Introduction

Moles appear due to the concentration of pigmented cells in the skin called melanocytes. Some are dangerous as they can lead to skin cancer and are called melanomas. Between 2 and 3 million cases of skin cancer are diagnosed per year, of which 230,000 correspond to melanoma.

What are they?

The medical term for moles is “nevi.” They are a common type of growth on the skin caused by a group of pigmented cells. They usually appear during childhood and adolescence, and it is normal for all of us to be between 10 and 40. Some remain the same throughout life, and others change their appearance or may disappear over time.

Most moles are benign, so in rare cases, they become cancerous. Still, it is important to monitor them to detect possible cases of skin cancer, especially malignant melanoma, early.

What types of moles are there?

They can be pink, tan, brown, or can be flat or raised. They are generally round or oval and no larger than an eraser. Here are the most common types:

The commonly acquired moles: They are in any part of the body and mainly in people with fair skin. Its appearance is due, in general, to exposure to the sun. You have to pay attention to see if they change shape or color over time.
Atypical moles: They are larger than the common ones and can be smooth or rough. They have a beige or brown hue and can appear singly or in groups. It is recommended to examine them regularly because they increase the risk of melanoma.
Congenital moles: They can be round or oval, and the color can be uneven. They appear in newborns, and their appearance has to do with genetics; if there is a trend in the family, the probability that they will manifest themselves increases.
Spitz moles: They usually appear in boys between 3 and 13 years of age. The place where they are usually located in the face or head. They are smooth and benign, and therefore it is not recommended to remove them unless they have a reddish hue or elevations. They are also known as spindle cell moles.
Moles with an areola: They are formed with a lesion and what distinguishes them is that they have a white aureole around them, an effect of depigmentation of the skin. They are usually harmless and can even disappear over time.

Melanoma is the main complication of moles. Some people are at higher risk for genetic reasons. But also, among the factors that increase the risk of melanoma, we can mention:

When they are large.
When they are rare.
When the person has many.
When there is a family history of melanoma.

When do you have to check for moles?

In general terms, we can say that the control of moles or nevi should be carried out at least once a year in a dermatological consultation. As we said before, some instances in which the control has to be perhaps more frequent:

1) When the patient has a personal or family history of skin cancer or another type of cancer.

2) When atypical nevi are detected, with a size or shape differently. 3) When the skin is very white.

4) When the patient has too many moles.

5) In cases of immunosuppression or genetic diseases predispose to skin cancer as xeroderma pigmentosum, albinism, etc.

Moles on the scalp or genital area are often more difficult to control. This is often enough to establish a specific diagnosis, but in cases where As doubts persist, a diagnostic biopsy of the spot can be performed.

You should go to a dermatologist if you notice:

New moles or spots in adults.
Increase in size.
Thicker moons.
Color changes.
Itching or bleeding from a mole.
Skin wounds that do not heal or reddened skin with scales.

The first consultation should always be done with a dermatologist who will determine if the mole is benign or malignant. This professional will refer you to a plastic surgeon to remove it or indicate if it is advisable to remove it with a laser.

How do I choose a dermatologist?

It is important that the dermatologist is professional and has the necessary studies in dermatology to be a specialist in everything related to the skin.

It is also often helpful to read the opinions of other patients on the internet to see how they have done and if they recommend this professional.

How are the procedures to remove moles?

Not all of them should be eliminated. In most cases, it is done for aesthetic purposes. But the dermatologist may also observe an irregular pigmented lesion and perform an extraction and subsequent biopsy of it to rule out the existence of skin cancer.

For example, whenever a mole has itching (itching), it is one element that indicates that these moles are surgically removed and the corresponding histopathological study performed. It is always necessary to evaluate each patient’s case to determine which is the most effective method.

Various methods can be used to eliminate them. The choice of one technique or another depends on several factors such as the type of lesion, its location, the purpose of removal, and the patient’s preference. The following techniques can be used:

Surgery: It is chosen mainly when necessary to carry out the histological study of the piece afterward. Local anesthesia is applied, and a small scar may remain. It is an effective technique for those located in the nasolabial fold. As it is a simple intervention, it is not a necessary hospital or postoperative admission. It will only be necessary to follow special care that the surgeon will establish according to each patient. The surgery can last one or two hours, depending on the mole’s size to be removed. Once removed, the surgeon usually administers antibiotics to prevent infection. The patient should follow the advice on caring for the area and will normally resume their routine after the procedure.
Surgical shaving: It is used mainly for exophytic lesions (moles that protrude from the skin). Local anesthesia or cryotherapy with nitrogen is used, and then the tangential cut is made with a scalpel. It is a speedy procedure, and the result is aesthetic. The mole can be left with the appearance of a completely flat and mainly black freckle. This technique has fewer risks and complications than surgery, but the probability that the mole will not be removed entirely is greater (between 13 and 20%, according to studies).
Depigmenting laser: This technique uses special equipment such as pulsed light or the Alexandrite laser to impact the melanocytes and destroy them. It is only used for flat melanocytic nevi, which have no volume. This method is not recommended if a biopsy is necessary.
CO2 laser: This type of procedure allows for instant elimination of the tissue where the light hits. It can be used as a kind of scalpel to cut (vaporize) protruding lesions. It has a high degree of precision and allows you to control the depth so that the scar that remains is minimal. No anesthesia is needed, and usually, no scar. It is a very fast, painless, effective and safe procedure. Also, side effects or complications such as infection, bleeding, etc., are unlikely to arise.
Electrocoagulation: With the electrocoagulation or electric scalpel that emanates heat, the tissue where the mole is located can be destroyed. A dermatologist must use it because if the temperature is not controlled correctly, a scar can remain on the skin.

What care should be followed after removing the mole?

After surgery, the recovery process is usually quick (between 1 and 3 weeks), and the scar fades over time. However, not all people heal in the same way, and not all body areas heal the same.

Some recommendations after surgery are:

Do not use force with the treated area because it can open despite having stitches.
Keep the lesion covered until the stitches are removed.
When bathing, cover the area with plastic to prevent it from getting wet.
Do not expose the injury to the sun even if it is covered.
In case of pain, discharge or bad smell, request a consultation with the doctor.

In laser treatment, your doctor may recommend a special ointment to be applied as directed. These creams improve healing and make the skin heal faster.

In both cases, the patient mustn’t expose himself to the sun. It is necessary to protect the skin from the sun’s UV rays and thus avoid the appearance of new spots and moles caused by overexposure to the sun.

Contraindications or side effects

Generally, the removal of moles with the techniques discussed above does not generate complications or side effects if it is done with a certified professional. Even so, as in any procedure, on rare occasions, it may appear:

Infection.
Bleeding.
Permanent scars.
Reappearance of the mole again.

Frequent questions

Are moles that have hairs evil? The benign and the malignant may have hairs, but it is only a characteristic of the mole that is not related to its benignity or malignancy.
Should moles that are fleshy or in areas of friction be removed? In earlier times, it was believed that moles on the palm of the hands or the foot could become malignant in the future. But today, it has been proven that this is not possible. You only have to remove them if they bother a lot due to friction.
When removing a mole with surgery, does it leave scars? When incisions are made in the skin, scars always remain. There are different means to minimize or “hide” their visibility. Time also tends to play in favor of the improvement of scars. According to experts, in general, any skin lesion, whether due to a wound or the excision of a skin tumor (mole or others), if it is deep within the skin, will leave a resulting scar. But if the size of the moles is small and treated appropriately, the scar mark may go unnoticed.
How does laser mole removal work? If the moles are benign and only want to be removed for cosmetic reasons, then the laser option is used. This avoids going through the operating room, and in a few seconds, the nevus can be vaporized without leaving a scar or leaving just a small mark.
Is laser mole removal safe? Yes, as long as a good diagnosis is made. For example, Melanoma requires special surgery.
How many sessions does it take to remove the mole? It is a simple, completely painless treatment that generally requires a single session, be it surgical or laser.
Do you recommend that I remove a large mole on my nose? Currently, there are many very effective and successful methods to remove a mole on the wing of the nose, such as the co2 laser, electrosurgery, plasma jet.
Also, being on the wing of the nose, the healing is very good. There is always an option that leaves a small difference with your skin tone, but it will be minimal.
Which laser is the best to remove a small flat mole on the face? The most important thing is the dermatological diagnosis with dermoscopy. Once you know that it is a benign lesion, several lasers or procedures can improve the aesthetic appearance.
If I remove a mole in summer with a CO2 laser, will there be scars? The healing will not depend on the moment you perform it but on the care you provide. Your specialist doctor will recommend the best for you and give you instructions. On the other hand, some people heal poorly. It is necessary to evaluate various factors and be clear that any abrasive procedure can leave a scar, sometimes very little obvious, but it can happen.
Flat moles on the lip can be removed? There are different techniques to solve the removal of moles that you tell us, depending on the specific characteristics of your problem. To advise you on which is the best option in your case, it is necessary to see you in the consultation, make an exact diagnosis and propose the different treatment options, which will also depend on your expectations and availability. Once the treatment plan has been finalized, which may include several options, you will be provided with financial information about the budget, payment method, and financing method in the same consultation.