When should moles be removed?
As long as they are medically inconspicuous, there is no need to have moles removed. However, if someone finds a harmless mole cosmetically unpleasant, they can seek help from a dermatologist. For example, those affected often want to have a large port-wine stain, protruding moles or a dark mole (mole) on the face or elsewhere on the head removed.
It is highly advisable to have a mole removed if the skin change is (potentially) malignant. Sometimes an initially harmless mole develops into skin cancer or a precursor of it. In other cases, a new skin mole appears that looks like a benign mole but is malignant from the outset.
Expectant mothers also often have or develop moles. These should only be removed during pregnancy if it is medically necessary. This recommendation generally applies to all treatments and procedures for pregnant women.
How much does it cost to have moles removed?
Do you need to have a mole (mole) removed for medical reasons? If so, your health insurance will usually cover the costs of this medical treatment. This applies, for example, if the doctor wants to remove a suspicious mole in order to examine it for malignant cells.
Clarify in advance with your health insurance company whether and to what extent you will have to pay part of the costs. For example, insured persons in Switzerland generally have to contribute to treatment costs (by means of a deductible and excess).
How can moles be removed?
Doctors can remove moles with a laser, a scalpel or by abrasion, for example. A bleaching cream, icing or chemical peeling can also be an option in certain cases. Which method is suitable in each individual case depends, among other things, on the type, size and location of the birthmark.
Ask your doctor in advance to explain exactly which methods can be used to remove your moles, how the procedure is carried out and what the benefits and risks are!
Removing moles by excision
It doesn’t always have to be a scalpel knife: Alternatively, some small moles can be punched out as a whole. Doctors then speak of punch excision. If only a part (tissue sample) is punched out for a more precise analysis, this is called a punch biopsy.
Excision is the method of choice for many nevi that need to be removed. Dermatologists use this method to remove (potentially) malignant moles in particular. If it is certain to be skin cancer or a precursor to skin cancer, they cut out the entire mole – together with part of the surrounding skin as a safety margin so that as few degenerated cells as possible remain at the edge.
If it is still unclear whether a mole is benign or malignant, the dermatologist can also remove it completely to be on the safe side and send it to the laboratory for analysis. Alternatively, he may first take a tissue sample for microscopic examination. If this confirms the suspicion of cancer, the doctor will also remove the rest of the mole together with a margin.
In the case of a malignant mole, further treatment may be necessary, such as radiotherapy. You can read more about this under Skin cancer: Treatment.
Removing moles with a laser
For example, the dermatologist can ablate a sebaceous gland nevus (nevus sebaceus) with a laser, for example with a CO2 laser. This procedure is called laser ablation.
There are also non-ablative laser treatments. Here, the laser beam is directed specifically at certain structures under the surface of the skin.
For example, the doctor can remove or at least lighten a port-wine stain or a spider nevus with a dye laser. Both are birthmarks that originate from blood vessels. The energy of the laser beam is mainly absorbed by the red blood pigment in the red blood cells (erythrocytes). The erythrocytes heat up in the process. As a result, they and the section of blood vessel in which they are located are destroyed. Doctors refer to this as laser coagulation.
Doctors also usually recommend non-ablative laser treatment with a pigment laser for café-au-lait spots and lentigines (such as age spots). This allows the pigment deposits in the tissue that cause the dark skin mark to be destroyed. The doctor uses a ruby or ND:YAG laser, for example.
Under certain circumstances, laser ablation can also be considered for café-au-lait spots and lentigines.
Difficult diagnosis of malignant changes
Doctors therefore generally recommend not to remove moles with laser if it cannot be ruled out with certainty that they are cancerous. Above all, they advise great caution in the laser treatment of pigmented skin changes, especially if the moles originate from melanocytes. In Switzerland, the law even prohibits the laser removal of such melanocyte nevi (liver spots).
In contrast, laser treatment is possible for the precancerous stage of actinic keratosis – in addition to other treatment methods. In certain cases, white skin cancer of the basal cell type (basal cell carcinoma) can also be “lasered” if there are serious reasons why the usual treatment (surgery or local therapies) is not suitable.
General information on the use of laser light for skin and eye diseases can be found in the article Laser therapy.
Removing moles with dermabrasion
During dermabrasion, the dermatologist removes the top layer of skin (epidermis). They can use a high-speed diamond cutter, for example. The patient is given a local or general anesthetic for the procedure.
Doctors also sometimes remove age spots (lentigines seniles) by carefully abrading the epidermis.
Removing moles with other methods
Electrocaustics is one of the methods used to treat spider nevi. In this procedure, the doctor uses a small device to cut through or vaporize the tissue at the desired location with short pulses of electricity.
Some moles can be frozen, i.e. removed in the same way as warts, using cryotherapy. This cold treatment can be used for age spots, for example. Sometimes doctors also use the curettage method to remove such age and UV-related moles: they use a curette – a type of round scalpel – to scrape away the top layers of skin.
Depigmenting agents are another option for removing or fading age spots and sometimes other pigmented moles. They are available as medical products or skin care products (cosmetic products) and are applied externally.
For example, bleaching and lightening agents with active ingredients such as hydroquinone, rucinol or vitamin C can be tried to combat deposits of the pigment melanin in the epidermis. The locally increased production of melanin can be slowed down with skin products containing the active ingredient butylresorcinol.
Removing moles yourself?
Some people try to remove a birthmark with apple cider vinegar, for example, or to tie off a raised birthmark. After all, it sounds simple, harmless and cheap. But can you actually remove moles yourself – with household remedies such as apple cider vinegar, by tying them off or with the help of electrical devices that are offered for this purpose on the internet, for example?
Doctors generally warn against attempting to remove moles or liver spots on your own. One reason for this is that laypeople cannot recognize with certainty whether a skin change is benign or malignant. And malignant moles must always be treated by a doctor!
In addition, the result of self-treatment is often not as desired: When patients remove a mole themselves, they are more likely to be left with an (ugly) scar than if they have it professionally treated by a dermatologist. In addition, this scar can make it more difficult to detect malignant skin changes that are developing or have already developed in this area.
Another argument: anyone who cuts, scrapes or scratches a mole on their own runs the risk of severe bleeding and wound infection.
After mole removal
Whether a scar remains after mole removal depends on the procedure chosen and the extent of the procedure. Excision, for example, often leaves a scar, especially when doctors remove larger moles with a scalpel. There is usually no scar or only a small one if you have moles lasered – which is an advantage on the face, for example.
It is best to discuss with your doctor when you can do sport after having a mole removed. For example, if you have had a small mole on your face removed by laser, you may not need to restrict your physical activities at all.
In other cases, doctors may recommend that you refrain from sport and other physical exertion for some time – so as not to disrupt the healing process and avoid complications. This may be advisable, for example, if the doctor has lasered away a large port-wine stain or removed a large, raised mole under the armpit with a scalpel.
Relapse and new moles
A mole (mole) suddenly reappears after removal? Such a recurrence is indeed possible, for example in the case of a nevus that has been incompletely excised or removed with an ablative laser.
In addition, new moles can form if you do not avoid the most important external risk factor – UV radiation. So don’t expose your skin to too much sunlight, especially at midday. Clothing, hats and sunglasses also (partially) keep out the dangerous UV rays. Use a suitable sunscreen and avoid tanning beds.
Consistent UV protection (preferably from childhood) can prevent the formation of pigmented moles. This may save you from having to have such moles removed.
