MOLE REMOVAL

A mole is a cluster of pigment cells, and the great majority are entirely harmless. Very occasionally, a change in a mole is the first sign of a melanoma, which is highly treatable when caught early and much less so when it is not.

That is the whole argument for assessing a mole before destroying it. At your consultation, our consultant dermatologist examines it, often with dermoscopy, a magnified light that shows structure the naked eye cannot see. If the mole is plainly benign, it can be removed. If anything about it needs closer attention, we say so.

We will not remove a mole that should be investigated as though it were a cosmetic blemish. Where a mole needs urgent analysis or specialist referral, that is what happens, and it happens quickly. The alternative, removing it without a look and without a laboratory, means that if it ever mattered, nobody will ever know

It is worth having a mole checked promptly if you notice any of the following, often remembered as the ABCDE signs:

• Asymmetry. One half does not match the other.
• Border. Edges that are irregular, ragged or blurred.
• Colour. More than one colour, or a colour that is changing.
• Diameter. Larger than about six millimetres, or growing.
• Evolving. Any change in size, shape, colour or height, or a mole that starts to itch, bleed or crust.

A new mole in an adult, or one that simply looks unlike your others, is also worth showing to a clinician. Having a mole checked commits you to nothing, and most turn out to be exactly what you hoped. If you would like a wider check rather than a single mole assessed, see our mole check and mole mapping service.

Where a mole is suitable for removal, it is excised surgically under local anaesthetic in our minor operations theatre, with a surgical nurse alongside you. The whole mole is taken, the skin is closed with fine sutures where the site needs them, and the sample is kept intact so it can be sent for histology when required to Nationwide Pathology, an accredited laboratory.

Removing it intact is the point. It is what allows a laboratory to examine all of it, which is the only way to be certain what it was. A fragment tells you much less, and a destroyed mole tells you nothing at all.

This is why we do not laser or shave off pigmented moles. Laser destroys the very tissue a laboratory would need, so it cannot be tested. A melanoma treated as a blemish is missed, and the consequences of that are serious. Assessment, intact excision and histology are the responsible sequence, and it is what you should expect from anyone removing a mole.

Mole removal is a day case procedure, and most people go back to normal the same day, avoiding heavy exercise while the wound heals. You leave with a dressing, simple wound care instructions, and an appointment for suture removal if the site needs it.

A wound closed with care looks worse before it looks better. It is normal for the site to be red and firm along the line for a few weeks, and scars keep improving for many months. There will always be some mark, because any removal that cuts the skin leaves one, and how noticeable it is depends on the site and on how carefully the wound is closed, which is the argument for having it done surgically rather than quickly. We share your histology result as soon as it is available and give you a named contact, so if anything worries you at week two, you are not starting again with a call centre.