Mole Removal

Moles, known medically as melanocytic naevi, are common benign growths that occur when melanocytes cluster together in the skin. While the majority of moles are harmless, some may require removal for diagnostic evaluation, cosmetic reasons, or because changes in their appearance raise concern for melanoma or other skin cancers. Mole removal is a routine outpatient procedure performed under local anaesthesia with minimal downtime.

When Mole Removal Is Recommended

Mole removal is recommended when a mole displays features that are clinically suspicious for malignancy. The ABCDE criteria are used to evaluate concerning changes: Asymmetry in shape, Border irregularity, Colour variation within the lesion, Diameter greater than 6 mm, and Evolution or change over time. Any mole that is new, growing, bleeding, itching, or otherwise changing warrants prompt evaluation.

Removal may also be sought for moles that cause irritation due to their location, such as those that catch on clothing or jewellery, or for cosmetic improvement when a mole is considered aesthetically undesirable. Regardless of the reason for removal, all excised tissue is submitted for histopathological examination to ensure no abnormality is overlooked.

Types of Moles

Common melanocytic naevi are typically small, round, and evenly coloured. They may be flat (junctional naevi), slightly raised (compound naevi), or dome-shaped (intradermal naevi). These moles develop during childhood and adolescence and are generally stable in appearance throughout adult life.

Dysplastic naevi, also referred to as atypical moles, are larger than common moles and often display irregular borders, uneven colour distribution, and an asymmetric shape. Although dysplastic naevi are benign, individuals with multiple atypical moles are at increased risk of developing melanoma and benefit from regular skin surveillance.

Removal Techniques

Shave Excision

Shave excision is used for raised moles that are not suspicious for melanoma. A blade is used to shave the mole flush with or slightly below the surrounding skin surface. No sutures are required, and the wound heals by secondary intention over several weeks. This technique is quick, produces a flat scar, and is well suited for moles on the trunk and extremities.

Elliptical Excision

Elliptical excision involves cutting around the mole in an elliptical shape, removing the mole along with a margin of surrounding normal skin. The wound is closed with sutures, resulting in a linear scar. This technique is preferred when melanoma is suspected, as it allows for complete removal with clear margins and provides the pathologist with a full-thickness specimen for thorough evaluation.

Punch Excision

Punch excision uses a circular blade to remove small moles in their entirety. The technique is particularly useful for small, flat moles that require full-thickness evaluation. The resulting wound is closed with one or two sutures, and healing is generally straightforward with minimal scarring.

Histopathological Assessment

All moles removed at the Centre for Medical and Surgical Dermatology are submitted for histopathological examination. The tissue is processed, sectioned, stained, and examined under a microscope by a dermatopathologist. This step is essential for confirming the clinical diagnosis, identifying any dysplastic or malignant features, and determining whether additional treatment is required.

Pathology results are typically available within one to two weeks. If atypical or malignant cells are identified, further excision with wider margins may be recommended. Patients are informed of all results at a follow-up appointment, where next steps are discussed in detail.

Recovery and Scar Management

Recovery following mole removal is generally rapid. The wound should be kept clean and moist with petroleum jelly or a prescribed ointment, and covered with a bandage until healing is complete. Sutures, when present, are removed within 7 to 14 days depending on the location of the excision. Strenuous activity should be limited during the initial healing period to avoid wound dehiscence.

All surgical procedures result in some degree of scarring. The appearance of the scar can be optimized through diligent wound care, sun protection, and the use of silicone-based scar treatments if recommended. Scars typically fade and flatten over the course of several months to a year.

Dr. Maksym Breslavets at the Centre for Medical and Surgical Dermatology provides thorough evaluation and removal of moles using the technique best suited to each individual case. Every removed mole is assessed histopathologically, ensuring that patients receive an accurate diagnosis and appropriate follow-up care.