Possibly you have ever wondered if you can remove that unsightly mole or wart that sticks out somewhere on your body. Or that maybe it gets irritated from time to time, starts to bleed or even black hairs come out of it.
I'm sure you have a solution! But first of all, the most important thing is to make a correct pre-surgical dermatological diagnosis to avoid problems in the future. Now I will explain why.
What will this article cover?
Why is it important to make an accurate diagnosis?
The first step for a successful treatment is to make a correct diagnosis of this wart or mole. There are different dermatological lesions that may present as raised lesions on the skin both benign as well as malignant.
There are many differential diagnoses of moles and warts and only a dermatologist is trained to diagnose them correctly.
Here are a few examples of some lesions that may look like moles on the face:
-
Dermal nevus -
Basal cell carcinoma -
Nodular melanoma -
Xanthelasma -
Seborrheic keratosis -
Dermal nevus -
Angioma -
Viral wart -
Acrocordones
As you can see, many times what we call moles or warts can have different diagnoses and therefore the treatment will be very different in each case. In some cases we can even find malignant lesions such as melanoma or basal cell carcinoma that can also present clinically as warts.
Therefore, it is important to consult a dermatologist before performing an operation on any lesion.. In our profession we are used to make accurate diagnoses by dermoscopy and in difficult cases even by confocal microscopy that will allow us to remove a mole safely.
The good news is that if we do everything correctly we can get very good results like the ones I show you below.
Is a mole or wart the same thing?
One of the things I see most often in my practice is patients who come in to have burn their "warts". However, lesions that patients interpret as warts are rarely warts. Knowing the difference between a mole and a wart is very important so that avoid applying treatments at home that may worsen the situation.
A mole is a group of cells called melanocytes. which are usually brown or black and can appear anywhere on the body. They usually appear before the age of 20 and most are benign.
On the other hand, the warts are viral lesions produced by the human papillomavirus (HPV). These warts have different clinical presentations depending on the site where they appear. In this way we can find them in the office:
- Palmar and plantar warts
- Genital warts (condyloma)
- Flat warts in children
It is important to know that viral warts are contagious and can continue to appear more if left untreated. But this is not what I will cover in this post.
How to remove a mole safely?
Once we have made the correct diagnosis of a dermal mole or other benign lesion we must choose the most appropriate procedure. There are different surgical techniques that should be assessed depending on the initial diagnosis of the lesion to achieve the best esthetic result.
Among the different surgical techniques we can find:
- Punch biopsy: A circular punch is placed over the mole to remove the mole with the smallest possible diameter.
- Excision by shaving (shave): We reserve it for raised lesions that look like warts in which we shave the lesion at the skin level. The aesthetic result is excellent.
- Surgical excision: We normally use it in flat lesions in which we need to remove the entire lesion to make a correct diagnosis. In this case stitches must be used.
- Ablative laser or CO2 laser: In benign and non-melanocytic skin lesions we can use the CO2 laser for vaporization. It has an excellent aesthetic result.
- Cryotherapy: Only in some benign lesions confirmed by dermoscopy can we apply cryotherapy. Cryotherapy uses liquid nitrogen to generate extremely cold temperatures (-196°C) to destroy the cells. Although it is a quick and easy procedure to perform in the office, the aesthetic results are worse, so I prefer to use other methods.
Subsequently, all lesions that we remove require a histological study, i.e. a biopsy and microscopic examination to rule out signs of skin cancer. It is not uncommon for a skin cancer to appear on a mole and sometimes the only clue to the diagnosis is microscopic study of the lesion.
Do you want me to assess if your mole can be removed?
Removing flat or raised moles
Removing a flat mole and a raised mole are different procedures due to the unique characteristics of each type of mole. This is very important when deciding whether to remove a mole or leave it alone.
Removing flat moles
Flat moles are found deeper in the skin. In order to remove them we will need to make a deep incision to be able to remove the entire mole and analyze it correctly under the microscope.
Generally, in these cases, the removal of these moles tends to be avoided.The reason? Well, because removing them involves undergoing a slightly more complex surgical procedure. As illustrated in the image below, the challenge is that removing a flat mole requires the application of stitches, which inevitably results in the formation of a scar. Consequently, we remove flat moles when we suspect that there is any suspicion of malignancy.
Removing raised or dermal moles
Dermal moles rise above the surface of the skin giving a warty appearance. Although these moles can be much more noticeable, in most cases they do not represent a medical problem and their removal is simpler than that of flat molesThe most common options are laser surgery or surgical removal by shaving.
In the following illustration you can see how we perform a shaving procedure to remove a mole with relief.
What can I expect after mole removal?
Once a mole has been removed, there will be a phase of recovery or regeneration of the skin. During this phase the patient will play a key role as it will require a specific wound and scar care protocol to be followed.
Healing time after mole removal depends on the individual. Younger people tend to heal faster than older adults. And, of course, a larger incision will take longer to close than a smaller one. In general, a mole removal scar will take at least two to three weeks to heal.
If everything goes well, we can observe very good results as the following picture shows the result after removing a dermal nevus or mole with relief.
Initial phase of healing
During the initial phase (0-14 days) when we still have a scab or surgical stitches in place will be very important:
- Follow the guideline specific care that your doctor has left you when removing the mole.
- Avoid exposure of the scar to sunlight, as it can cause it to heal more slowly. It can also make the scar darker and more noticeable.
Recovery phase
The recovery phase will begin when the scab from a shaving wound has fallen off or when the surgeon has removed the stitches. Normally the healing process usually lasts from a few months to 1 year. It will be essential for your care:
Massage the wound
Massaging the scar can help to make it less hard and improve vascularization. You can do this 1 to 3 times a day by gently massaging the scar for 1-2 minutes.
Use silicone-based products
Silicone products, such as silicone sheets and gels, can improve healing and have been the most studied. You can use them under makeup and clothing and for a minimum period of 3 months.
- Silicone sheets: Silicone sheets can help make your scar smoother and flatter. To use a silicone sheet, cut it to the size of your scar and apply it over it. You can leave it on for up to 7 days without changing it. Some brands of silicone sheeting include Trofolastin silicone patches and the Cica-Care
- Silicone gels: To use a silicone gel, use it 2 times on your scar and let it dry. Some brands of silicone gels are Mederma silicone gel with sun protection and also Dermatix gel
Protect your scar from the sun
Laser-assisted healing
If you are very concerned about aesthetics, lasers can further aid in the treatment of surgical wounds by speeding recovery and improving scars. Acting quickly and performing them as soon as possible is advantageous, maximizing benefits and scar quality. If you have any questions you can ask us.
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Are there any risks when removing a mole?
The biggest risk after surgery is that the site may become infected and leave a visible scar. If you carefully follow the instructions we will give you to care for the wound until it heals, it is very rare for this to happen.
Will there be much scarring?
Whether from surgery or a scrape on the knee, all skin wounds can leave a scar. A scar is the body's natural way of closing the skin and healing a wound.
If you follow all the post-surgical instructions, the chances that you will be able to the wound heals well will be very high and will leave little mark. It is always important to talk to your dermatologist before any procedure to assess the risk of scarring depending on the location and size of the mole.
Can I remove my moles at home?
You should never apply an anti-wart treatment or try to remove something from your own skin if you do not know the diagnosis. Many times we find in the consultation with moles very irritated by treatment that do not correspond and end up leaving a scar or residual hyperpigmentation. This is something we see very frequently in our office and that is why I decided to write the following article: Why is it not a good idea to remove a mole at home?
But not all concerns are aesthetic. The biggest problem associated with removing something from your skin on your own is that there is no way of knowing whether you are removing a benign lesion or a malignant one. At the Melanoma Unit of the Hospital Clínic de Barcelona we repeatedly encounter patients or people not trained to make a proper diagnosis who burn malignant lesions. This leads to late diagnosis of malignant lesions that can be potentially fatal.
Messages for home
In conclusion, I always recommend you to go to a dermatologist to correctly assess your moles or other skin lesions and choose together the best treatment for your case.
If you plan to have a mole removed, talk to your dermatologist about your options for minimizing scarring. Share your concerns up front and ask what you can do after the procedure to help make the scar as faint and small as possible.
353 Responses
Hello, good morning. I have a question.
Yes, if you remove a mole with a CO2 laser, it's possible for it to grow back.
Hi Juan,
If you remove a mole with a laser, the mole's roots typically remain deeper down. In rare cases, the mole might grow back a little, but not to the extent it was before. In these situations, the procedure can be repeated without any issues.
Best regards
Thank you very much
Good morning, excuse
Hello,
It may be possible to do so, but it's always important to discuss it with a dermatologist or surgeon to assess the aesthetic outcome that can be achieved. We must remember that we will be replacing a mole with a scar, and depending on the location, the pros and cons need to be weighed. Best regards.
My daughter is 10 years old and her birthmark covers the first third of the bridge of my index finger on her face (between her eye and the bridge of her nose). She's been under dermatological observation since she was one year old and it hasn't changed much. They tell me she would have cosmetic surgery to remove it, but it's highly likely it would grow back.
Hello again,
I would love to give you my opinion on your daughter's case, but it's very difficult for me to do so without seeing her in person. Normally, when a mole is completely removed, it shouldn't reappear.
Best regards
Hello! I have a mole that.
I would like to know if you could remove it (it's where my left eyebrow begins)?
Thank you for your attention.
Warm regards.
Dear Javier,
Given the size you describe, removing this mole shouldn't be a problem. As I've explained in this post, before removing any mole, a proper study of it with dermatoscopy is necessary to establish a diagnosis. Afterward, we will choose the best method to remove it. Best regards.
Do you have a clinic in Mexico City and what is the location so I can start a diagnosis for my mole?
Thanks for your attention
Greetings
Dear Javier. I only work in Barcelona, Spain.
Hello Doctor, Good Morning, I would like to have a mole removed with an incision. Is it true that the mole will be removed from the root, will it leave a scar, and will the mole no longer grow back in the extracted area?.
Dear Fernando,
There are many different ways to remove a mole.
When they are raised, we have the option to shave them down to skin level through a procedure called «shave excision.» In this first case, the roots remain, and there is a small possibility of regrowth, but the advantage is that no stitches are used, and it is more aesthetically pleasing.
Secondly, there is an excision (incision), which is what I imagine you're asking about. In this case, the mole is removed deeply, creating a wound that requires stitches. The advantage is that we remove the entire mole, but we have to put in stitches, which is usually less aesthetic.
Best regards
Good morning, I went to the dermatologist and she told me that she hadn't detected any problems with the moles I wanted removed, but that she couldn't guarantee they wouldn't become malignant moles in the future. So she recommended removing the moles with surgery instead of laser.
What I don't understand is, if I have moles removed surgically, should I keep the removed samples myself? And for how long? Until the removed mole becomes malignant? Or are they sent to a laboratory and do I have to pay a fee every X amount of time to keep them there?
Thank you very much, and I apologize for any inconvenience.
Hi April,
We ourselves send the moles we remove for analysis in the laboratories, and they are responsible for preparing a report and storing the samples. Therefore, you will not have to worry about this particular matter.
Best regards
Good evening, I hope you're doing well. I'm writing to you again with a question. I went to a clinic to have my moles removed with a laser (at first I wanted to have them removed surgically, but the doctor told me it would leave a scar and that they had a high-end laser—one that only five clinics in Mallorca had—and I don’t know what else), After the laser session, the doctor told me I would have to take pills called “Dermovance M” for 3 months to prevent the moles from becoming pigmented again. But the problem is that after two weeks, it looks like the moles are coming back, so I’ll make an appointment for a follow-up.
My doubt is whether “Dermovance M” really works or if it's a scam for.
Hello Doctor, blessings to you and your family. A mole appeared under my left breast, but it has been growing and it hurts. I am going to the dermatologist, and God willing, it doesn't come out with malignant characteristics. What procedure should be done to remove it? And is there a risk it will develop faster with removal? What do you suggest?
Hello Miredys,
I hope you are doing very well. As you say, the most important thing is that you first see a dermatologist to properly evaluate this mole and they can tell you what it is. Once we have the diagnosis, we can better explain whether it needs to be removed, the procedure, and its risks.
Hello Doctor... I have a skin tag on my head and every time I go to the hairdresser, they pull it off, but not completely. It's like a little blood sac that has formed... I need to get it removed because I cut it myself or the hairdresser does... What do you suggest? Thank you
Hello Natalia,
Just as you say, the recommendation would be to remove this «flesh mole» by a dermatologist and analyze it under a microscope. My The practice is located in Barcelona, Spain if you happen to be nearby.
Best regards
Good morning, next week my daughter is going to have a mole removed from her head. She's had it since birth, and at first it was a small mole, but it has become like a wart. The dermatologists told us it was all normal and that they would remove it if it bothered her, and honestly, it's bothering her more and more when she combs her hair, and it's visible when she ties her hair back. They told us it's like pulling a tooth, but that they have to do it from the root with a scalpel, outpatient surgery with local anesthesia. We are a bit scared. We don't know how anesthesia works on the head, if the surgery will require stitches, and if her hair will grow back in the area. Thank you very much.
Dear Marco Antonio,
As you explain well in your message, it is surely a benign lesion and the reason for removing it is the discomfort it causes.
Regarding the anesthesia, it's quite simple as it's placed just under the skin.
Since it's a congenital mole (from birth), they will surely remove it through surgery with stitches. If it's small, only a small scar will remain, which will be perfectly hidden among the hair.
Best regards
Hello. I had three moles removed from my face, I think it was with a laser or radiofrequency (something), the point is that they didn't put those protective glasses on my eyes and I don't know if that can affect my vision. HELP PLEASE.
Hello Monica,
If you haven't been given protective glasses, it's likely because it was removed through electrofulguration or a similar technique. When we use lasers, we do use eye protection. It's best to ask directly at the center where you had the treatment done.
Best regards
Hello, my father's mole on his left cheek is getting worse and worse, so much so that the skin has opened up. Horrible!
I would like to know how to treat it.
Hello Rudis,
Without a doubt, what you need to do is go in person to a dermatologist so they can evaluate this lesion live and make a correct diagnosis.
Hello, I'm from Virginia, I'm interested
I have a 1-year-old baby diagnosed with a giant congenital melanocytic nevus located on her cheek. What is the recommended age for lesion removal, what technique is considered ideal from an aesthetic perspective, and which specialist is most recommended (plastic surgeon, dermatologist, pediatric surgeon)?
Hi Nayely,
Based on what you've told me, it's likely not a giant congenital nevus, but rather a medium congenital nevus if it only affects one cheek. Dermatologists classify congenital nevi (birthmarks) into small, medium, large, and giant depending on size that they have at birth. In the case of small and medium moles, the future risk of developing melanoma It is not bigger that of any other mole on our body, so removing it would only be indicated for aesthetic reasons.
Nowadays, removing congenital nevi of this type is largely a parental decision that should be evaluated alongside specialists. If a good aesthetic result can be achieved, it might be advisable to remove it. In many countries around the world, these moles are not removed, while in others, their removal is encouraged for aesthetic reasons. In Spain, there is an association of congenital giant nevus where you can read patient testimonials and learn a bit more about the topic.
Regarding the best specialist, I think it depends more on each person's expertise and the country you are in.
Warmest regards, and I hope I've answered some questions.
The doctor consulted me about having a mole removed on my shoulder. The dermatologist referred me to plastic surgery. The plastic surgeon indicated that there are two ways to perform the procedure: in the operating room or in the office.
I chose a topical anesthetic, but I'm regretting it because I'm nervous. The doctor told me she'll make a large incision to remove everything, then stitch the tissue and then the skin.
What do you recommend? Change the procedure and do it in the operating room?
Hi Jessica,
Largely, the choice of whether to perform surgery with local or general anesthesia will depend on the size of the lesion to be removed. Typically, small/medium moles < 4 cm can be perfectly
Good morning, Doctor. I live in Madrid and I saw that you are in Barcelona. What a shame!!!
A few months ago, I had some moles removed with a laser, and honestly, the marks they left are very noticeable. They're red, as if they were burned. When I asked, the doctor told me it was normal because I have a darker complexion and that's just how it is. His answer surprised me because when I was younger, I also had moles removed, and it's true that a small scar was left, but it was almost unnoticeable because it was the color of my skin and blended in very well. On that occasion, they cauterized the moles, and the result was excellent.
I read in your post that laser treatment yields better results, but that wasn't the case for me;
Thank you very much for your response.
Greetings
Hi Lola,
I hope you are doing very well. Although I can't give much of an opinion without seeing you in person, it's normal for the red marks to gradually disappear over the course of a few months. Laser is a very good method for removing moles because it is very precise, but there are also other methods like cauterization, which you mentioned. It's also true that during childhood, marks/scars tend to heal much better than in adulthood, and this may be the reason why they are taking longer to heal now.
For now, it's very important that you protect yourself very well from the sun with a broad-spectrum sunscreen and apply a good scar cream.
Best regards
Hi, I would like to inquire about the price. I have a mole on my forehead that appeared when I was 13 years old. From what I've seen on pages, I think it might be melanoma.
Hello Milagros,
Based on what you're telling me, it would be very unusual for you to have melanoma, as it's quite rare in childhood and it.
Greetings
The dermatologist diagnosed me with seborrheic keratosis and I intend to have the laser procedure. Is it appropriate?
Hello Lorena,
Yes, seborrheic keratoses can be removed in many ways, and CO2 laser is a very good option.
Best regards