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Forum Name: Dermatology Topics

Question: Mole Removal


 Jbminor - Thu Jun 17, 2010 12:13 am

I have an abnormal amount of moles, on my torso, back and front. There are probably 25 to 30 I want to get rid of, ranging from the size of a pen head, to the size of a penny. I have had moles removed in the past, by traditional incisions, and found that I have a high probability of keloiding. I also have a job that requires a lot of manual labor, bending, stretching etc... I could take off of work to have the moles removed, and give ample time for healing, but can't find anyone willing to remove more than one or two moles at a time. If I had them removed at this pace, it would take years, and excessive amounts of time absent from work. I am very discouraged, and looking for any advice on how to get these moles removed. They are really unsightly, and hindering me from living life the way I would like. Thanks..
 Dr.M.Aroon kamath - Sat Jun 19, 2010 6:20 am

User avatar Hi,
Theoretically, one certain way of significantly reducing the incidence of malignant melanomas would be to remove all moles from all people. Some have calculated that if every surgeon on earth started to remove moles every day and does nothing else, each surgeon may end up having waiting lists running into years!Therefore, removal of all the moles may not be feasible.

The logical approach would include

Identification of individuals at high risk:
- Personal/family history of melanoma in a first-degree relative,
- a personal history of non-melanoma skin cancer,
- atypical mole syndrome/dysplastic nevus syndrome,
- tendency towards blistering sunburns,
- immunosuppression,
- a history of prior therapy for psoriasis with ultraviolet (UV) A light &
- UV exposure at tanning salons. .

Identification of certain phenotyps— such as
light complexion, blue/green eyes, blond or red hair,
freckles (esp in the upper back), sun sensitivity,
and an inability to tan— that have been shown to be associated with increased risk.

Once the individuals at risk have been identified, they must be put through increased surveillance.
- any suspicious mole can be removed with an adequate margin (excision biopsy).
- moles in high risk areas may be monitored/removed.

Simple visual assessment has limitations. Dermoscopy is a technique increasingly being used in the monitoring and diagnosis of cuteneous naevi.

I do understand that your main concern is cosmetic rather than melanomas.There are several methods of mole removal being practiced.

The most scientific & safe method of-course is surgical excision with an adequate margin (so called elliptical excision).In this, the surgeon performs a three dimensional wide excision.This gets rid of the mole and the risk of melanoma. Variable scarring is an unavoidable risk.
Shave excision is suitable for protruding moles, but deeper melanocytes will be left behind (unsafe).
Laser treatment of moles simply evaporates the mole and histopathological diagnosis is not possible.

The best option for you is to consult an experienced plastic surgeon and discuss your concerns.
Good luck!

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