Cheshire Cosmetic

Mole Removal

The average adult has between 15- 40 moles, which appear between childhood and up to the age of 40 years. A mole is made of a collection of melanocyte pigment cells, which give the mole its colour. Moles are normal and appear in childhood. The more sunlight a child is exposed to can increase the number of moles. Some families have many moles on the skin, which is normal for those family members as the number of moles is under the control of genes.

Illustrated below are a few normal moles, which can be flat or raised.

What does removal of a mole / skin lesion involve?

• Informed consent with pre-treatment photographs
• Skin cleaned and sterilized with alcohol or iodine
• Local anaesthetic injection into the lesion using a very fine needle
• Mole / skin lesion removed by one of 5 methods:
  • Excision – a leaf shaped incision is made around the mole using a small tip scalpel. The wound is then closed using a fine suture. This technique is used for flat, pigmented moles and lesions and leaves a fine linear scar.
  • Shave Excision – suitable for raised or fleshy lesions, especially on the face. The lesion is removed by running a blade flat across the base of the lesion and leaves a round and flat scar.
  • Cautery – this is a similar technique to shave excision but uses a fine electrical cutting tip instead of a scalpel. It is commonly used to remove skin tags.
  • Curretage – is a scraping technique and is appropriate for skin lesions which are superficial and look “stuck on” (eg. seborrhoeic warts). Scarring is minimal and is usually flat and slightly paler than the surrounding skin.
  • Cryotherapy – uses liquid nitrogen spray to create a ball of ice in the tissue, which freezes and destroys the skin lesion. It is suitable for most warts and normally takes 2-3 treatments to remove the skin lesion. Scarring is minimal and usually depends on the depth of the lesion.
• All skin biopsy specimens are sent for histology analysis
• Any bleeding is treated with either an electro-cautery or silver nitrate tip
• The wound is dressed and any sutures are removed at 5-7 days
• Full wound healing and cosmetic benefit is achieved at 4-6 weeks

What are the side effects of Mole Removal?

• Scarring depends on the type, size and site of mole / skin lesion and is UNCOMMON
• Bleeding and infection are RARE when performed aseptically
• Allergy to the local anaesthetic or iodine is RARE
• Hyperthrophic (thickened) and keloid scarring is abnormal and VERY RARE

Common Skin Lesions

Seborrhoeic Warts
are common with increasing age and usually present in the late 30s. Their cause is not well understood. They tend to be brown in colour and have a rough surface with a "stuck on" appearance. They are not harmful, however can be easily treated by cryotherapy (freezing) or by curettage (scraping) under local anaesthetic. They may recurr despite sucessful removal.

Sebaceous Cysts
are caused by blockage of the sebaceous gland of the hair follicle. They usually present as smooth firm swellngs in the skin and can become intermittently infected (red and sore). Common areas are the face, neck, chest and scalp. Treatment usually involves surgical removal under local anaesthetic, which leaves a linear scar behind.

Skin Cancer
Moles that change in colour, size, shape or surface may represent skin cancer and should be assessed by a doctor. There are 3 main types of skin cancer, all of which are caused by sun exposure.

Basal Cell Carcinoma (BCC)
is the most common form of skin cancer and usually presents as a lump just under the skin. Sometimes there is a characteristic "rolled edge" and this may later break down to form a "rodent ulcer". Surgical excision is usually an effective treatment although regular review and high factor sunscreen is recommended subsequently.

Squamous Cell Carcinoma (SCC)
is the second most common form of skin cancer and tends to present on sun exposed areas of the body (face, arms, hands). It appears more superficially and scaly than BCC and can often occur at a site of previous skin damage. Small tumours can be surgically removed but larger lesions may require cryotherapy (freezing) or fluorouracil cream (cell cycle slowing).

Malignant Melanoma
affects 6000 people in the UK every year and causes 2000 deaths annually. It can appear like a normal mole initially but if left untreated, can then spread to other parts of the body. The main features tend to be change in colour (darker), size (>6mm), border (irregular) and surface (uneven). Any such changes should be seen by a doctor, as surgical removal is simple and effective in the early stages of melanoma.

Mole Removal FAQs