Mole removal can be done by cutting or cauterization (burning). Some doctors have tried to remove moles or nevi with lasers, but laser light doesn’t penetrate deep enough. The doctor or dermatologist may choose excision with or without stitches depending on the depth of the mole and the cosmetic results.
People refer to a mole as a dark spot or irregularity of the skin but they also include birthmarks, abnormal collection of blood vessels (hemangiomas) and benign or precancerous spots or keratoses which usually appear after the age of 30. As some moles appear over time, some people are born with them. Sun exposure causes the development of atypical or dysplastic moles. Heredity may play a part in atypical moles that can eventually become melanoma or skin cancer.
The risks of removing a mole vary from infection to an allergic reaction to the anesthetic to nerve damage. This is why it is important to find a qualified, skilled professional to diminish these risks. The most common difficulty after a mole is removed is the scar. During your initial consultation with your doctor you should discuss where and how large the scar will be and if there are alternative treatments to reduce the scar tissue.
To remove a mole the area will be cleansed by alcohol, Betadine or another suitable solution then numbed with an anesthetic such as lidocaine or another numbing agent. After the numbing agent is applied it is best to wait at least 15 minutes for its full effect. Also, epinephrine is added in many cases to help stop any bleeding.
If remove is done by cutting without stitches the doctor will use a scalpel and shave the mole off flush or slightly below the skin then cauterize the area. After, a topical antibiotic is applied along with a bandage to cover the wound. Your doctor will give you instructions on how to care for your wound.
Cutting with stitches is usually done on darker or flat moles. The doctor will sterilize and numb the area then a scalpel is used to cut the mole and an area around it. This depends on the possible chances of precancerous or cancerous mole that is being removed. Then stitches will be placed deep in the wound. These stitches will be absorbed by the body and will not have to be removed. The top stitches that do not absorb will have to be removed later at a time recommended by the doctor.
Again the area is applied with an antibiotic salve and a bandage will be placed. At home you may be required to clean the wound once or twice daily with either water or diluted hydrogen peroxide. Then apply the salve and rebandage. These steps are often repeated until the wound is healed. Treating the area in this way will shorten healing time. Do not apply vitamin E as this will slow healing and has been shown to worsen scars if applied directly on the wound as it is healing. Vitamin E can minimize the scar once the wound is healed, but talk to your doctor about using anything on your scar, as it may not be recommended. Doctors also prefer Polysporin in lieu of Neosporin, because some patients have developed an allergic reaction to this brand. Sometimes Vaseline Petroleum Jelly will work just as well.
With some mole removals a follow up visit is required to get lab results (if lab results showed a precancerous or cancerous outcome they may require a full body examination), remove stitches which can take up to 21 days and prevent infection.
If you notice any signs of infection, such as discharge, bleeding, foul smell or have a high fever (over 100 F) and/or in severe pain that doesn’t go away with over-the-counter pain medications call your doctor right away. If you are on blood-thinning medications or taking Omega 3 fish oils let your doctor know before you have surgery as these will slow the healing process and cause excess bleeding. If excess bleeding does occur put pressure on the wound for at least five minutes. You can also try to apply ice to the wound for pain management, but ice does not stop bleeding.
Media file 1: This is a raised, irregularly colored mole before removal. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 2: Alcohol is being used to clean the area prior to numbing it. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 3: The area is being numbed with lidocaine. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 4: The area is ready to be removed. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 5: The author is using a scalpel to remove the mole. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 6: The mole is being removed. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 7: This is what the area looks like just after the mole has been removed. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 8: The area of the shave excision is being cauterized. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 9: The area of the shave excision is now bandaged. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 10: This mole is a dark, irregularly colored mole that needs to be removed with a deeper excision because the mole cells go farther into the skin. It will be removed by a punch excision process with stitches. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 11: Prior to numbing the area for excision, it is cleansed with alcohol. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 12: It is now being numbed. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 13: Mole removal. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 14: The punch biopsy excision instrument is being placed over the mole to be removed. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 15: The punch biopsy has been done, and now the area has the mole in the middle but not yet removed. It will be taken out with forceps (a tweezer-like instrument) and put in a specimen bottle to be sent to the lab for analysis. It is important that every mole be sent for analysis in order to make sure that no bad cells remain or that it isn't a bad type of mole. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 16: The forceps is being used to remove the specimen from the area. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 17: The mole has been removed, and the area is ready for suturing (stitches). Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 18: The area of the punch excision is being sutured. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 19: The suture is being tied. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 20: The area is now sutured and ready for bandaging. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 21: After the mole removal, the area is cleaned with hydrogen peroxide to remove any debris. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Media file 22: A bandage or dressing is applied. Photo courtesy Joel Schlessinger, MD, Board Certified Dermatologist, lovelyskin.com.
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Resource and Photos: http://www.emedicinehealth.com/mole_removal/article_em.htm
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