Moles (Nevi) and Their Surgery

25 min reading time Last Update Date: 10.07.2023

What is a Mole (Nevus)?

A mole, also known as a nevus, is a type of skin lesion that develops on the skin. Moles originate from melanocytes, which are pigment cells in the skin. Moles are usually brown in color and can be found on various parts of the body. While most moles are harmless, they can sometimes develop into a type of skin cancer called melanoma, which carries a risk of malignancy.

Formation and Description of Moles

Moles form due to the abnormal growth of melanocytes. Melanocytes produce melanin, the pigment that gives color to the skin and provides protection against ultraviolet (UV) radiation damage. Moles can be present at birth or develop throughout a person's lifetime.

Moles can vary in size, shape, color, and surface characteristics. Some moles may appear flat and irregular, while others can be raised or have a hairy appearance. The color of moles can range from light brown to dark brown. Additionally, some moles may consist of a single spot, while others can appear as clusters or have an irregular distribution pattern.

Types of Moles and Their Differences

Moles can be classified into different types, each with its own characteristics. Here are a few examples of common types of moles:

  1. Epidermal Moles: These moles develop in the epidermis, the outermost layer of the skin. They are typically flat and brown in color. Epidermal moles are generally harmless and often do not raise aesthetic concerns.
  2. Dermal Moles: Dermal moles form in the dermis, a deeper layer of the skin. They can be raised or round-shaped and may appear darker than the surrounding skin. Dermal moles tend to be more noticeable compared to epidermal moles.
  3. Compound (Junctional) Moles: These moles occur at the junction between the epidermis and dermis. They are usually flat or slightly raised and often appear brown in color. Compound moles typically develop during childhood.
  4. Vascular Moles: These moles develop in areas where blood vessels are enlarged or clustered. They can be red or purple in color and often have a raised structure. Vascular moles can occur in both the skin and underlying tissues.

The mentioned types of moles are just a few examples, and there can be various other types or subtypes of moles. Each type of mole may exhibit differences in clinical features, growth rate, and potential risks. While most moles are benign, it is important to seek professional evaluation from a dermatologist if you notice any changes or concerning features in your moles.

Observation and Evaluation of Moles

Regular observation and evaluation of moles are important for maintaining skin health. Here is some information about methods used to assess moles and monitoring signs of abnormal moles:

ABCDE Rule: Checking Moles

A common method used to evaluate a mole is the ABCDE rule. This rule allows for careful examination of moles and identification of any abnormal features. Here are explanations of the ABCDE rule:

Rule Description
A Asymmetry: The two halves of a mole should be symmetrical. If one half is different from the other, it may be a potential sign of abnormality.
B Border: The borders of a mole should be regular, smooth, and well-defined. Irregular or jagged borders can be noteworthy.
C Color: The colors of a mole should be homogeneous. The presence of multiple colors or abnormal color changes could be observed.
D Diameter: The diameter of a mole is generally smaller than 6 mm. Large or rapidly growing moles can be significant.
E Evolving: Changes in a mole over time should be monitored. The appearance of a new mole or changes in size or shape can be abnormal signs.

By using the ABCDE rule, you can regularly check your moles and consult a dermatologist if you notice any potential signs of abnormality.

Signs of Abnormal Moles and Monitoring

Signs indicating abnormal moles may indicate a risk of skin cancer. Here is some information about signs of abnormal moles and their monitoring:

  • Changing size: If your mole shows a noticeable increase in size or is rapidly growing, it may be a concerning sign.
  • Changing shape: If your mole's shape has suddenly changed or become irregular, it may be an abnormal feature.
  • New moles: The appearance of new moles during adulthood can be noteworthy. New moles may have a different appearance than existing ones.
  • Color changes: Color changes in a mole, especially the presence of multiple colors or abnormal color changes, can be a warning sign.
  • Suspicious surface: If your mole exhibits signs such as bleeding, crusting, scaling, or ulceration on its surface, it may be an abnormal condition.

By regularly observing your moles and monitoring the mentioned signs of abnormality, you can take proactive steps for early detection and consult a dermatologist for professional evaluation. Early diagnosis and treatment can help prevent serious issues like skin cancer.

Risks and Importance of Moles

Moles carry certain risks and are of significant importance when it comes to skin health. Here is some information about the risks and importance of moles:

Melanoma Risk and the Role of Moles

The most important risk associated with moles is their link to melanoma, a rapidly spreading form of skin cancer that originates from melanocytes. Moles can play a role in determining the risk of melanoma. Here are some key points regarding the role of moles in melanoma risk:

  • Atypical Moles: Atypical or dysplastic moles are a higher risk factor for melanoma. These moles are typically larger, have an irregular shape, and may exhibit different colors.
  • High Number of Moles: Having multiple moles can also increase the risk of melanoma. Individuals with more than 50 moles may have an elevated risk of melanoma transformation.
  • Family History: Individuals with a family history of melanoma should be more cautious about their risk. Genetic predisposition can increase the risk of melanoma.

While the risk of moles transforming into melanoma is generally low, individuals with the mentioned factors should be more vigilant and regularly monitor their moles.

Sun Exposure and the Dangers of Moles

Sun exposure is a significant factor in the formation of moles and the risk of melanoma. Harmful ultraviolet (UV) radiation from the sun can contribute to abnormal growth of melanocytes and increase the risk of skin cancer. Here are some important points regarding the dangers of sun exposure on moles:

  • Prolonged Sun Exposure: Long-term and repeated sun exposure can increase the number of moles and contribute to the formation of atypical moles.
  • Intense Sunlight: Exposure to intense sunlight can lead to an increase in the size of moles. This can elevate the risk of melanoma.
  • Sunburns: Severe sunburns during childhood can increase the risk of melanoma. Paying attention to moles in areas where sunburns have occurred is especially important.
  • Sun Protection: Protecting oneself from the harmful effects of the sun is crucial in reducing the risk of moles and skin cancer. Measures such as using sunscreen, covering the skin with clothing, and seeking shade should be taken.

Limiting sun exposure and sunburns can be effective in reducing the risk of melanoma. Regularly monitoring your moles and taking precautions to protect yourself from the sun are important for maintaining skin health.

Mole Surgery: When is it Necessary?

Mole surgery is a procedure performed in specific situations. Here is some information about when mole surgery is necessary:

Evaluation of Abnormal Moles

Abnormal moles are moles that may require surgical removal in certain cases. A dermatologist or plastic surgeon will assess the characteristics of the mole and perform surgical intervention if deemed necessary. Here are some reasons for mole surgery during the evaluation of abnormal moles:

  • Dysplastic (Atypical) Moles: Atypical moles are abnormal moles that carry a risk of cancer. Dermatologists recommend removing atypical moles to reduce the risk of melanoma.
  • Suspicious Moles: If a mole is suspicious for melanoma, a surgical excision procedure may be performed. Dermatologists can determine whether the mole is cancerous or not through histopathological evaluation.
  • Growth or Changes: If a mole shows abnormal growth or changes in shape, surgical removal may be considered. This can help assess the risk of melanoma and remove potentially cancerous cells.

Surgical removal of an abnormal mole provides access to tissue for pathological analysis and helps eliminate potential cancerous cells.

Removal of Moles for Cosmetic Purposes

In some cases, moles may be removed for cosmetic reasons. Aesthetic concerns may cause individuals to feel self-conscious about their moles. Here are some reasons for cosmetic mole removal:

  • Visibility: Moles located in specific areas may be desired to be removed for aesthetic reasons. For example, moles on the face or exposed areas.
  • Comfort: If moles cause discomfort due to friction or irritation from clothing, surgical removal may be preferred.
  • Self-Confidence: When moles affect an individual's self-confidence, their removal for aesthetic purposes may be requested.

Cosmetic mole surgery is performed to improve the appearance of the mole or enhance the individual's comfort. Such procedures are typically simple and low-risk.

Removal of Potential Cancerous Moles

In certain cases, a mole may need to be surgically removed due to its potential to harbor cancerous cells. Dermatologists recommend the removal of moles that carry a risk of melanoma or are suspected to be cancerous. Here are some reasons for the removal of potential cancerous moles:

  • Biopsy Results: If a biopsy confirms the presence of cancerous cells in a mole, surgical removal may be required.
  • High-Risk Factors: Individuals with high-risk factors may be advised to have potential cancerous moles removed. These factors may include a family history of melanoma, a high number of atypical moles, or a previous diagnosis of melanoma.
  • Risk Assessment: Dermatologists can assess the characteristics of a mole to determine the risk of melanoma and recommend surgical removal when necessary.

Surgical removal of potential cancerous moles allows for early diagnosis and treatment, preventing the progression of melanoma.

Mole Surgery: How is it Done?

Mole surgery is a procedure used for the removal of moles. Here is some information about how mole surgery is performed:

Local Anesthesia and Surgical Procedures

Mole surgery is typically performed under local anesthesia. Local anesthesia numbs only the area where the procedure is being done and does not affect the patient's consciousness. Prior to the procedure, the surgeon will choose an appropriate anesthesia method to ensure the patient's comfort and relaxation. During the procedure, any pain or discomfort is minimal.

Various surgical techniques can be used for mole surgery. The two most commonly used methods are excisional and non-excisional techniques. The choice of technique depends on factors such as the size, location, and pathological evaluation of the mole.

Mole Removal Techniques: Excisional and Non-Excisional

There are two common techniques used for mole removal: excisional and non-excisional:

Removal Technique Description
Excisional Technique The excisional technique involves the complete removal of the mole. The surgeon cuts around the mole, either with a margin or a complete skin area. This method is often preferred for large moles or moles with a risk of cancer. The excised tissue is then examined for pathological analysis.
Non-Excisional Technique The non-excisional technique involves the removal of the mole's surface through a procedure applied to the mole. This technique can be performed using methods such as laser ablation, electrocautery, or cryotherapy. Non-excisional techniques are typically used for small, well-defined, and benign moles.

The surgeon will select the appropriate technique based on the characteristics of the mole and the patient's needs. After the procedure, the excised mole is sent for pathological analysis.

Sutures and Healing Process

In excisional mole surgery, sutures are usually used. Sutures are placed to ensure the proper healing of the skin. The healing process can vary depending on individual factors and the size of the mole. The surgeon will provide the patient with necessary care instructions and schedule a follow-up appointment to monitor the healing process.

Sutures are typically removed around one week after the surgery. During the healing process, the wound should be kept clean and dry, and necessary precautions should be taken to reduce the risk of infection. The surgeon may provide recommendations regarding daily activities and sun exposure.

The healing process can vary for each individual, but generally, the wound heals within a few weeks and the scars fade over time.

Post-Mole Surgery Care and Follow-Up

Proper care and follow-up are important after mole surgery. Here is some information about post-mole surgery care and follow-up:

Wound Care and Cleansing

After mole surgery, wound care and cleansing are crucial to expedite the healing process and reduce the risk of infection. Here are some important points regarding wound care and cleansing:

  • Wound Cleansing: The wound should be regularly cleansed according to the instructions provided by the surgeon. Typically, the wound is gently cleaned using mild soap and water.
  • Keeping the Wound Dry: The wound should be kept dry during the healing process. A wet or moist environment can increase the risk of infection. Recommended dressing materials provided by the surgeon can be used.
  • Wound Protection: The wound should be protected from external factors. Avoidance of direct sun exposure is especially important, and a suitable dressing or protective clothing should be used to prevent contamination of the wound.
  • Doctor Check-ups: Regular attendance of follow-up appointments scheduled by the surgeon is important. These check-ups allow for the evaluation of the wound healing process and any necessary interventions.

Adhering to wound care and cleansing guidelines supports the healing process and reduces the risk of complications.

Healing Process and Scar Formation

The healing process after mole surgery can vary from person to person. Here are some important points about the healing process and scar formation:

  • Initial Days: Mild pain, swelling, and redness can be normal in the first few days. Pain medication and cold compresses provided by the surgeon can help alleviate these symptoms.
  • Wound Healing: Wound healing typically takes several weeks. A scab may form as the wound closes. The scab should be allowed to naturally fall off and should not be removed forcibly.
  • Scar Formation: Scar formation is a normal part of the healing process after mole surgery. Scars usually begin as pink or red and gradually fade over time. Each person's scar formation may be different.
  • UV Protection: Sun exposure can darken and intensify scars. The use of sunscreen recommended by the surgeon and taking sun protection measures is crucial.

During the healing process, regular attendance of doctor check-ups and adherence to the surgeon's recommendations are important.

Scar Removal Treatments

In some cases, scars that form after mole surgery can be reduced or eliminated. Here is some information about scar removal treatments:

Scar removal treatments are used to improve the appearance of scars. These treatments may include laser therapy, dermabrasion, microdermabrasion, chemical peels, silicone gel or sheet applications, among others. The choice of treatment depends on the type and size of the scar, as well as the individual's characteristics.

Scar removal treatments are typically performed after the expected healing process following surgery. The surgeon will evaluate suitable treatment options and make recommendations based on the individual's needs.

Scar removal treatments can enhance the appearance of scars and boost an individual's self-confidence.

Risks and Side Effects of Mole Surgery

Mole surgery, like any surgical procedure, carries certain risks and potential side effects. Here is some information about the risks and side effects associated with mole surgery:

Infection and Inflammation Risk

There is a risk of infection and inflammation following mole surgery. Although measures are taken to minimize the risk, it is important to be aware of the possibility. Here are some key points regarding infection and inflammation risk:

  • Preventive Measures: The surgical site is prepared in a sterile manner to reduce the risk of infection. Antibiotics may be prescribed to minimize the risk of bacterial infection.
  • Signs of Infection: It is important to monitor the surgical site for any signs of infection, such as increased redness, swelling, warmth, pus, or fever. If any of these signs occur, medical attention should be sought.
  • Proper Wound Care: Following the surgeon's instructions for wound care can help minimize the risk of infection and inflammation. Keeping the wound clean and following hygiene practices is crucial.

Vigilance in monitoring for signs of infection and proper wound care can help reduce the risk of complications.

Wound Healing Issues

Wound healing problems can occur after mole surgery. Although most wounds heal without complications, certain factors can contribute to delayed or problematic healing. Here are some important points regarding wound healing issues:

  • Delayed Healing: Factors such as poor blood circulation, certain medical conditions, or excessive tension on the wound can contribute to delayed wound healing.
  • Wound Dehiscence: In rare cases, the wound may partially or completely separate, resulting in wound dehiscence. This can occur due to factors such as infection, tension on the wound, or improper wound care.
  • Hypertrophic Scarring or Keloids: Some individuals may be prone to developing hypertrophic scars or keloids, which are raised, thickened scars that can occur after surgery.

Proper wound care, adherence to post-operative instructions, and regular follow-up appointments can help identify and address any potential wound healing issues.

Scar Formation and Color Changes

Scar formation and color changes are common after mole surgery. Here are some important points regarding scar formation and color changes:

  • Scar Appearance: Scars can vary in their appearance and may be flat, raised, or indented. They may initially appear pink or red and gradually fade over time.
  • Color Changes: Some individuals may experience color changes in the scar, such as hyperpigmentation (darkening) or hypopigmentation (lightening). These color changes are typically temporary but can persist in some cases.
  • Scar Management: Proper scar management techniques, such as scar massage, silicone gel application, or sunscreen use, can help minimize the visibility of scars and promote optimal healing.

It's important to note that everyone's healing process and scar formation can be different. Regular follow-up appointments with the surgeon can help monitor the progress of scar healing and address any concerns.

Protection of Moles and Tips for Healthy Skin

Taking certain precautions is important for the protection of moles and maintaining healthy skin. Here are some tips for protecting moles and promoting healthy skin:

Sun Protection and SPF Usage

Sunlight can be harmful to moles and overall skin health. Therefore, it is important to protect yourself from the sun and use SPF (Sun Protection Factor) products. Here are some key points regarding sun protection and SPF usage:

  • Sun Exposure Duration: Avoid prolonged sun exposure, especially during the peak hours of the day (noon).
  • Use of Sunscreen: Regularly apply sunscreen with a suitable SPF to your face, body, and especially on moles.
  • Wide-Brimmed Hat and Sunglasses: Wear a wide-brimmed hat and sunglasses to protect the skin around your face and eyes from the harmful effects of the sun.
  • Seek Shade: Instead of prolonged sunbathing, spend time in shaded areas or wear appropriate clothing to protect yourself from the sun.

Practicing sun protection measures plays a vital role in protecting the health of moles and maintaining overall skin health.

Self-Monitoring of Moles

Regularly monitoring your moles is important for early detection and identifying any potential abnormalities. Here are some important points regarding self-monitoring of moles:

  • Regular Check-ups: Regularly examine your moles and observe for any changes, growth, or itching.
  • ABCDE Rule: The ABCDE rule is a method used for monitoring moles. Pay attention to Asymmetry, Borders, Color, Diameter, and Evolution. If you notice any abnormalities, consult a dermatologist.
  • Photography: Take regular photographs of your moles to track any changes over time. Photographs can serve as a reference for monitoring progress.

Self-monitoring allows for the surveillance of mole health and facilitates early detection of potential issues.

Regular Dermatological Examinations

Regular dermatological examinations are important for the assessment of moles and overall skin health. Here are some important points regarding regular dermatological examinations:

  • Professional Evaluation: A dermatologist can professionally evaluate your moles and overall skin health. Regular dermatological examinations help in the early detection of potential abnormalities.
  • Risk Factors: Regular mole examinations are particularly important if you have risk factors. For example, if there is a family history of melanoma or if you have a high number of moles or atypical moles, you may be at a higher risk.
  • Follow-up Plan: After evaluating your moles, a dermatologist can create a regular follow-up plan. Adhering to this plan ensures the early detection and management of potential issues.

Regular dermatological examinations play a crucial role in monitoring moles and overall skin health, contributing to a healthy skin condition.

Moles and Aesthetic Beauty

Moles can be a source of aesthetic concern for some individuals. Removing or correcting moles for cosmetic purposes can boost a person's self-confidence. Here are some important points regarding moles and aesthetic beauty:

Removal of Moles for Cosmetic Purposes

In certain cases, moles may be removed for cosmetic reasons. Here are some key points regarding the removal of moles for cosmetic purposes:

  • Aesthetic Concerns: Removing moles for aesthetic reasons can help individuals feel better about themselves and enhance their confidence in their appearance.
  • Location of the Mole: The location of the mole is a significant factor in determining cosmetic concerns. Mole removal is often preferred for moles located on the face, neck, or hands—more prominent areas of the body.
  • Surgical or Non-Surgical Options: Mole removal can be performed using surgical or non-surgical methods. The choice depends on the characteristics, size, and location of the mole.

Removing moles for cosmetic purposes can help address aesthetic concerns and enhance a person's self-confidence.

Aesthetic Appearance of Moles and Its Impact on Self-Confidence

The aesthetic appearance of moles can have an impact on a person's self-confidence. Here are some important points regarding the aesthetic appearance of moles and its effect on self-confidence:

  • Visibility and Location: The visibility and location of moles are significant factors in determining aesthetic concerns. Moles located on the face or other prominent areas of the body can affect a person's self-confidence.
  • Personal Perception: Aesthetic perception is also influenced by how individuals perceive their own moles. Some individuals embrace their moles as unique features, while others may feel aesthetically uncomfortable with them.
  • Self-Confidence and Mole Surgery: Removing or correcting moles can boost self-confidence by addressing aesthetic concerns.

The aesthetic appearance of moles can impact a person's self-confidence, and mole surgery can help alleviate these concerns.

Risks and Costs of Mole Surgery

The costs associated with mole surgery can vary depending on several factors. Here are some important points regarding the risks and costs of mole surgery:

  • Number and Size of Moles: The cost of mole surgery is related to the number and size of the moles to be treated. Removing more or larger moles generally requires a higher cost.
  • Surgical Technique: The cost of mole surgery can vary depending on the surgical technique used. In some cases, non-surgical methods may be more economical.
  • Clinic or Hospital: The cost of mole surgery can vary depending on the location and reputation of the clinic or hospital.

The costs associated with mole surgery can vary based on specific circumstances and individual factors.

Pricing of Mole Surgery

The pricing of mole surgery can differ among healthcare facilities and surgeons. Here are some important points regarding the pricing of mole surgery:

  • Initial Consultation and Evaluation: The price of mole surgery includes the cost of the initial consultation and evaluation of moles. The cost of this process can vary based on the policies of the healthcare facility.
  • Surgical Technique and Procedure Duration: The price of mole surgery is associated with the surgical technique used and the duration of the procedure. More complex or time-consuming procedures generally require a higher cost.
  • Additional Expenses: The price of mole surgery may include additional expenses such as anesthesia, laboratory tests, or post-operative care.

The pricing of mole surgery can vary based on the policies of the healthcare facility and the specific characteristics of the surgical procedure.

Insurance Coverage for Mole Surgery

The costs of mole surgery can vary depending on whether it is covered by insurance. Here are some important points regarding insurance coverage for mole surgery:

  • Insurance Company and Plan: The costs of mole surgery can differ based on the coverage provided by the insurance company and plan. Some insurance companies and plans may consider mole surgery as a cosmetic procedure and exclude it from coverage. However, in some cases, it may be covered if there are medical indications or health risks involved.
  • Prior Authorization and Documentation: Prior authorization or documentation may be required for insurance coverage of mole surgery. It is important to follow the necessary procedures and provide the required documentation to ensure the approval of the insurance claim.
  • Special Circumstances: Certain special circumstances may expand insurance coverage or classify mole surgery as a medical necessity. For example, the removal of potentially cancerous moles or the correction of moles causing functional limitations may be covered by insurance.

Insurance coverage for mole surgery depends on the policies of the insurance company and plan. It is important to communicate with the insurance company to verify coverage.

Which Department of Hospitals to Consult for Mole (Nevus) and Surgery Appointments?

For mole (nevus) evaluation and surgery appointments, it is generally recommended to consult the dermatology department. Here are some important points regarding which department of hospitals to consult for mole (nevus) and surgery appointments:

  • Dermatology Department: The dermatology department focuses on skin diseases and skin surgery. You can schedule appointments for mole evaluation, surgical removal, or other skin-related concerns in the dermatology department.
  • Plastic Surgery Department: In some hospitals or clinics, mole surgery may also be performed in the plastic surgery department. You can also schedule appointments and receive evaluations and treatments related to mole surgery in the plastic surgery department.

When scheduling appointments for mole (nevus) and surgery, it is generally recommended to start by consulting the dermatology department. A dermatologist can provide the best guidance regarding the evaluation and treatment of moles.

References

  • Mole Excision Murphy | Dysplastic Nevi: https://www.planomurphypcp.com/mole-excision-diagnostic-partners-of-north-texas.html
  • A Comparative Evaluation of Surgical, Electrosurgery and Diode Laser in the Management of Maxillofacial Nevus: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181846/
  • Giant Nevi Removal | American Society of Plastic Surgeons: https://www.plasticsurgery.org/reconstructive-procedures/giant-nevi-removal
  • Optimal management of common acquired melanocytic nevi (moles): current perspectives: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3965271/
Note: The page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.

Doctors Relevant for Moles (Nevi) and Their Surgery

Op. Dr. Mehmet Durmuş KURT
Pendik/İstanbul
Uzm. Dr. Erol ÖZAN
Başakşehir/İstanbul
Op. Dr. Turgay YILDIZ
Gaziosmanpaşa/İstanbul
Op. Dr. Barış Veli AKIN
Esenyurt/İstanbul
Op. Dr. Abdurrahman AKAY
Melikgazi/Kayseri
Doç. Dr. Osman Halit ÇAM
Üsküdar/İstanbul
Op. Dr. Hüsamettin BAYRAKTAR
Çerkezköy/Tekirdağ
Prof. Dr. Emine DERVİŞ
Gaziosmanpaşa/İstanbul
Uzm. Dr. Şehriyar NAZARİ
Şişli/İstanbul
Uzm. Dr. Alborz MOSHFEGHI
Gaziosmanpaşa/İstanbul
Uzm. Dr. Şefik BEKİR
Gaziosmanpaşa/İstanbul
Op. Dr. Mert DEMİREL
Kadıköy/İstanbul