Moles that have deep roots can be difficult to remove, but there are several effective methods you can try. The key is choosing the right approach based on the size, depth and location of the mole.
What are deep root moles?
Most moles only grow on the top layer of skin and have roots that extend into the dermis. However, some moles have roots that go deeper into the subcutaneous fat layer or even down to the muscle fascia. These are known as “deep root moles.”
Deep root moles tend to be larger in size, with a diameter of 6mm or more. They penetrate deeper into the skin layers, so they cannot be shaved off easily. Attempting to cut them can result in scarring and skin discoloration.
It’s important to identify deep root moles early and have them examined by a dermatologist. Though most are benign, there is a small risk they could progress to melanoma over time.
Methods for removing deep root moles
Excisional surgery
Excision is the most effective way to remove a deep root mole. This minor surgical procedure involves numbing the area with local anesthesia and cutting out the mole along with a margin of clear skin around it.
The mole is cut all the way down until the roots are fully removed from the deeper skin layers. This helps ensure none of the abnormal cells are left behind to potentially regrow.
The excision leaves behind a round or oval wound that is stitched closed. This will leave a small scar once healed, but results in complete removal of the mole.
Punch excision
Punch excision or punch biopsy is suited for small, deep moles. The dermatologist uses a special surgical “punch” tool to cut a perfect circle around and under the mole, removing it as a cylinder in one piece.
The punch excision does not require stitches. The round wound is left to heal on its own, which results in minimal scarring. However, this method can only be used for moles less than 4-5mm in size.
Laser surgery
Laser mole removal may be an option for deep root moles in certain locations, such as the face. A laser is used to target the pigment in the mole cells.
This causes the cells to heat up and disintegrate. The dead cells are then discarded by the immune system over the next few weeks.
With multiple treatments, the laser can penetrate down to the deeper roots of the mole to destroy the abnormal cells.
Lasers do not guarantee full removal compared to surgical excision. But they result in less scarring and are gentler on delicate facial skin.
Cryosurgery
Cryosurgery involves freezing moles to destroy them. Liquid nitrogen is applied directly on and around the mole using a cotton swab or spray device.
The extreme cold causes the cells to crystallize and die. Over a few weeks, the dead cells slough off. Each session goes deeper until all root cells are frozen.
Cryosurgery works best on raised moles. Flat deep root moles may require multiple treatments to penetrate to the full depth.
Prescription creams
Prescription products like imiquimod cream may help remove very small, superficial moles when applied regularly over weeks.
The cream works by stimulating the immune system and causes inflammation that breaks down the abnormal mole cells.
However, prescription creams cannot reach deeper root cells, so they are generally ineffective for larger or deep moles.
Home remedies
While home remedies for mole removal are popular, most cannot treat deep root moles effectively or safely remove them entirely. Methods like applying apple cider vinegar, garlic, hydrogen peroxide, or castor oil run the risk of burning, scarring or discoloring the skin.
Attempting to cut, scrape, or pick at a deep root mole at home can lead to infection and spread of the abnormal cells deeper into the skin.
It’s best to avoid home methods and see a dermatologist to discuss the removal options tailored to your specific mole.
When to see a dermatologist
You should have any mole evaluated if it:
- Is large in size, generally bigger than 6mm
- Has an irregular shape with uneven borders
- Has multiple colors mixed together
- Has recently changed in size, color or shape
- Tingles, itches, hurts or bleeds
- Has an unusual growth or an odd appearance
A dermatologist can examine suspicious moles with a dermatoscope to evaluate if they have any characteristics of melanoma. They can also determine if a mole has deep roots requiring surgical removal.
Preparing for mole removal
Before having a deep root mole removed, be sure to:
- Avoid blood-thinning medications like aspirin and ibuprofen several days beforehand
- Stop any retinoid creams, which can increase skin sensitivity
- Stay out of the sun and use sunscreen diligently for a few weeks before
- Consider taking an antiviral medication if you have a history of cold sore outbreaks triggered by surgery
- Arrange for transportation, as you cannot drive immediately after the procedure
- Ask your provider if you need to have someone accompany you and drive you home
What to expect during the procedure
The steps involved in surgically removing a deep root mole include:
- The skin is thoroughly cleaned and sterilized.
- Local anesthesia is administered via injections around the mole. This numbs the area.
- Using a surgical pen, the borders are mapped out and marked.
- An incision is made around and under the mole using a scalpel or razor.
- The mole is lifted out in one piece, including the entire root.
- Bleeding is controlled using cauterization as needed.
- The wound edges are approximated and stitched closed.
- A sterile bandage is applied over the site.
For punch excision, the cylindrical punch tool is rotated while pressing down to cut around and underneath the mole prior to removal.
Laser and cryosurgery involve application of the freezing agent or laser beam to the surface and edges of the mole in a slow, methodical manner.
Recovery and aftercare
Proper aftercare is vital for minimizing the risks and improving healing after mole removal surgery. Be sure to follow these tips:
- Keep the wound covered with a fresh bandage for 24-48 hours.
- Apply antibiotic ointment and change the bandage daily.
- Take over-the-counter pain medication as needed for discomfort.
- Avoid getting the wound wet for 2-3 days.
- Absorbable stitches may be used that dissolve over time.
- Non-absorbable stitches are removed after 7-10 days.
- Avoid strenuous exercise and sun exposure until fully healed.
- Watch for signs of infection like pus, swelling, redness, which require antibiotics.
- Use silicone gel sheets or creams to minimize scarring.
Full healing can take 2-4 weeks depending on the depth and size. Schedule a follow-up visit with your dermatologist to confirm complete mole removal.
Results and outlook
When performed properly by a skin specialist, surgical removal successfully eliminates deep root moles in almost all cases.
The risks of the mole recurring or resulting in scarring are minimal when the appropriate technique is selected based on the mole’s specifications.
Any biopsy of the mole can determine if there are any concerning cellular changes requiring additional treatment.
Regular self-exams and skin cancer screenings in the future are recommended to monitor for any new unusual growths.
Preventing new mole growth
While many moles are primarily genetic, sun exposure can also trigger new abnormal mole development. To minimize additional moles forming:
- Apply broad spectrum SPF 30 or higher sunscreen daily.
- Wear protective clothing like hats, long sleeves and sunglasses outside.
- Avoid prolonged sun exposure during peak hours (10 am – 2 pm).
- Seek shade whenever possible when outdoors.
- Avoid tanning beds, which emit high-intensity UV radiation.
- Conduct regular skin self-exams each month to look for changes.
- See a dermatologist annually for a full body skin cancer screening.
When to see your doctor
Consult a dermatologist promptly if you notice any of the following:
- A new mole that appears suddenly or is rapidly changing
- An existing mole that has become raised, enlarged or darkened
- Itching, bleeding, oozing or crusting of a mole
- A mole with irregular, blurred or notched borders
- Variegated colors in the same mole
- A mole larger than 6mm in diameter
- Pain or discomfort arising from a mole
Catching any suspicious changes in existing moles or new abnormal moles early is critical for proper diagnosis and treatment.
Conclusion
Deep root moles can be challenging to eliminate, but are very treatable. Making the right choice between excision surgery, punch excision, laser or cryosurgery is key based on the mole’s specific features and location.
With a skilled dermatologist, even moles with deep roots in the skin can be removed fully to minimize the risk of recurrence. Proper aftercare and sun protection can help prevent any new moles from developing.
Regular self-exams and dermatology checkups will help identify any moles needing removal before they progress to melanoma skin cancer.
