(MOLES, NEVUS, BIRTH MARKS, FRECKLES)

There are a variety of moles described, like Congenital Mole, Common Mole, Atypical (Dysplastic), Melanoma Mole. The latter two mole types are worrisome as an Atypical Mole can turn into a Melanoma, which is an aggressive kind of skin cancer.

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

If a mole appears on your skin after you are 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 don’t change in way through 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 are under follow-up with your dermatologist for these.

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.

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

Border- does the mole have irregular, poorly defined borders.

Color-has the colour in your mole changed, are there more than one colour in your mole.

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

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 that you don’t need to be worried about. Most adults have about 20 – 40 moles all over their body, which are 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 has appeared in adulthood, please go to your doctor and get it seen to.

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 being removed purely for cosmetic purposes are removed by one of two methods. Radio-Surgery Shave Excision and 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 leaves the least scarring and 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 don’t need to be removed later, or external stitches with knots that need to 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 an 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 you will feel 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 on if you can return back to work and what precautions and aftercare needs to be taken.

In most instances both Radiosurgery Shave Excision or 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.