Mole removal: when to do it and when not to do it
Miscellaneous / / October 23, 2023
Your life may depend on it.
Are all moles really dangerous?
Moles, or, scientifically, nevi, are skin formations consisting of melanocyte cells. These cells produce pigment in the skin and protect it from the harmful effects of UV rays. And their clusters just look like specks.
The main fear associated with moles is the possibility of their degeneration into melanoma. This is a malignant neoplasm that can metastasize to other organs. This is indeed possible. But it cannot be said that melanoma will necessarily develop from a mole.
Ekaterina Minotskaya
Malignant tumors arise from melanocytes, but these cells are found throughout our skin. Therefore, melanoma can appear not only from a mole, but also in any other place.
Ekaterina says that from moles Melanoma occurs in less than 30% of cases. Moreover, if a tumor appears from a nevus, it most often comes from a flat nevus. At the same time, people are more afraid of the degeneration of convex moles and even cover them up when going out into the sun.
In addition, not all brown skin growths are generally nevi. Some of them may look similar, but be completely harmless.
Yuri Bazhov
Often moles are called keratomas - thickening of the stratum corneum of the skin. They do not have melanocytes and cannot develop into melanoma. Moreover, the appearance of these neoplasms is very diverse: from barely noticeable light brown spots to almost black plaques several centimeters in size.
Thus, formations on the skin can be both potentially dangerous and completely harmless. And without special knowledge and analysis, it is impossible to determine their type.
At the same time, there are indirect signs that will help you decide whether you should make an appointment with a dermatologist or whether you can leave the mole alone.
When should you consider mole removal?
There is a popular rule ABCDE mole scores, in which each letter represents one possible sign of melanoma:
- Asymmetry (Asymmetry) - one half of the mole is not similar in shape to the other.
- Borders (Border) - fuzzy, blurry or torn edges.
- Color (Color) - more than one shade in a mole, such as spots of pink, black and brown.
- Diameter (Diameter) - more than 5 mm or, to make it easier to imagine, more than an eraser on the tip of a pencil.
- Change (Evolving) - growth, change of shape and color, appearance of bleeding, crusts, itching.
However, dermatologists caution against using this method on your own because the ABCDE rule may produce a false positive result.
Yuri Bazhov
Seborrheic keratomas correspond to all of the above characteristics: they are almost always asymmetrical, with uneven edges, unevenly colored, have a diameter of more than 5 mm and grow rapidly. By applying the ABCDE rule to self-diagnosis, a person may recognize a harmless tumor as cancer and experience severe stress.
The video below shows photographs of a seborrheic keratoma taken using a dermatoscope.
Instead of the ABCDE rule, Yuri Bazhov advises using the “ugly duckling” method - comparing a suspicious mole with other skin formations on a person.
Most normal nevi are similar to each other, but melanoma stands out in comparison. It may be noticeably larger or smaller, lighter or darker than surrounding moles. An “ugly duckling” can also be an isolated focus of pigmentation without surrounding moles for comparison.
Be sure to watch for changes. If an existing mole suddenly grows or changes color or shape, you should make an appointment with a doctor. It is also worth visiting a dermatologist if you have injured formation on the skin.
Will a mole need to be removed if it is damaged?
You can often hear that any trauma to a mole can lead to its degeneration into a malignant neoplasm. This is a common myth that causes people to worry unnecessarily.
Ekaterina Minotskaya
There is no connection between trauma to a mole and the occurrence of melanoma. This myth arose because previously this tumor was detected much later - at those stages when it is easily damaged and bleeds. For the average person, this event looks like a “mole injury.” And when the patient reaches a doctor who diagnoses melanoma, the logic for him is simple: if he damages a mole, a tumor appears.
And although it is not necessary to remove an injured mole, it is worth making an appointment with a dermato-oncologist to make sure that it is a harmless nevus or keratoma.
Also, you should not treat a damaged mole with colored antiseptics, such as brilliant green, iodine or potassium permanganate, since the paint will greatly complicate dermatoscopy - a research method in which the formation is examined under a large increase.
To avoid infection, treat the injured area with an aqueous solution of chlorhexidine or clean water, and then seal it bandage with absorbent pad.
If the doctor confirms that the mole is harmless, you can leave it. However, if it is bulging and is in an area where it is constantly damaged, it will be safer to remove it to avoid re-injury.
Can removing a mole cause harm?
Dermatologists agree that mole removal is a safe procedure. And it can only cause harm if it is performed without the necessary tests.
When removing a mole, two studies are performed:
- Dermatoscopy — method, in which the mole is examined under high magnification. It can be optical or digital. With its help, the doctor can visualize the deep layers of the tumor and understand whether it is dangerous. Thus, dermatoscopy increases the accuracy of diagnosis.
- Histological examination — using a scalpel, the entire mole or part of it is cut out and sent to the laboratory. There they study the structure of the tumor and determine whether there are pathological changes in the cells.
If the doctor does not conduct any of the studies before removing a mole, there is a risk that he will miss the melanoma, mistaking it for a benign formation. After this the tumor Maybe continue to develop, metastasize and appear again with a long delay - from 2 to 10 years.
Which method is best for removing a mole?
Clinics offer different methods for mole removal.
Yuri Bazhov says that for suspicious formations, only the traditional method is used, which includes excision with a scalpel followed by histological examination. If it is necessary to remove the nevus so that there is no scar left, you can use a less traumatic method - radio wave. It allows minimal damage to the skin, as well as sending part of the tumor for histological examination.
Regarding laser removal, this method is more suitable for correction vascular lesions skin, age-related pigmentation and skin resurfacing and is not recommended for the removal of melanocytic neoplasms.
In any case, the appropriate option for mole removal should be selected by a doctor, but only after an in-person consultation.
Ekaterina Minotskaya
In case of removal, histological examination is of great importance. Therefore, if the doctor did not perform a dermatoscopy, but took histology, this is normal. But if he plans to remove a mole just like that, “by eye,” and does not take the material for research, it is better to look for another specialist.
And under no circumstances try to remove a mole yourself. The risk of error many times outweighs the savings on a visit to a dermato-oncologist.
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