Risks and benefits of mole excision

Overview

Mole excision is a minor surgical procedure to remove a mole from the skin. It may be done because the mole looks suspicious (could be skin cancer) or for cosmetic reasons. The mole is cut out, often with a small amount of surrounding skin, and the wound is closed with stitches.

Yes, millions of mole excisions are performed worldwide each year. It is one of the most common skin procedures.

Anyone with moles can have a mole removed. It is more common in people with many moles, a history of sun exposure, or a family history of skin cancer.

Symptoms

Common symptoms

• A mole that has changed in size, shape, or color
• A mole that is asymmetrical or has irregular borders
• A mole that is itchy, painful, or bleeds
• A mole that looks different from other moles on your body

Symptoms in children

• A new mole that appears suddenly and grows quickly
• A mole that is larger than a pencil eraser
• A mole that bleeds or itches without injury

Symptoms in older adults

• Any new mole after age 30 should be checked
• A changing or bleeding mole on sun-damaged skin
• Moles that become crusty or elevated

Causes

Main causes

• Moles are clusters of pigment cells. They are mostly harmless but can sometimes become cancerous.
• Reasons for excision include suspicion of skin cancer, cosmetic concerns, or irritation from clothing.

Risk factors

• Having many moles (more than 50)
• Family history of skin cancer or atypical moles
• History of sunburns or excessive UV exposure
• Fair skin that burns easily
• Weakened immune system

When to see a doctor

See a doctor urgently if:

• A mole that changes quickly over weeks or appears suddenly in adulthood
• A mole that bleeds, itches, or becomes painful for no reason

Book a routine appointment if:

• Regular skin checks every year if you have many moles or risk factors
• If you are concerned about the appearance of a mole and want it removed

Diagnosis

A doctor will look at your mole with a special magnifying tool called a dermatoscope. If the mole looks suspicious, they may recommend removing it for testing.

Tests that may be done

• Dermoscopy – examination with a magnifying lens and light
• Biopsy – removal of the mole (or a small piece) to be checked under a microscope

What to expect at your appointment

The doctor will numb the area with a local anaesthetic injection. The mole is then cut out. You will feel pressure but no pain. The sample is sent to a lab, and results usually come back in one to two weeks.

Treatment

The main treatment for a suspicious mole is surgical removal. This can be done in a doctor’s office. The type of removal depends on the mole’s size, depth, and appearance. After removal, the wound is closed with stitches, and you will be given aftercare instructions.

Self-care at home

• Keep the wound clean and dry for the first 24 to 48 hours.
• Follow your doctor’s advice on when to change the dressing.
• Avoid swimming, heavy exercise, or soaking in baths until the wound heals.
• Protect the scar from the sun with clothing or sunscreen for at least a year.

Medical treatments

Mole excision can be done by shave excision (shaving off the mole at skin level) or surgical excision (cutting out the mole with a margin of healthy skin). The choice depends on the mole’s features. Local anaesthetic numbs the area. Stitches may be absorbable or need removal after a week or two. The removed tissue is always sent for biopsy.

When is surgery considered?

Surgery is recommended when a mole shows signs of being skin cancer or pre-cancer, or if the mole is bothersome (catches on clothing, bleeds often, or is cosmetically unwanted).

Living with this condition

After mole removal, you can return to most normal activities within a day or two. Avoid heavy lifting or strenuous exercise for about a week if you had stitches. The scar may be pink or raised for several months but usually fades over time.

Lifestyle tips

• Use sunscreen SPF 30 or higher every day on exposed skin.
• Wear a hat and protective clothing when outdoors.
• Check your skin monthly for any new or changing moles.
• Avoid tanning beds and direct sun during peak hours (10am to 4pm).

Diet and exercise

A balanced diet rich in fruits, vegetables, and lean protein can support healing. Staying hydrated helps your skin recover. Gentle exercise is fine once the wound is healed, but avoid exercise that stretches the wound until stitches are removed.

Mental health and emotional wellbeing

Worrying about skin cancer is common. If you feel anxious, talk to your doctor or a counselor. Some people feel self-conscious about scars; they usually fade and can be improved with silicone gels or sheets.

Prevention

Not all moles can be prevented, but you can lower your risk of developing suspicious moles or skin cancer by protecting your skin from the sun and avoiding sunburn.

Screening programmes

No routine screening is needed for everyone, but if you have many moles or risk factors, your doctor may recommend annual skin checks. You can also do regular self-exams using a mirror to look at all areas of your skin.

Complications

If left untreated

• A suspicious mole that is left untreated could be skin cancer that spreads to other parts of the body.
• An irritated mole may continue to bleed or become infected.

Long-term outlook

Most mole excisions are straightforward and heal well with minimal scarring. If the biopsy shows cancer, early treatment has a very high success rate. The outlook is excellent when suspicious moles are caught and removed early.

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