Mole

There are various types of Moles such as Congenital Mole, Common Mole, Atypical (Dysplastic), and Melanoma Mole. While the first two types of moles are nothing to worry about, the latter two moles are worri­some. The reason being, ‘Atypical Mole’ can turn into a Melanoma, which is an aggressive kind of skin cancer.

Congenital Moles are Moles that are present since birth. They are relat­ively very small moles (<0.5 cm at Infancy expected to no more than 1.5 cm in adult­hood are gener­ally harm­less). However, if you observe any sinister changes, that are gener­ally indic­ated by a change in shape, size, colour, texture or an asso­ci­ation with pain or bleeding/oozing, it is a good idea to be under the super­vi­sion of a dermatologist.

If a mole appears on your skin after you were born, it is called a Common Mole or Acquired Mole. It is very common and most fair skin adults will have between 10–40 moles. These moles are gener­ally smaller than 6 mm (or the size of the eraser at the back of a pencil), oval or circular, of a uniform colour, with or without hair, with clear borders and seldom change throughout your life.

Atypical Moles or Dysplastic Moles or Dysplastic Nevus

Dysplastic Moles are gener­ally larger in size (> 6 mm), have an odd shape as against the symmet­rical round or oval shape of the Common Mole. Dysplastic moles can show a mix of colours and often appear on the trunk (they can also appear on your scalp, head, neck and rarely your face). Atypical Moles can turn into a Melanoma, so it is advis­able that you consult with your dermatologist.

If you have 4 or more Atypical Moles, or a parent, sibling or child who has had a Melanoma, or if you have had a Melanoma in the past, you need to be under a Dermatologist’s supervision.

Melanoma Mole or a malig­nant melanoma is a type of skin cancer often asso­ci­ated with sun exposure and tanning beds. Any mole can change into a Melanoma, or a Melanoma Mole can appear out of nowhere. If you are vigilant and an early diagnosis is made, most Melanomas have a good survival rate.

When you are examining your moles, you should look out for the ABCDE system developed by the American Academy of Dermatology.

A – Asymmetrical shape-is each half of the mole a different shape.

B – Border – does the mole have irreg­ular, poorly defined borders.

C – Colour – has the colour in your mole changed, are there more than one colour in your mole.

D – Diameter – is your mole bigger than 6 mm or larger than the eraser at the end of the pencil, is it growing bigger.

E – Evolving – does the mole keep chan­ging all the above, or becomes thicker, starts oozing, hurting or bleeding.

Having moles is extremely common and in most cases a normal occur­rence need not be worried about. Most adults have about 20–40 moles all over their body, which is perfectly harmless.

While the occur­rence of Melanoma in coloured skin is much less than fair or Caucasian skin, they do occur. The Melanomas in coloured skin gener­ally happen on areas like the palms, soles of feet, in between toes/fingers, under toe/finger nails, unlike those in fair Caucasian skin.

Most fair skinned people have moles, but if a new one appears in your adult­hood, please visit your doctor and get it examined.

If you have been diagnosed with a benign mole by your General Practitioner or Dermatologist, and want it removed for cosmetic purposes, Dr Prashant at Reforme Medical in Cardiff can certainly help you with its removal.

Harmless or Benign Moles that are removed purely for cosmetic purposes are done by either of the two methods – Radio-Surgery Shave Excision or Excisional Biopsy techniques.

In Radio-Surgery, a special­ized energy device is used to scoop out all the pigmented skin, leaving behind a shallow crater that gets filled up by skin cells from the depth and sides. Radiosurgery is one of the best devices for this purpose, as it will have the least scar­ring and/or pigment changes in the treated area, often resulting in a near scar less removal of the benign mole.

In the Excisional Biopsy tech­nique, an ellipt­ical wedge of tissue including the mole, a margin of normal appearing skin around it, is cut out, leaving behind a skin and tissue defect that looks like a valley. This defect is then closed with stitches that can be buried without external knots (that need to be removed later) or external stitches with knots which will be removed at the clinic later.

Excisional Biopsy tech­nique is used when the appear­ance or beha­viour of the Benign Mole suggests that it be examined under micro­scopy by a Histopathologist (a doctor special­ising in diagnosing condi­tions under micro­scopy). This allows an accurate diagnosis of the nature of the mole.

Excisional Biopsy however does leave you with a scar. In most instances these scars fade over a year or two, settling into the background.

Most mole removal surgery happens as a Local Anaesthesia Day Case. So, other than the initial bee sting like sensa­tion when the local anaes­thesia is being admin­istered, you should have a pain free procedure. Depending on the tech­nique used, your doctor will be able to advise you when you can return back to work along with precau­tions and after­care that needs to be taken.

Both, Radiosurgery Shave Excision and Excisional Biopsy surgeries are asso­ci­ated with very few risks or side effects. A more detailed descrip­tion of rarely encountered prob­lems is given in our consent form that you will be given at your consultation.