Mole Removal: Your Questions Answered
Medically Reviewed By: Kelli Bryant, MD
Moles, also called nevi, are sometimes considered beauty marks. But if you have a mole — especially a facial mole — that’s more of an eyesore, or if a mole is easily irritated by clothing or gets snagged on jewelry, chances are you’d rather be rid of it.
Can you remove moles? The answer is often yes. For many moles, mole removal at your dermatologist’s office is an option.
Here, Kelli Bryant, MD, a board-certified dermatologist at Water’s Edge Dermatology, answers common questions about mole removal and explains why you shouldn’t attempt it at home.
Do moles have to be removed?
In most cases, whether or not to remove a mole is entirely up to you. But if the mole shows signs of skin cancer, your dermatologist may have to remove it. Suspicious (atypical) moles are identified using the ABCDE rules:
- A for Asymmetry. One part of the mole doesn’t look like the rest of it.
- B for Border. The border of the mole is irregular or poorly defined.
- C for Color. The mole is multi-colored. You may see shades of tan, brown or black along with red, white or blue areas.
- D for Diameter. The mole is larger than 6 millimeters, which is about the size of a pencil eraser.
- E for Evolving. The mole is changing in shape, size or color.
Do atypical moles need to be removed? Not necessarily. “Many benign moles break the ABCDE rules,” Dr. Bryant said. Still, you should have any suspicious mole evaluated by a skin care provider, who may biopsy it to check for cancer.
Is there an effective way to remove moles at home?
At best, home remedies and over-the-counter mole removal tools are a waste of time and money. But in some cases, mole removal at home can be downright harmful.
“Some of the home remedies you see online, such as applying iodine or apple cider vinegar to the mole, can cause a lot of skin irritation, to the point that it’s almost like a chemical burn,” Dr. Bryant said.
Other purported DIY treatments, such as taping a banana peel or garlic clove to the mole, may not be as dangerous but are equally ineffective. What about using a mole removal cream or cauterizing (burning) the mole with a mole removal pen? Those approaches won’t make a mole disappear and may lead to scarring and pitting.
“If those products should happen to work, it’s because the ‘mole’ was actually a different type of skin growth, such as a seborrheic keratosis,” Dr. Bryant said.
Never attempt to remove a mole with a razor blade or scissors. The risk of infection and scarring is far higher than if you have a mole removed professionally. Cutting off a mole at its base with a razor blade can cause profuse bleeding. Also, the risk of mole recurrence after removal is higher if you try to slice off the mole yourself, simply because you probably won’t get it all.
Even if any of these approaches did work, it’s still a bad idea to remove a mole yourself, Dr. Bryant said. “Any mole, no matter how benign it looks, could be malignant, so you should always see a dermatologist to have it evaluated and removed safely.”
How do dermatologists remove moles?
Water’s Edge Dermatology providers offer two mole removal options: shave excision and punch biopsy. Laser mole removal is not an effective method.
Shave excision for raised moles and large moles
Shave excision is the most commonly used mole removal technique and is typically recommended for raised or large moles. The provider injects the treatment area with a local anesthetic, then shaves off the mole with a surgical blade.
Shave excisions can be superficial or deep. If the mole is benign, it’s cut down to the level of the surrounding skin. But if the mole looks suspicious, the dermatologist will likely perform a deep shave excision, or saucerization biopsy. In this case, a curved blade is used to remove the mole and layers of tissue beneath it so they can be checked for cancer cells. Stitches usually aren’t needed to close superficial excisions, but they are often needed for deep ones.
If your mole is very large, you may choose to have it removed by a plastic surgeon rather than a dermatologist in case any reconstruction work is necessary.
Punch biopsy for small moles, flat moles and penetrating moles
For moles that are small, flat or penetrate deeper into the skin, your skin care provider may recommend a punch biopsy.
After injecting an anesthetic, the provider inserts a pen-like instrument into the skin under the mole. The instrument has a sharp end that looks like a tiny round cookie cutter. The device is rotated until the end cuts through the epidermis and dermis and into the fat below. Next, the mole and the plug of tissue beneath it is pulled from the skin with forceps and snipped away with surgical scissors. The area is closed with a few stitches.
Will I have a scar after mole removal?
Removing a mole always creates a scar, regardless of the technique used, Dr. Bryant said. You may be left with an area that’s lighter than the surrounding skin (a hypopigmented scar) or a line that can be either paler or darker than your skin tone.
Some people have an exaggerated scar response to mole removal in which thick, hypertrophic (raised) scars or keloids form. Hypertrophic scars and keloids are somewhat similar, but unlike hypertrophic scars, keloids can extend beyond the treated area.
“If you have a history of keloid scars, it might be better to leave the mole alone,” Dr. Bryant said. Your dermatologist will discuss the risks and benefits of mole removal to help you decide if you want to proceed.
If a mole removal scar does develop, scar treatments are available that can lessen their appearance, such as pulsed dye laser treatments to remove redness and flatten raised scars and cortisone injections to soften firm scars.
Can a removed mole grow back after being removed?
Mole regrowth is possible, particularly if the mole was raised. The reason: “There are almost always some mole cells left behind when you remove a mole,” Dr. Bryant said.
Your dermatologist can try to remove the mole again if it regrows, but you may find that the regrown mole doesn’t bother you as much as the original. “When a raised mole returns, it usually doesn’t grow back to its original height, so it may be less noticeable,” said Dr. Bryant explained.
Make an appointment to discuss mole removal with a Water’s Edge Dermatology provider.
Article Written By: Jessica Brown, a health and science writer/editor based in Nanuet, New York. She has written for Prevention magazine, jnj.com, BCRF.org, and many other outlets.
Common and Atypical Moles
Skin cancer is a prevalent problem in the United States, with an estimated one in five Americans developing the condition over the course of their lifetime. Typically caused by a combination of UV exposure, risk factors, and genetic predisposition, skin cancer is not only life-threatening, but can also result in a number of troubling side effects, including a weakened immune system and candida infections in the lungs, liver, and skin.
For this reason, it is important that patients take measures to prevent harmful sun exposure, stay informed of their risk factors, and schedule regular appointments with dermatology and skin cancer specialists at a local dermatologist clinic. This is especially important for people who have more than 50 moles, large moles, or atypical moles, as these conditions can substantially increase one's risk of developing melanoma and needing treatment for skin cancer. This article aims to answer many questions people with these moles, or atypical nevi, may have, including how to identify a cancerous mole and when you may need to undergo a dysplastic nevus removal. Read on to learn about this common risk factor.
Moles
Moles are a common physical feature that are either present at birth or appear during childhood. By adulthood, most people will have anywhere from ten to 40 moles, also called nevi, above the waist on areas exposed to the sun. They are typically smaller than 5 mm, have defined edges, and can be pink, tan or brown. New moles can develop over time due to sun exposure, but it is important to regularly check all of these marks for physical changes, as pain or a difference in appearance can be a sign of cancer.
Atypical Moles
In contrast, a mole with unusual characteristics is called a dysplastic nevus. These nevi may be bigger, have an uneven shape, mixed colors, or an irregular border. Like normal moles, these are typically found in areas that receive a lot of sun exposure, but can also develop in areas that are not exposed to the sun and below the waist. People with a high number of typical moles often have several dysplastic nevi mixed in. Having a high number of these nevi is part of a condition called dysplastic nevus syndrome, which has an even higher likelihood of developing melanoma.
Having dysplastic nevi can be nerve-wracking, as the moles often naturally resemble skin cancer. However, while a person's chances of developing melanoma and other skin cancers increases with the number of dysplastic nevi they have, these moles often remain stable as long as the person protects their skin, eschews tanning, and performs a self-exam at least once a month. If a change is noticed in a mole's texture, appearance, or sensation, the patient should make an appointment with their dermatologist immediately. Some patients may wonder if they can undergo a dysplastic nevus removal to avoid these measures; however, because new moles and patches can form on the skin, this is often pointless and expensive. Instead, a dysplastic nevus removal is typically reserved for the process of identifying and treating skin cancer.
Having an increased risk of skin cancer can be a frightening prospect. However, by taking the proper steps, you can help protect yourself from the condition, even if you have common or atypical moles. How do you protect yourself from skin cancer?
What is Dysplastic Nevus Syndrome?
With skin cancer now estimated to affect one in five people in the United States at some point in their lives, many people are now aware of the various risks associated with this condition and how to prevent it. However, even if you wear sunscreen and check your skin fairly regularly, you may still have an increased risk of developing this disease. This is especially true if you have dysplastic nevus syndrome, a condition that has been linked to serious conditions like melanoma.
It is commonly known that a person with 50 or more moles has an increased risk of developing skin cancer, especially melanoma. Accordingly, dysplastic nevus syndrome refers to the presence of a high number of unusual moles, called dysplastic nevi. These may resemble melanoma from the onset and signify an unusually high risk of developing a real case of the condition. Someone with dysplastic nevus syndrome may have 10 or 12 times the risk of developing skin cancer and melanoma than the general population, and as a result, dysplastic nevi are much more common among skin cancer patients than those without the disease. Dysplastic nevus syndrome runs in families and represents an inherited tendency to develop different types of skin cancer.
There is no dysplastic nevus treatment that can reduce the risk of developing skin cancer, but because of the nature of the condition, it is important that people with this disorder see dermatology and skin cancer specialists as soon as possible to prevent potential problems. Because the syndrome runs in families, dermatologists typically recommend that patients begin receiving full-body exams at age 10, including checks on the scalp, eyes, genitals, nails and other areas. Because a high percentage of people with dysplastic nevus syndrome develop melanoma in their teens, this is one of the most effective preventative options available. Patients who also have a family history of pancreatic cancer are also offered the chance to receive screenings starting at age 50, or 10 years before the age that their earliest family member was diagnosed.
Research shows that only 2-8% of the Caucasian population have dysplastic nevi. However, if you have noticed a number of atypical moles on your body and have close family members with skin cancer or melanoma, you have good reason to discuss your chances of developing these conditions with a dermatologist specialist. Fortunately, the field of dermatology has experienced a number of scientific breakthroughs in everything from acne therapies to skin cancer treatment, meaning that you have a good chance of treating any problems that may have occurred due to this genetic prevalence. Visit a dermatologist clinic today to discuss these options and preventative care with a professional today.