Moles, or melanocytic nevi in medical terms, are growth of the skin made from melanocytes, or pigment cells. You can have moles at birth or continue to develop them throughout the first 4 decades of life. Moles are normally harmless but occasionally can become irritated, and rarely, can turn into the melanoma type of skin cancer. Cancer risk is increased in large moles that are present at birth and in people with more than 50 moles.
There are many reasons for a mole to be removed. The most common is if there is concern for skin cancer or pre-cancerous changes. Everyone should perform monthly self skin exams looking for changes in their moles. Concerning signs include changes in the symmetry, boarder, color, or size of the mole. Any type of growth in a mole should be reported to your dermatologist. Moles can also be removed if they become irritated, showing signs of pain, itch, or bleeding.
Mole removal is a quick, in office procedure and performed with minimal discomfort, often at the same appointment as your exam. The most common technique is called a shave removal and involves numbing the skin and using an instrument to plane the skin relatively flat or with a slight scoop, depending on the thickness of the mole. This results in a flat scar, of similar size to the original mole. Healing typically takes place over 10-14 days with minimal restrictions and simple daily wound care.
A punch excision is a more advanced technique used to treat larger moles or previously biopsied moles that show pre-cancerous changes. Using a “cookie cutter” type instrument, this technique allows a more complete removal of the mole by cutting a wider margin around and under the mole. After numbing the mole, the area is removed as a plug of skin, which is then repaired with sutures, resulting in a linear scar. Depending on the location on the body, some physical activity may need to be limited for the 2 weeks that the sutures are in place to avoid unnecessary tension on the wound and promote appropriate healing.
All moles that are removed are examined by a board certified dermatopathologist, a pathologist that has undergone additional specialized training in diseases and cancers of the skin. Patients are typically notified within 2 weeks of their results. Although there can be exceptions, most of the time mole removal is covered through insurance. Your are encouraged to notify your dermatologist if a mole grows back after removal.