"Moles must be removed"? So, should moles be removed or removed?

Photo: Chen Yan, Li Jingyu, Zhejiang Provincial People's Hospital

Reviewer: Wu Sufan, Chief Physician, Zhejiang Provincial People's Hospital

Regarding moles, this "little thing" that we used to not take seriously but has made us uneasy again due to various reports recently, our attitude towards it should be not to be overly nervous but also not to take it lightly. We should pay attention to observation, seek medical treatment in time, and listen to the doctor's advice on how to deal with it.

In fact, there are not many malignant moles. The main reason for removing moles is aesthetics. After all, these naughty "little things" often grow to unsightly places accidentally.

So the question is, should we remove the mole or remove it?

Let's first look at the difference between "cut" and "point":

Surgical removal of moles

Method: Surgical removal of the diseased tissue around the mole.

Advantages: You can choose to remove the mole partially or completely, and you can perform different treatments depending on the nature of the mole.

Disadvantages: It is difficult and time-consuming, and is rarely used for common moles.

Indications: ① malignant or unknown moles; ② large and raised moles with a diameter of more than 5 mm; ③ moles with irregular shapes and uneven pigment distribution or blue moles; ④ moles in friction areas such as the palms, soles, under the nails, external genitalia and oral mucosa, which may become malignant and are best removed surgically.

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Laser mole removal

Principle: In the past, moles were mainly removed by electrocautery, freezing and chemical corrosion, but with the continuous development of laser technology, CO2 laser is now more commonly used for removal. The principle of laser mole removal is mainly to absorb most of the water in the mole tissue through carbon dioxide pulse laser, which then causes the mole tissue to coagulate, carbonize and vaporize, and accurately acts on the melanin nevus cells to cause necrosis.

Method: CO2 laser is mainly used to remove pigmented nevi, especially larger and deeper nevi. Some shallow nevi can also be removed with pigmented laser, such as Nd:YAG laser, alexandrite laser, etc.

Advantages: Laser mole removal can control the size and depth of the optimal light spot, and is less likely to leave scars or become infected.

Disadvantages: There is a possibility of recurrence, but it is very small.

Indications: ① Moles that are judged to be benign by professional doctors; ② Moles with a diameter of less than 5 mm; ③ Shallow intradermal moles; ④ Except for moles in friction areas such as the palms, soles, under the nails, external genitalia and oral mucosa, moles in other parts of the body can basically be treated with laser.

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Precautions after laser mole removal

1. Apply topical antibiotic ointment such as chloramphenicol eye ointment or mupirocin ointment after surgery to keep the wound dry and clean. It usually heals in 7 to 10 days.

2. After the operation, avoid contact of the wound with water and avoid scratching. Wait until the scab forms and falls off naturally before contacting the wound with water.

3. Pay attention to sun protection after the scab falls off after the operation to prevent pigmentation.

4. If recurrence occurs, it will generally take more than 3 months before the next treatment.

Special case: eyelid nevus

As the name suggests, eyelid margin nevus is a pigmented nevus growing on the eyelid margin, some of which can invade the conjunctiva. Eyelid margin nevus with a diameter less than 5 mm are preferably removed by laser because laser is more precise and the scar is basically not obvious. If surgery is performed, it may cause scars, abnormal eyelid margin structure, and may even irritate the conjunctiva due to improper suturing.

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Frequently asked questions about laser mole removal

1. Is laser mole removal permanent? Will the mole grow back?

Answer: Laser mole removal is permanent. Depending on the depth of the mole, 1 to 3 treatments are usually required, and the recurrence rate is very small.

2. Will laser mole removal leave scars?

Answer: Laser mole removal generally does not leave scars (except for people with scar-prone constitutions), but darker moles may leave small pits after removal, which usually gradually flatten after 3 to 6 months.

3. How long after laser mole removal can I come into contact with water? What should I do if I come into contact with water?

Answer: Generally, you have to wait until the scab falls off (7 to 10 days) before it can come into contact with water. If it accidentally comes into contact with water, it is recommended to use iodine tincture for disinfection and topical antibiotic ointment.

4. What should I do if the treated area is very red after recovery from laser mole removal?

Answer: Generally, red marks will appear after the scabs of laser mole removal fall off. Don't panic, as they will gradually fade over time. There is no need to intervene, just pay attention to sun protection. If you want to remove it as soon as possible, you can choose dye laser intervention.