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Mole/Nevus Removal

Mole/nevus removal — surgical excision and pathological examination of suspicious or bothersome moles.

Removal of moles that are suspicious in color, shape or size, or are removed for cosmetic or functional reasons, by minor surgery, with pathological examination.

Indication

  • Moles suspicious by ABCDE criteria — Asymmetry, Border irregularity, Color variation, Diameter > 6 mm, and Evolving features
  • Newly appearing or rapidly changing, bleeding, itchy or ulcerating moles
  • Moles in locations exposed to constant friction and trauma (belt line, bra line, sole)
  • Facial/neck moles causing aesthetic concern and interfering with daily activities such as shaving or makeup
  • Lesions selected for removal after dermoscopic follow-up in individuals with a family history of melanoma (the most aggressive skin cancer)
  • Moles showing atypical features on dermoscopy (color disorganization, abnormal vascular pattern)

Preparation

  • Adjustment of blood thinners (aspirin, warfarin, new-generation anticoagulants) with physician approval
  • Known allergy to local anesthesia or adhesive bandages should be reported
  • If there is active infection (acne, folliculitis) at the procedure site, the appointment is rescheduled
  • Hypertension, diabetes and pregnancy status are reviewed before the procedure
  • Avoid makeup, self-tanning cream and perfume application before the procedure

How it's performed

  1. The physician first examines the mole in detail with a dermoscope; documents with photographs when needed
  2. The removal method is decided: shave (superficial), punch, or elliptical excision
  3. The area is cleaned with antiseptic and local anesthesia is injected
  4. The mole is removed with appropriate surgical margins; bleeding is controlled with electrocautery or pressure
  5. Absorbable or non-absorbable sutures are placed if needed and a sterile dressing is applied
  6. The removed mole is always sent to the pathology laboratory; results are evaluated within 7-14 days

Post-procedure

  • Information is given on dressing care and not wetting (usually first 24-48 hours)
  • Suture removal is generally planned within 5-7 days on the face, 7-14 days on the trunk and extremities
  • The pathology report is always evaluated together with the physician; if melanoma is found, oncologic completion and follow-up are planned
  • Sun protection for 6-12 months is recommended for scar color and contour
  • If the patient has other suspicious moles, full skin screening every 3-6 months may be planned

Risks

  • Risk of infection, bleeding and hematoma in any surgical procedure (low rate)
  • Scar formation; prominent scarring in keloid-prone individuals
  • Color change (hyperpigmentation or hypopigmentation), especially with sun exposure
  • Rare allergic reaction to local anesthesia
  • Regrowth of the mole if removal is incomplete (residual nevus); for this reason the pathology report is important

FAQ

Is mole removal with laser safe?

Moles with suspicious features or those considered to be possibly cancerous should not be removed with laser, because the laser burns the tissue and pathological examination cannot be performed. Therefore the assessment is the dermatologist's responsibility.

Does removing a mole cause cancer?

No. A mole removed with proper technique for medical indications does not cause cancer. On the contrary, by removing a suspicious mole, melanoma can be detected early through pathological examination.

When does the pathology result come and could it be melanoma?

The pathology report is usually available within 7-14 days. Depending on the result, the procedure may be sufficient or additional completion surgery may be required; the result is evaluated together with your physician.

Which moles should I monitor?

Moles showing the ABCDE rule (asymmetry, irregular border, color variation, diameter over 6 mm, rapid change) or newly appearing moles should be evaluated; individuals with many moles or a family history of melanoma should also have regular check-ups.