood. While most moles are harmless, some can develop skin cancer if left untreated. Monitoring existing moles and seeing a dermatology provider about any suspicious changes is essential.

Reasons for Mole Removal

There are several common reasons why a patient may opt to have one or more moles removed. Understanding the different motivations can help provide context around decision-making.

Cosmetic Reasons for Mole Removal

Many remove unattractive, noticeable, or distracting moles for aesthetic purposes alone. Common locations targeted for cosmetic reasons include the face, neck, hands, and other visible areas. While not medically necessary, mole removal can improve your self-esteem and satisfaction with your appearance. Dermatology providers understand the desire for cosmetic enhancement and will perform removals when deemed a safe option.

Unwanted Moles

Beyond cosmetic qualms, some patients want certain moles gone because they cause annoyance, discomfort, or functional issues. Examples include moles that frequently become irritated from clothing bumps or grow in bothersome sites like the eyelids. Quality of life is improved when these problematic yet benign lesions are surgically removed.

Atypical Moles

Also known as dysplastic nevi, atypical moles have irregular borders or shapes and varied pigment patterns within the lesion compared to a typical mole. Atypical moles carry a higher risk of becoming malignant melanoma. As a precaution, dermatology providers often recommend removing them to prevent potential cancer development. Close monitoring is still required after excision due to the elevated melanoma risk that persists with a history of atypical moles.

Suspicious Moles

Any mole that exhibits signs of change in size, color, elevation, or textures warrants concern. Rapidly growing moles or those with spots of redness, scaliness, or bleeding also raise suspicion for melanoma. Biopsies are necessary to evaluate such moles and determine if surgical excision is required for further histopathologic examination. Early detection and prompt treatment offer the best outcomes, making regular skin exams vital.

Different Methods of Mole Removal

An excisional biopsy is the standard surgical procedure for removing moles. During this operation, dermatology providers use a local anesthetic to numb the mole site and surrounding skin. They then carefully cut or shave off the entire mole in a single piece using a scalpel or electrodesiccation method. The specimen is sent to a lab for microscopic analysis by a pathologist who will assess for cancerous cells. Most benign moles are entirely removed with clear margins to decrease the risk of recurrence.

Types of Mole Removal Surgery

In addition to standard excision, other mole removal techniques used include:

  • Shave biopsy: A razor is used to shave off just the top layers of a shallow mole and is often used for suspicious pigmented lesions.
  • Punch biopsy: A sharp circular instrument cuts out a mole with a clean cylindrical margin. It’s suitable for flat moles.
  • Curettage and electrodesiccation: Scraping and burning are used to remove some skin cancers and atypical moles layer by layer, leaving a minor wound.
  • Mohs surgery: Specialized, highly effective method for skin cancers involving multiple stages of precise examination and controlled excision until all abnormal cells are eliminated.

Preparing for the Surgery

Proper mole excision requires little specific preparation. Over-the-counter pain relievers can be taken prior as needed. The site will be cleansed with antiseptic and anesthetized using a topical cream, gel, or injection. No food/drink restrictions typically apply unless general anesthesia is required. Comfortable, loose-fitting clothing is best for afterward.

You should have a ride home following excision, depending on the anesthetic used, and healing doses of prescription cream or oral antibiotics may be provided.

The Healing Process

After mole removal, you can expect the wound site to appear red and swollen and possibly ooze minor amounts of fluid for several days. A small bandage will be applied until the initial scab forms, which usually takes 5-10 days. Scabs may itch or feel uncomfortable as new skin develops over 1-2 weeks. Our dermatology physician assistants recommend keeping the area clean and dry while allowing natural scabbing without picking. Pink or dark pigmentation is common during healing but fades significantly over several months.

Risks Associated with Mole Removal Surgery

As with any surgical procedure, excision carries inherent risks that you must be aware of beforehand. However, proper technique from an experienced dermatology provider helps minimize complications.

Risk of Scarring

Some degree of permanent scarring is anticipated following excisional biopsy, though the location and size of the original mole impact scar appearance. Scars tend to improve over 6-12 months but may remain slightly raised or discolored long-term in places like the face or other prominent areas. Treating new scars early on with silicon or bio-occlusive sheets can aid healing.

Risk of Infection

While rare, wound infections are possible after mole removal despite preventative cleaning and antibiotics. Signs include increasing redness, swelling, oozing, foul discharge from the biopsy site, and fever or flu-like symptoms. Seeing a doctor promptly for evaluation and possible oral antibiotic treatment is essential to prevent spread or complications.

Final Thoughts

By understanding the reasons for removing a mole, the surgical process itself, expected healing timelines, and potential side effects, you can feel empowered to remove moles with our guidance and care. Overall risks are very low when appropriately done, and dermatologic monitoring continues into the months following treatment. Find out more about mole removal from the Wisconsin Institute of Plastic Surgery.