Moles, medically known as nevi, are extremely common and usually harmless. Most people, particularly those with fair skin, have 30 to 40 moles on their bodies, none of which are cause for concern. Nonetheless, though moles rarely become cancerous, patients should be aware that changes in size, borders, or coloration of moles may be the first signs of melanoma, the type of skin cancer most likely to metastasize (spread to other parts of the body). For this reason, moles that alter in appearance should always be evaluated by a well-trained dermatologist.
Obviously, if a skilled dermatologist like Dr. Harvey, finds a mole suspicious, she will remove it and have the tissue biopsied. A biopsy is a microscopic examination to determine whether the cells are cancerous or benign. The doctor may also remove a mole because she feels it has a high probability of becoming malignant at some point in the future. In general, atypical (dysplastic) moles are more suspect, although the majority of these are also benign.
Most of the time, moles are removed for cosmetic reasons. They may also be removed because their location makes them rub on clothing and create irritation. When a mole becomes itchy or painful, it is not typically a dangerous sign. Most frequently, this occurs because there has been some small trauma to the area. Even so, any questionable mole or skin lesion should be evaluated by a skilled dermatologist.
Whether your doctor strongly recommends mole removal for health reasons, or you want a mole removed because it is unattractive, the procedure can usually take place during one office visit, though on occasion it may require two appointments. Mole removal is performed outpatient under a local anesthetic and may be done in one of two ways, surgical excision or surgical shave. Whichever method is used, the dermatologist first cleans and sterilizes the area:
During a surgical excision, the doctor cuts out the whole mole, then closes the wound with sutures. If the mole is in any way suspected of being cancerous, it will be sent to a pathology lab for microscopic examination. This process is known as a biopsy and it may take a week or more to get the biopsy results. Surgical excision leaves a scar, though a skilled dermatologist knows how to minimize scarring.
In locations where scarring will be more noticeable, the dermatologist may perform a surgical shave, which is a more delicate process than an excision. In this procedure, the doctor uses a very fine blade to remove the mole in horizontal layers. Because of the method used, surgical shaves leave minimal, if any scars and are therefore desirable for removal of moles on the face and neck. After a surgical shave, suspicious tissue will also be biopsied.
Depending on what type of mole removal you’ve had, you may come out of the dermatologist’s office with sutures or a small open wound. In either case, the site is usually bandaged to protect it from injury or infection. You must also do your part to keep the site clean so proper healing can take place.
If you are caring for an open wound, bear in mind that it has to heal from the bottom up. Whether you are instructed to keep a dressing over the wound or leave it open to the air will depend on the doctor’s directives. In either case, the site should be washed and dried at least once daily. To prevent the wound from scabbing prematurely, your doctor will probably suggest that you coat the area lightly with vaseline or antibiotic ointment. Try to avoid pulling off a dressing that has stuck to the wound. Instead, wet the bandage and try to gently dislodge it.
What you don’t do may be as important as what you do after minor dermatological surgery. The following should be avoided:
The removal of moles or other small lesions very rarely results in complications of any kind. If you experience any of the following, however, you should contact the doctor promptly:
Our office is designed to provide you with the best dermatological care available, both in terms of medical treatment and cosmetic procedures. Dr. Dyan Harvey has a high level of surgical competence and a personal concern for your appearance as well as your health.
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