Mole Removal: What You Need to Know

Mole removal is a procedure performed daily in dermatology offices as part of routine skin examinations. Hundreds of thousands of moles are removed every year in the United States. Moles can be removed for medical and cosmetic reasons. If you want to have a mole removed or need to for medical reasons, the good news is it is a low-risk procedure with minimal discomfort.

What is a mole?

A mole (nevus) is a common, harmless skin lesion. Most adults have 10–40 moles (nevi) on their bodies. Moles can appear at birth, during childhood, and throughout adulthood. Some moles may fade or change over the years.

Moles can have different colors, sizes, and shapes. They can be flat or raised, small or large. Moles come in various colors, such as pink, tan, brown, or black. Most are round or oval-shaped and smaller than a pencil eraser. Moles may appear anywhere on the body.

Why are moles removed?

There are several reasons why a mole may be removed. During your skin examination, your dermatologist may find a suspicious-looking mole. There are signs that a mole could be cancerous or precancerous. These signs are called the ABCDEs:

A - asymmetry of the mole.

B - irregular, jagged, or ill-defined borders.

C - the mole has changed color or has multiple colors.

D - diameter enlarging.

E - the mole is evolving – changing size, shape, and color, or becomes symptomatic (hurts, itches, or bleeds).

A mole may also be removed if it gets irritated, such as by clothing or when brushing your hairThe patient may want a mole removed for cosmetic reasons.

What are the different ways to remove a mole?

There are two main ways to remove a mole: shaving and excision. Both are outpatient procedures that do not require general anesthesia, only local.

Shave removal of a mole is a quick procedure. The area is sterilized and then injected with local anesthesia. Once the area is numb, a blade is used to shave off the mole. Stitches are not required, and the wound is covered with a bandage.

Mole excision can be performed with a circular punch tool that looks like a cookie cutter or a scalpel blade. This procedure takes a little longer. As with the shave removal, the area is sterilized and injected with local anesthesia. Once the area is numb, the mole is cut out with the punch tool or scalpel blade. Then the wound is sutured closed, and a bandage is placed.

Other techniques have been used to remove a mole, such as a laser, electrocautery, or cryotherapy, but they are not recommended. These are not preferred methods because the recurrence of the mole is higher, the mole cannot be sent to the pathologist to be examined, and there is a higher chance of scarring.

How do I care for the wound after mole removal?

It is critical to care for your wound as instructed by your doctor. Wounds that are cared for properly heal better and faster. Daily wound care is necessary until the wound is completely healed or the sutures are removed. Wound care includes cleansing the wound, applying Vaseline or antibiotic ointment, and covering it with a bandage. Physical restrictions should be adhered to if you have sutures; otherwise, you risk breaking the sutures and opening up your wound. This can lead to bleeding, infection, and bad scarring.

After the wound has healed, it is vital to keep it out of the sun. Sunlight can permanently darken the scar. You must protect it with daily sunscreen or protective UPF clothing.

What are the risks of mole removal?

Mole removal is a low-risk procedure. However, there are some risks associated with it. They include, but are not limited to:

• Bleeding
• Infection
• Scarring
• Nerve damage
• Recurrence
• Allergic reaction to anesthesia or topicals
• Irritation from topicals or bandages

Is mole removal painful?

There is some minor discomfort associated with mole removal, which usually occurs during the injection of the local anesthetic. The needle injection may pinch and cause mild pain, like an ant bite or bee sting. The local anesthetic may burn temporarily upon injection. The discomfort resolves in a few seconds, and the area will become numb.

After the procedure, there may be some soreness or tenderness, especially for the first couple of days. It lessens quickly with time. If the wound gets bumped or irritated, that will cause discomfort. This is why it is critical to keep the area protected during healing.

Will I have a scar after mole removal?

Scarring will occur after mole removal, but it is usually minimal. The better you protect and care for your wound, the better it will heal. If you are prone to bad scarring or keloids, inform your dermatologist.

Is my mole sent off for testing?

After mole removal, the mole is usually sent off for testing to ensure there are no atypical or malignant cells. One of the main reasons for mole removal is to test for cancer, especially if the mole looks suspicious. It can take several days, even up to 2 weeks, to get the results back on your mole testing.

Can a mole be removed at home?

It is dangerous to remove a mole at home. You risk infection from poorly sterilized instruments. You may not be able to stop the bleeding at home. Dermatology offices have professional, hospital-grade autoclave machines to sterilize instruments and other tools to stop bleeding. Finally, if you remove the mole yourself, it will not be sent off to pathology for cancer testing. This will delay a cancer diagnosis, which will have grave consequences.

Mole removal is a common procedure performed for medical and cosmetic reasons. Shave removal and excision are the best ways to remove a mole. Both procedures carry minimal risks and can be performed quickly under local anesthesia by your dermatologist. If you have a mole that is bothering you or changing, you must see your dermatologist immediately.