Moles, or nevi, are clustered skin growths that can occur almost anywhere on your body and are frequently encountered on the face and neck. They are usually pigmented – either brown or black in color – but can also be somewhat clear – or similar to the surrounding skin color. Facial moles are usually noted during early childhood, although some may not appear until decades later.
Moles are dark growths composed of pigment cells on the skin that typically form because of a genetic pre-disposition to get them and because of sun exposure. Many moles are not a medical threat, however, some lesions may represent a risk for melanoma skin cancer. These higher risk moles will that have an irregular shape, have dark or light discoloration, and will change and should be evaluated to make sure they are not cancer prone.
If the decision is made to remove and analyze a mole, techniques are used to minimize scarring and achieve the best cosmetic result.
Depending on their size or location of the mole it may be a beauty mark or a distractingly lumpy lesions. Sometimes if the mole is located in an area of rubbing or shaving occurs, it may become irritated or infected.
Congenital Nevi are moles that appear at birth. They occur in about 1% of all people and may be more likely to develop into melanoma (cancer). A mole or freckle should be checked if it has a diameter of more than a pencil eraser or any characteristics of the ABCDEs of melanoma (see the skin cancer section for more detail)
Dysplastic Nevi are moles that are irregular in shape and larger than average (larger than a pencil eraser). They tend to have uneven color with dark brown centers and lighter, uneven edges. Any changes in a mole should be checked by one of our dermatologist to evaluate for skin cancer.
The vast majority of moles are not dangerous, however, if you have moles and ten notice one that looks different in size, color or shape – you need to get it checked. Another thing to consider is if you do not have many moles and start to get some after the age of 30, have your doctor check them on you next regular check-up (provided they do not look suspicious). Additionally, if any of your moles begin to bleed, ooze, itch, or become tender or painful – have it checked.
Remember, if a mole does not change over time, there is little reason to be concern. If you see any signs of change in an existing mole, if you have a new mole, or if you want a mole to be removed for cosmetic reasons.
There are various methods of removal, and the techniques available depend on numerous factors including the type and size of the mole. Before any mole removal procedure, the area is sterilized and the patient is given a local or topical anesthetic to prevent pain during the procedure.
Most are removed surgically by cutting or shaving it off the skin,
Shaving a facial mole implies that a scalpel is used to cut under the base of the mole in parallel with the skin surface. As the scalpel is passed entirely under the mole, it is essentially shaved off the surface of the skin. However, most facial moles have microscopic cells (you cannot see them with the naked eye) that extend below the immediate surface of the skin. If these cells are left alone and remain in the skin, they will increase the likelihood the mole will simply grow back in the future – referred to as recurrence of the mole.
Excision of a mole also involves use of scalpel, however, in this instance it is used to cut down into the skin. The most common excision method involves making a cut around the mole that is in the shape of an ellipse, or a football. Instead of cutting along the superficial surface of the skin, excision of a mole involves making a deeper cut into what is called the dermal layer (or dermis) of the skin. The entire ellipse of skin is then removed – along with the attached, overlying mole. As you can imagine, there is a fairly visible defect in the skin in the shape of the ellipse that was just excised. In order to close this defect, the skin edges need to be brought togethe. Once this is accomplished, the actual skin edges are then brought together using very fine sutures. In some cases these skin sutures are quickly absorbed while in others they are non-absorbable and removed in 5-6 days after the procedure.
As with any medical procedure there are both benefits and risks. Unless a mole is very large, many of the risks associated with anesthesia are eliminated through the use of topical or local anesthetics. Removal of a mole may result in scarring or infection. Freezing or burning moles to remove them are more likely cause the skin in that area to change pigmentation after healing.
The benefits of getting rid of them depend on the reasons for removal. For some individuals, the procedure is done to biopsy the area. Removal of the mole may put the individual’s mind at ease, even if it is benign. In circumstances where it is malignant, treatment prevents the cancer from spreading and putting the person’s health at risk. If the removal of a mole is purely cosmetic, the procedure can improve self-confidence.