Melanoma scan skin cancer clinic

Melanoma Scan
Skin Cancer Clinic

Mole Removal

Not all moles are dangerous but sometimes the location can be annoying causing irritation. At Melanoma Scan we perform cosmetic mole removal with simple in-house surgical procedures.

What is a mole?

A mole is a growth of melanocytes and skin cells, otherwise known as a melanocytic naevus. Usually brown or black - that can appear anywhere on your body. They usually show up on children and teenagers before adulthood. Most are moles benign, meaning they’re not cancerous therefore not requiring mole removal procedures.

Who gets moles?

Everyone has at least one mole on their body, but some people have many. People with many moles may be diagnosed with dysplastic naevus syndrome, especially if their moles have an asymmetrical appearance. It's best to stay on top of the moles on your body to check for skin conditions (worst case scenario: skin cancer) with a regular skin check with your doctor.

When should I get a mole removed?

If a mole is changing or growing it should be seen by a doctor for a skin check. The skin Doctor will diagnose the mole as either a benign or atypical naevus. Atypical naevi may be imaged and watched for change using specialised imaging systems. Alternatively, if thought to be at risk, the Doctor may remove the mole to check for melanoma. You will need to watch the area, as sometimes a mole can grow back.

 If a mole is in a place that can rub when you get dressed or shave, or it is unsightly cosmetic mole removal is also an option. A simple shave procedure can completely remove an unsightly mole from your face, arms or body.

How is a mole removed?

First, your skin doctor will perform a mole check. If the mole doesn't look normal, the Doctor will have the mole removed straight away.

A mole is usually removed using a biopsy technique, which can include punch excision, shave excision or ellipse excision. The college of dermatologists recommends that if a biopsy is deemed necessary, then complete excision of suspicious moles be performed where practical to assess for melanoma.

Mole removal is a surgical procedure, and as such should be preformed by a skin doctor within a surgical environment.

What does cosmetic mole removal involve?

Cosmetic mole removal involves the removal of a mole to give the best cosmetic result. This often depends on the particular skill set of the surgeon, but in many cases a shave excision when the surgeon has adequate training will result in both an excellent cosmetic outcome once healed, and also an adequate sample to send to histopathology to rule out melanoma. Removing a mole may require a cosmetic mole removal procedure where local anaesthetic is administered. Doctors prefer to do mole removal surgically so a biopsy can be performed to rule out melanoma and other cancers.

How long does it take to have a mole removed?

Mole removal occurs it two ways, either a shave excision, which is very quick, or formal ellipse excision, which takes a little longer. 

Shave excision

Is a technique that involves putting a small amount of local anaesthetic under the mole and then using either a straight or curved blade, which is passed through the skin directly under the mole, resulting in the mole being removed with a narrow margin of normal tissue under and around it.  Occasionally, if the mole is being removed for benign reasons (for example, it is raised and gets in the way of shaving and repeatedly traumatised) the doctor may remove the raised part of the mole and leave a small amount of mole tissue behind, in an effort to minimise any visible scar or depression left by the mole removal. 

This procedure normally takes between two minutes and 5 minutes to do, using low sting local anaesthetic, which has the dual advantages of hurting less and giving almost immediate numbing to superficial lesions like a mole.  This type of mole removal can often be incorporated into a skin check or 15 minute procedure time.

Formal ellipse excision

Takes a little longer, because a larger area of skin needs to be numbed, and a formal excision setup needs to be done by the doctor or nurse. The mole needs to be removed as an ellipse of skin (boat shaped piece of skin removed) and the wound sutured, usually in two layers, closing both deep and superficial parts of the skin, minimising the risk of scar stretching and tram track marks being left behind from the sutures. 

A typical mole removal using this technique takes about fifteen minutes to perform when assisted by a nurse, or 25 minutes without the assistance of a nurse.  Normally a 30 minute procedure time is booked to allow for set up and tidy up before and after.

Is it a standard procedure time

A shave excision can be done in a standard 15 minute appointment, however, an ellipse excision is usually booked into a 30 minute procedure appointment, so it depends on the technique that you have discussed with your doctor.

How long will it take to heal?

The healing time is different for the two different types of mole removal and the location, and also the reason for the excision.  The healing time of a cosmetic mole removal on a face can be 7-10 days, during which there will be a scab form and then fall off as the skin heals up under the scab.  A deep shave excision for testing for possible melanoma is a much deeper and wider shave excision and depending on the location on the body, can take between 2 and 4 weeks to heal.  There can be a risk of infection on the lower leg with this technique (or any excision on the lower leg) due to poor immune function and blood supply on the lower leg, which can further delay healing.

Ellipse excision on the face takes 7 days to heal enough for sutures to be removed, and other parts of the body usually take between 7 and 14 days to heal to the point where sutures can be removed. However, this is only the early stage of healing, with deep sutures continuing to support the wound for the next 6 weeks until further strength has developed in the wound.  During this time, sporting activities, lifting, carrying, bending and squatting need to be avoided depending on the location of the wound, and the wound needs to be supported with taping with micropore tape or similar. Wound can be as little as at 10% of their eventual strength at day 7 without supportive deep sutures, and can reach 80% of their eventual strength at 3 months, hence the need to continue taping for an extended period and limit physical exertion, especially on the area affected by the surgery.

What can I do to reduce scarring?

The Melanoma Scan doctor and nurse will give you detailed instructions on how to care for your wound to reduce scarring.  With shave excisions, the best results can be achieved using moist wound healing, using antibiotic ointments such as chloromycetin ointment or otocomb on high risk areas for infection, or using strataderm or stratamed silicone containing gels for areas at risk of keloid scarring.  For some areas simple moist wound dressings using Vaseline, antiseptic creams or pawpaw ointment may be a low cost and suitable alternative.  Your doctor will recommend the treatment that he believes is most suitable for your particular wound and situation.

With ellipse excisions, taping is an important aspect of wound care to prevent a stretched up scar despite the support of the deep sutures. Equally important is abstaining where possible from exercise for up to 6 weeks following surgery.  That may not always be possible with people engaged in manual work, but often with care and getting assistance with lifting and carrying, stretching of the scar can be minimised.

Keloid scarring is a feared outcome for all excisions, however is very uncommon outside of a small group of people who appear to be prone to them.  In this group, silicone gels are utilised and the wound is reviewed 3-4 weeks after surgery to see if there is any sign of keloid formation, which can often appear after apparently normal early healing as a raised red itchy and uncomfortable scar.  Occasionally steroid injections may be used to halt keloid formation or reduce an established keloid scar, but the results are not always satisfactory in this keloid prone group of patients.

Are there stitches involved? Do I need to come back to have the stitches removed?

Sutures are used for closure of ellipse excisions, and these need to be removed at 7-14 days, depending on the site.  Most are removed at day 7 but lower legs take longer to heal.  Deep sutures dissolve by themselves over an extended period of time, however if they poke out through the skin at any stage in the healing process, they are usually removed to allow the wound to close completely.  Shave excisions do not need sutures and heal up like a graze wound with appropriate dressings and wound care.

 

If I have a lot of moles, does my risk of melanoma increase?

Large numbers of moles are associated with both a genetic predisposition to mole formation, and an increased sun exposure in childhood as a trigger for mole formation.  Moles in at risk individuals, tend to cluster in areas of previous sun exposure and sun damage, including areas that have been sunburnt in the past.  In this way, large numbers of moles can act as a marker for people at increased risk of both melanoma and non melanoma skin cancer (such as BCC and SCC).  If you have large numbers of moles, particularly if you have odd looking or asymmetric appearing moles, then a regular (at least annual) skin check with an experienced skin cancer doctor is recommended because you may be at higher risk of melanoma, particularly with advancing age, although melanoma can occur in any age group.

Why use Melanoma Scan to have my mole removal?

Melanoma Scan doctors are dedicated skin cancer doctors, who are focussed on giving you the best outcome of your mole removal.  Whether it is a cosmetic shave excision, or a biopsy to diagnose or exclude melanoma, your doctor will provide you with the best experience possible under the circumstances, and the piece of mind that your mole will always be tested to exclude the possibility of melanoma or other skin cancer in the tissue. We are dedicated to giving you the best possible cosmetic outcome as well, especially where the mole is removed from the face or body because it is raised and getting traumatised or just generally “in the way”.  In these examples, our primary focus is on achieving an excellent cosmetic outcome.  Where melanoma is a possibility, the focus is on giving the pathologist the whole lesion to analyse, so a larger wound may be required, which of course can take longer to heal, but will ensure that the most accurate diagnosis is achieved. Your doctor will guide you through the process step by step to ensure it is pain free and minimise inconvenience.

 

Melanoma Scan have three locations in Brisbane, by clicking the following link, it will take you through to the Contact Us page.