Mole Removal

What is mole removal?

Mole removal is a minor dermatologic procedure that removes moles from the skin and is typically painless. While most moles are harmless, a dermatologist may recommend the procedure due to health risks, such as skin cancer.

At Lumine Dermatology & Laser Clinic, we remove moles for medical and cosmetic reasons. We prioritise safe removal and minimal scarring.

What causes moles?

Moles are made of melanocytes, which are cells that produce pigments that give your skin its natural colour. Moles occur when melanocytes grow in clusters instead of evenly throughout the skin.

Moles are very common, with most people having between 10 and 40 of them throughout their body.

 Generally, there are three types of moles:

• Common acquired melanocytic nevi: common acquired melanocytic nevi are normal moles, usually small in size, with a distinct edge.
• Congenital nevi: congenital nevi is a type of mole present at birth. Larger congenital melanocytic nevi are at risk of developing into melanoma.
• Dysplastic nevi: dysplastic nevi, also known as atypical moles, have an irregular shape. They appear uneven-coloured, asymmetrical, or growing more in proportion to the other moles. They may also be itchy. Individuals with multiple dysplastic nevi have a higher chance of developing melanoma.

What does a cancerous mole look like?

Cancerous moles can be identified by conducting a skin self-check at home utilising the ABCDE rule:

• Is the mole asymmetrical? (A)
• Does the mole have irregular borders? (B)
• Is the mole uniform in colour? (C)
• Does the mole have a diameter larger than 6 mm? (D)
• Is the mole evolving (itching, scabbing, or changing appearance)? (E)

If your mole checks some of the boxes, it is best to consult a dermatologist. After an evaluation, they will decide whether to test it for skin cancer or continue monitoring it.

Additionally, higher-risk individuals are encouraged to undergo a routine check-up with their dermatologist and schedule an annual skin cancer screening. Doing so will allow your dermatologist to monitor your moles and be more vigilant of warning signs.

How are moles removed?

Not all moles are the same. The first step in removing moles is to have a trained dermatologist examine the mole with a dermatoscope to determine if the mole is benign or malignant. Photos of the moles will also be taken.

Should the mole be suspicious for malignancy, an excisional biopsy with a 2 mm border will be performed, and the entire mole submitted for histological examination.

If the mole is benign, it can be left alone or removed by the following techniques:

• Laser mole removal: at Lumine Dermatology & Laser Clinic, we use a carbon dioxide laser, a picosecond 755 nm laser, and a long-pulsed alexandrite 755 nm laser. Depending on your mole type, we could use either lasers or a combination to achieve successful mole removal. Laser treatment is usually suitable for flat and small moles.
• Shave excision: shave excision involves using a blade to remove the mole off the skin’s surface. The same effect can also be achieved with the carbon dioxide laser. No stitches are required in this technique. If residual pigmentation is at the base after a shave excision, a long-pulsed 755  nm alexandrite laser or picosecond laser can treat it. This method is suitable for slightly raised moles.
• Surgical excision: surgical excision involves excising the entire mole. This technique is often used if the mole is suspected to be cancerous or if it is assessed to have a deep root. Lasers can then be employed to treat the remnant scar, which usually results in a better cosmetic outcome than repeated attempts at removing recurrent or remnant moles.

Benefits of mole removal

The main benefits of mole removal are:

• Improved appearance
• Removes moles that are prone to irritation/inflammation
• Reassurance through histological confirmation to ascertain the nature of the mole
• Allows for early treatment of skin cancer (if detected)

How many mole removal sessions are required?

The number of mole removal sessions required depends on the type of mole and the mole removal technique. Most moles can be removed in one session. However, for lasers or shave excisions, two to three sessions are required before they can be completely removed. Should a mole continue to recur, it is prudent to send the mole specimen for histological analysis to exclude malignancy. Additionally, individuals may remove multiple moles in one session if necessary.

What can I expect during the mole removal procedure?

Mole removal is an outpatient procedure. It is safe, quick, and painless. Local anaesthetic injections or topical numbing medications can be applied to the site before the procedure. Oral painkillers or oral antibiotics are typically not required post-procedure. For laser mole removal, you can resume normal activities immediately after. For shave excisions and excision biopsies, you must minimise high-intensity exercises and swimming for 1-2 weeks post-procedure, depending on the size and location of the mole removed.

Frequently asked questions

Are there any side effects to mole removal?

While generally safe, mole removal involves potential side effects, as with any medical procedure. These include:

• Scarring: to minimise this, it is important to choose the right procedure for the right type of mole and patient. If the cosmetic outcome is worse than having the mole there in the first place, it may only be worth it to embark on the mole removal journey if malignancy is suspected.
• Infection: follow post-procedure instructions to minimise this risk.
• Incomplete removal or recurrence: this is more common with shave excisions and laser mole removal. Sometimes, the benefit of complete mole removal must be balanced against the risks of scarring. In this case, more sessions may be required to achieve a good outcome.

To minimise the risks, it is essential to choose a qualified dermatologist or skin surgeon for mole removal. They can thoroughly evaluate and recommend the appropriate method based on your mole characteristics and skin type.

Are there any age restrictions for mole removal?

No, there are no age restrictions. We have the facilities and expertise to perform mole removal for children. However, it is advisable to consult your dermatologist, who will advise you on the suitability of the treatment. It also depends on your child's disposition and whether they can cooperate with medical procedures under local/topical anaesthetic.

Does removing a mole leave a scar?

Yes, it can leave a scar. Although, it depends on the size, location of the mole, and the removal technique used.

What are the safest mole removal methods available?

At Lumine Dermatology & Laser Clinic, we prioritise your safety and well-being. In Singapore, we offer various safe mole removal methods, including surgical excision (shave biopsy and excision biopsy), laser therapy (long pulsed 755 nm laser, picosecond 755 nm laser, CO2 laser), or a combination of both. During your consultation, we'll assess your mole's characteristics and recommend the most suitable method.

How much does mole removal typically cost?

The cost of mole removal in Singapore can vary depending on the size, location, number of moles removed, and the chosen removal method. Generally, prices range from SGD 150 to SGD 500 per mole, excluding histology. During your consultation, we'll provide a personalised quote based on your specific needs.

What factors should I consider before choosing a mole removal method?

Before choosing a mole removal method, it's essential to consider factors such as the size, location, and type of mole, as well as your skin type, medical history, and expectations on mole removal. Patients sometimes remove specific moles on the face because it affects their self-esteem, or the mole repeatedly gets inflamed, or they believe the location of a particular mole on the face may affect their job prospects or future. During your consultation, we will carefully evaluate these factors and recommend the safest and most effective removal method.

Can moles grow back after removal?

Moles can regrow after removal, especially if all the mole cells aren't completely removed during the procedure. A balance must be struck between the possibility of scarring and effective mole removal, and a mole removal process may involve a series of laser treatments instead of just one session. If a mole grows back, it is usually within the first six months.

If the mole keeps recurring, a biopsy is another possibility, as one must always consider the suspicion of malignancy.

However, we take great care to ensure thorough removal, minimising the chances of regrowth. Additionally, we recommend regular skin checks to monitor any changes and catch any potential regrowth early.

Is it necessary to get a biopsy after mole removal?

Biopsy after mole removal is recommended. The decision to send for histology depends on several factors, including the mole's appearance and characteristics. In some cases, especially if the mole shows any suspicious features or if there's a concern about melanoma, we must perform a biopsy to examine the mole cells more closely. We will discuss this option with you and ensure you're well-informed every step of the way.