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How to Deal with Moles

By Robert Kotler, MD, FACSAugust 19, 2010
From the WebMD Archives

A mole is a lay term for a benign, non-cancerous, round, smooth surfaced dome-like growth on the skin anywhere on the body. They tend to be more common on the face. Sometimes they have some speckled color and often they are identical in color to the surrounding skin. They tend to be slow-growing and unpopular only because of the appearance.

There have been some high profile people that have been very happy to keep their moles on their face. Marilyn Monroe had a mole. So did Cindy Crawford, until recently.

Some people report a family history of them, and others report having many of them over the course of their lifetime.

Frankly, if one wishes to have the mole removed, it is strictly for cosmetic reasons – unless there has been a change in its appearance, rapid growth suggesting the possibility of malignancy, in which case, it becomes somewhat of a medical dermatologic emergency. For most people, the moles are removed because they just don’t like the way they look.

If people are walking around with a mole and are not happy with it, often it is because they are afraid to have it removed. There are old wives tales about “if you cut into a mole to remove it will grow and spread”, suggesting that it would be cancer or malignant. That is just not true. Others are afraid to have it removed because “there would be a scar.” That is possible if it is not done in the best way, nor in the most experienced hands.

Let me tell you about the preferred method which has served patients very well for many years. In my opinion, the ideal technique to remove one of these moles is to do what is known as a microsurgical shave excision. That is a long medical term for shaving it off the face, using an operating microscope and removing it completely. Incidentally, when that is done at the desire of the patient or suspicion of the doctor it can be sent to a pathologist to be closely examined and make sure there is no malignancy.

The microsurgical aspect of it is very important because using an operating microscope, a high-tech magnifying system, the surgeon can clearly see how deep he is going, whether or not there is some residual mole at the base of the wound, and it prevents the surgeon from having to remove, unnecessarily, normal tissue either at the edges or base. In other words, the technology helps the surgeon do a better job by not performing more surgery than necessary. The smaller the wound, the faster and better the healing.

With microsurgical shave excision there is no stitching. The minor excavation caused by removal of the mole will heal in by itself, both from the bottom and from the sides, within three to four days if the mole has been on the face, a little longer if on the arms, legs or trunk. The only care required is that the area, which looks like a bit of a “scrape”, be kept constantly covered with antibiotic ointment and a dressing because if the wound were allowed to dry out healing would be much slower.

Typically, there is a pink color to the fresh skin that has grown in to replace the mole, and that pink color fades within two to three months.

So, if you have a typical mole on your face and you don’t like it, don’t despair, it can be dealt with as an office procedure with rapid healing and ultimately nearly invisible evidence of it ever having been there.

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