Synonyms
Birthmark, mole, nevus (= mole, plural nevi, nevus cell nevus, nevus pigmentosus, junctional nevus, compound nevus, dermal nevus Medical: Navüs
The acquired moles do not have to be removed in principle, since they are usually benign in nature. The patient’s desire to remove the cosmetically disturbing mole (without suspicion of degeneration) is also a reason for excision. However, a microscopic examination should still be performed afterwards.
It is also recommended to cut out the mole, which is constantly subject to trauma, for example on the soles of the feet. In all other cases, i.e. when there is no risk of skin cancer, self-observation by the patient and, if necessary, regular check-ups by the dermatologist are sufficient. The therapy is similar for congenital liver spots.
However, since there is an increased risk of degeneration, the mole should be checked regularly by the dermatologist, ideally by means of photo documentation. Smaller changes can be surgically removed from the age of 12 years, larger changes should be removed from the age of 6 months. However, if skin cancer is suspected, the liver spots must be removed immediately. In general, the risks for the presence or development of skin cancer, for the operation as well as the cosmetic risk must be weighed up with regard to the excision.
Methods for removal
Especially suspicious liver spots should be removed and sent to the examination laboratory for histological examination. The largest number of liver spots is usually initially inconspicuous, and regular check-ups by a dermatologist are sufficient. The removal of inconspicuous liver spots for cosmetic reasons in one of the numerous beauty and cosmetic institutes should be considered sufficiently.
Probably the oldest method for removing liver spots is excision, i.e. cutting out the suspicious area. Here, the superficial skin area is first injected with a local anesthetic to numb the area. As a rule, drugs such as lidocaine or skandicain are used.
Before and after the anaesthetic, the corresponding skin area is disinfected generously and an appropriate exposure time is observed. Then a scalpel is used to cut around the liver spot and the corresponding skin area is levered out or removed with tweezers. It is important to note that the entire mole is reached and removed even in the depth.
Depending on the size of the cut out area, the skin must then be provided with one or two small sutures, which can then be removed again after 7-10 days after the wound has healed. Usually, depending on the suturing technique used, a small scar remains. The most gentle method is the so-called intracutaneous suture, where there is only a puncture site and a puncture mark.
The entire thread runs under the skin. There is no larger scar. A newer method is the laser technique, which aims at the sole removal of the mole.
However, no samples can be obtained for histological examinations. Therefore a statement about a possible malignancy is not possible. For this reason, laser removal is used almost exclusively for cosmetic liver spot removal.
The pigments of the mole are scattered in the skin by the laser treatment, a wound does not occur during the laser treatment, therefore a suture treatment is not necessary. With both removal methods, the surgical site is covered with a bandage, which should remain on the skin area for 1-2 days. The removal of liver spots is a low-risk procedure.
However, there can always be postoperative bleeding or skin irritation (especially after laser surgery). After the surgical excision of the mole, wound healing can be impaired, which in some rare cases may have to be operated on again. Blood-thinning medications should be discontinued 2-3 days before the procedure to avoid complications.
