We all have moles. Moles can occur all over the body. In some people, the moles can occur on the head, neck and face. In these situations, some people wish to have them safely removed. I often have patients come to my clinic with benign (Not-cancer) moles that they wish to have removed due to concerns about the cosmetic appearance. The purpose of this article is to discuss moles and how we can remove them safely. Also, I will discuss some key safety considerations with moles and the care after removal.
What is a Mole?
Although this is a large topic in itself, simply put, a mole is a collection of a type of cell called a Melanocyte. These melanocytes can produce a type of skin pigment that has a brown, dark black or even blueish color to them. This type of lesion is considered benign and not-dangerous. However, any mole that changes quickly, bleeds, starts to grow or has an ulcer should always be checked by a doctor. To some people, moles are so common, they are not in themselves considered a ‘disease’ or defect. We all have them. It is extremely rare for a benign mole to change into a skin cancer, but as mentioned, any mole that changes needs to be checked by a doctor.
How can we treat moles?
If your doctor does not think there is any risk or concern about the mole, there are two main options for removal. The first is surgery to completely remove the mole. The benefits of this method, is that you can be assured the mole is gone. However, the downside is you will have a scar. Everyone heals differently and it is impossible to predict how the final scar will look. I often tell patients, a large part of the appearance of scarring is determined by genetics, no matter how good the incision looks after the surgery.
The second method is something called, Radio-Surgery Mole Removal.
What is Radio-Surgery Mole Removal?
Radio-surgery uses a device called Radiofrequency. This devices uses a very high frequency wave, similar to lasers, but different. It allows us to remove the mole at very precise depths in the skin and the make sure the surrounding healthy tissue is not injured. In the hands of a skilled surgeon with experience in head and neck surgery, this can be extremely effective. Radio-frequency device looks like a small non-sharp sterile needle. It emits a type of energy that is absorbed by the skin. This absorption results in heating of the skin, which depending on the settings, can ablate or remove the mole tissue. The benefits of Radio-surgery mole removal is that, there is a lower chance of scaring and complications. The downside is, you can never fully remove the mole. The goal, is to get rid of the color of the mole and make the mole the same level as the skin so it is no longer noticeable. Once the area heals, skin grows over the old mole and you can no longer see it.
The important thing about Radio-surgery Mole removal, is that there is still mole tissue under the skin, so like all moles, if there are any changes in the skin, re-growth, bleeding or ulceration you need to have a doctor look at it to make sure there is no concerns with the mole.
What does Radio-Surgery Mole removal involve?
When people come to my Ottawa clinic for their mole removal, their visit is typically less than 30 minutes. When you come in for your treatment, a small amount of lidocaine (freezing) will be injected under the skin. The mole removal is typically painless and takes less than 5 minutes. Afterwards, we have patients apply ointment to the area for a few weeks. It may feel like a small burn, so over the counter pain medication can help if its bothersome.
What are the typical results of Radio-Surgery Mole Removal?
Typical, results are excellent and nearly all patients are happy. Research conducted into this type of surgery confirm the safety and effectiveness.
There are some potential risks of the surgery. A study by Niamtu (2013) noted that the mole can recur in about 1% of people. There is always a risk of scarring and discomfort. Overall however, the risk is very low and the vast majority of patients are very happy with the treatment.
In some rare situations, a second attempt at removal is required. The reason for this, is that you want to be conservative with removal. Rather than end up with a scar, its best to remove only what is necessary. In some situations, this means a second smaller procedure is required to remove the remaining parts of the mole.
Dr James P Bonaparte, MD, MSc, FRCSC
Facial Cosmetic and Reconstructive Surgery
Head and Neck Surgery|
Ottawa, Ontario, Canada