Moles are common growths on the skin that are usually harmless. However, some moles can develop into melanoma, which is a serious form of skin cancer. So how do you know if a mole needs to be removed by a doctor?
Here are some quick answers to key questions about concerning moles:
– Does the mole look unusual or different from your other moles? Changes in size, shape, color can be a red flag.
– Has the mole changed or grown recently? Any new development could be a warning sign.
– Does it bleed, ooze, or itch? Abnormal symptoms like this need evaluation.
– Is it larger than 6 millimeters? Large moles have higher risk of being abnormal.
– Does it have an irregular border? Jagged or faded edges are concerns.
– Is the color uneven? Multiple shades of brown, black, red, blue, or white are worries.
– Is the mole in a high risk place like the face or groin? Moles here have more sun exposure.
Signs a Mole May Need Removal
Moles, also called nevi, are very common skin growths. It is normal for people to have between 10-40 moles by adulthood. Most moles are benign and no cause for concern. However, some moles can exhibit warning signs that mean they should be evaluated by a dermatologist.
Some signs that a mole may be abnormal and require removal include:
Asymmetry
Benign moles are typically symmetrical, meaning if you drew a line through them, both halves would match. Suspicious moles can have an asymmetrical shape, with one half differing from the other half.
Irregular Borders
Most harmless moles have smooth, even borders. Abnormal moles can have borders that are irregular, jagged, or poorly defined. The edges may be faded rather than crisp.
Color Changes
Common moles are usually a uniform brown color. If a mole has a mix of different colors – brown, black, pink, red, white, blue – it warrants a closer look. Varied colors or very dark colors are of concern.
Size Changes
It is normal for moles to slowly increase in size over time. But if a mole is rapidly growing or changing shape, it should be evaluated. Any mole larger than 6mm has a higher risk of being melanoma.
Elevation
Most moles sit flat against the surface of the skin. Moles that become raised or elevated above the skin need examination.
Oozing or Bleeding
Healthy moles do not bleed or ooze fluid. If a mole becomes ulcerated or bleeds, even from minor injury, it is considered abnormal until proven otherwise.
Itching or Irritation
Common moles do not normally cause discomfort. A mole that becomes painful, tender, itchy, or irritated may signal a problem.
Location
Moles in high friction areas like the groin, underarms, neck, scalp, hands, and feet have a greater risk of turning abnormal. The face is also riskier due to sun exposure.
Types of Abnormal Moles
There are different classifications used to describe atypical moles that may require removal:
Dysplastic Nevus
This describes a mole with abnormal features, but does not meet the criteria of melanoma. It may exhibit uneven color, irregular borders, asymmetry, or other odd traits. Some doctors consider dysplastic nevi pre-cancerous.
Congenital Nevus
Congenital nevi are moles present at birth or that develop in early infancy. Large congenital nevi greater than 20cm have a higher chance of becoming cancerous. Smaller congenital nevi can also be removed for cosmetic reasons.
Atypical Mole
Atypical moles, also called Clark’s nevi or B-K moles, look different than common moles. They are larger with irregular borders and variations in coloring. People with many atypical moles have an increased melanoma risk.
Recurrent Nevus
This refers to a mole that has returned after being previously surgically removed. Any mole that recurs after excision should be evaluated again.
Inflamed or Bleeding Nevus
A mole that becomes red, swollen, painful, or bleeds easily could be turning cancerous and requires urgent evaluation. Bleeding does not necessarily mean melanoma, but should not be ignored.
Melanoma
Melanoma is the most serious form of skin cancer arising from pigment producing cells called melanocytes. An existing mole that develops melanoma needs swift removal and staging. Catching melanoma early is critical for survival.
Reasons a Dermatologist May Recommend Mole Removal
There are several reasons a dermatologist might recommend surgically removing a mole:
Suspicious Features
If a mole shows signs of being potentially cancerous, the dermatologist will likely remove it for biopsy to test it for melanoma or other skin cancers. Signs include asymmetry, irregular borders, color changes, swelling, and larger size.
Precancerous Changes
Some moles may exhibit precancerous changes or be considered premalignant. Dysplastic nevi and atypical moles could turn cancerous over time. Early removal is recommended.
Preventive Screening
Those with many abnormal looking moles or a family history of melanoma may choose to have some moles removed prophylactically to head off any changes. This also establishes a mole’s baseline appearance for future monitoring.
Location
Moles in high friction areas and regions vulnerable to sun damage are more likely to turn abnormal. Dermatologists often remove moles on the scalp, face, hands, feet, or groin areas.
Appearance
For cosmetic reasons, patients may request removal of moles they find embarrassing or unsightly, even if the mole is benign.
Discomfort
Moles that become irritated by clothing, bleed easily, or are constantly injured while shaving or washing may be taken off for comfort reasons.
Change Over Time
If a mole exhibits any change in size, color, shape, symptoms, or appearance over time, the dermatologist will likely remove it to be safe. Any new development warrants a closer look.
How Moles Are Removed
Moles can be removed either via excision (cutting) or ablation (burning):
Surgical Excision
Excision uses a scalpel or scissors to shave the mole and a margin of normal skin off the top layer. The wound is stitched closed, leaving a linear scar. Excision allows full thickness biopsy of the mole for analysis.
Punch Biopsy
Using a circular blade, the mole is extracted including deeper portions of the dermis. Stitches usually close the small hole left behind. Punch biopsy combined with shave removal ensures clear margins.
Laser Excision
A focused laser beam slices through the mole, vaporizing tissue. A local anesthetic is given. Little to no cutting or suturing is involved. The laser cauterizes while removing the mole.
Cryosurgery
Liquid nitrogen or nitrous oxide gas rapidly freezes and destroys moles cells through extreme cold. The dead mole then sloughs off. Minimal scarring occurs with this technique.
Curettage and Electrodessication
A sharp curette scrapes off the mole, then an electric needle desiccates any remaining cells. The procedure is repeated in cycles until the mole is fully removed. Local anesthesia is administered.
Shave Removal
Using a sharp blade, the mole is shaved flat with the top layer of skin. Stitches are not required. Variations include dermabrasion to sand down the mole before shaving it smooth.
Recovery and Aftercare
Proper aftercare helps minimize scarring and reduces the risk of infection following mole removal:
Bandaging
Keep the area bandaged for 24-48 hours. Apply antibiotic ointment and change the dressing daily while healing. Watch for signs of infection like warmth, redness, swelling, oozing, and fever.
Stitches
If stitches were used, keep them dry for 5-7 days until removal. Avoid submerging the area. Carefully cleanse around the stitches with mild soap and water.
Bruising
Expect some bruising, which usually fades after 1-2 weeks. Apply a cold compress to reduce bruising and swelling. Keep the area elevated. Over-the-counter pain medication can help.
Scabs
Scabs will form as the wound heals. Do not scratch or pick scabs. Gently wash the area and pat dry. Scabs will gradually slough off on their own after 1-2 weeks.
Scarring
Some scarring is inevitable. Use sun protection on healed scars for at least 6 months. Silicone sheeting, gels, creams, injections, laser treatment, and microneedling can minimize scars over time.
When to See the Doctor
Consult your dermatologist if you experience:
– Increased pain, swelling, warmth, oozing, or redness past 48 hours, signaling possible infection
– Bleeding that does not stop with pressure after 24 hours
– Loss of feeling around the mole removal site
– The wound fully splits open
– Fever over 101˚F
– Pus or foul-smelling discharge coming from the site
– No signs of healing after 2 weeks.
Results of Biopsy
It takes about 1 week for mole biopsy results. If it is benign, you simply continue healing. If melanoma or another skin cancer is found, additional treatment will be needed like wider excision, lymph node mapping, or chemotherapy. Your doctor will discuss appropriate next steps.
Long Term Care of Area
Going forward after mole removal, continue protecting the spot from sun damage. Apply sunscreen regularly once fully healed. Monitor the site for any new moles or skin changes, which could indicate new abnormal cells. Report any unusual developments to your dermatologist. Schedule annual full body skin checks.
Conclusion
Most moles are harmless, but unusual looking moles or those exhibiting suspicious physical changes warrant evaluation. An experienced dermatologist can judge if a mole needs removal based on its appearance, symptoms, and risk factors. Biopsy results determine if additional treatment is appropriate. Take steps to care for the removal site properly during recovery. Be vigilant about monitoring your skin, applying sunscreen, and getting regular skin cancer screenings in the future. Catching concerning moles early allows for simple, effective treatment.
| Sign | Indicates |
|---|---|
| Asymmetry | Mole halves don’t match |
| Irregular borders | Jagged, faded edges |
| Color changes | Shades of brown, black, red, white, blue |
| Size increase | Rapid growth or diameter over 6mm |
| Elevation | Raised above skin surface |
| Oozing or bleeding | Abnormal fluid or bleeding |
| Itching or irritation | Pain, tenderness, itching |
| Location | Face, scalp, hands, feet, groin |
