Moles

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Introduction

Moles and other unwanted marks, lumps or blemishes can often be removed or improved with surgery.

Procedure

The operation is usually carried out under local anaesthetic (injection to make the skin numb). It is usually classified as an outpatient or daycase procedure. You are usually only in the hospital for a short period before and after the procedure.

Tangential excision and cautery

Some ‘moles’ are best removed by tangential excision or curettage. The area is then usually cauterised. Although healing varies from person to person this frequently leaves a good cosmetic result. However it may also leave a scar.

Formal Excision

For a formal excision the ‘mole’ is excised by removing a diamond shaped piece of skin with the mole in the centre. The diamond shape is then closed with stitches to leave a straight line. Stitches may be absorbable (dissolving) or may need to be removed. On the face usually sutures that need to be removed are used.

Testing (histology)

It is usual practice for all ‘moles’ that are removed to be sent to the histology laboratory for analysis to check they are benign.

Risks

With all surgery there is the possibility of complications. The main complications with removal of small moles from the skin are:

Bleeding: bleeding following surgery occasionally results in the need to re-operate to stop bleeding or to remove a build up of blood under the skin (haematoma).

Infection: there is always a small risk of an infection with surgery. Usually these will settle with antibiotics. Rarely they can be serious.

Wound break down and slow healing: if the wound opens up, usually due to infection, then healing can be slow afterwards.

Damage to nerves: at certain sites, particularly on the face, there are small but important nerves running under the skin. These can be damaged during surgery. It is most unusual with simple skin removals but more likely where there are deeper lumps.

Poor scarring: scarring depends more on how an individual heals than on how the operation is carried out. Some people make great scars that may be difficult to see. Other people’s scars may stretch or turn hypertrophic and keloid. Hypertrophic and keloid scars tend to be lumpy, red, itchy even painful and may take a long time to settle.

Recurrence: moles that have been removed may sometimes grow back. This is more likely with tangential excision.