Mole
Moles do not usually become malignant but if they gradually increase in size, are dark or light in color, are not symmetrical in shape, have indistinct borders or become a lesion that does not heal, there is a possibility that it is malignant and should be examined as soon as possible.
Pigmented Nevus
Nevus cells exist at the border between the epidermis and dermis or in the dermis and produce melanin pigment, making them appear brown or black in color. Sometimes they are hairy or raised.
Treatment of Moles
Excision suture
A mole is removed with a scalpel under local anesthesia. The scar is neatly sutured along the skin crease to make it less noticeable. The suture closure has the advantage of reducing scar tissue, rather than leaving it to heal naturally.
Although shaving moles with a CO2 laser is a good and simple method, we believe that the "cut and stitch" method is also a good method for clean wound healing. Another feature of this method is that it is less likely to cause a recurrence than the shaving treatment.
In addition, there is a special suturing technique called "purse-string suture(PSS)". In cases where the excisional suture results in a long incision line, the line is shortened by closing the incision like a drawstring after the mole has been excised.
Punch exicision
A mole is removed under local anesthesia using a special circular punch blade and if the mole is 1 to 2 mm in diameter, it will often heal itself and epithelialize (new skin will grow to close the hole), resulting in a clean scar.
However, from the standpoint of wound healing, this is secondary healing and in some cases the scar may be noticeable. Therefore in our clinic, we try to make the scar as unnoticeable as possible by stitching together with a fine thread and aim to achieve primary healing.
Radio-frequency Scalpel Cauterization
This method uses a high-frequency scalpel called Surgitron to cauterize moles that are located in the relatively shallow dermis. This is a good option for patients with large moles who do not wish to have a scalpel blade inserted and who will have a long scar if a suture is used to excise the mole. Care should be taken to avoid deep cauterization, as this will result in a noticeable scar. Sometimes, the treatment is combined with Q Switch laser.
Large moles
If the mole is large and wound closure is difficult, or if there is a high possibility of scarring during secondary healing, a split excision is performed in which the mole is excised in several sections. If split excision is also difficult, local skin grafting, in which the healthy skin adjacent to the mole is removed or skin grafting, in which the skin is taken from another location is performed. Then the skin will be grafted onto the excised area of the mole.
Postoperative Schedule
and Precautions
Stitches are removed about one week after the surgery. After the stitches are removed, taping therapy is performed to make the scars less noticeable for approximately 3 months.Sunscreen will be applied over the taping to prevent inflammatory hyperpigmentation. Depending on the location of the mole, the scar will become red and hard after the surgery. This will blend in with the surrounding area within six months. If a hypertrophic scar develops, treatment will be steroid injections and steroid taping medication. In the case of using high-frequency scalpel, a wound dressing material is left in place for approximately one week. Taping and shading with sunscreen are used as the skin forms by epithelialization. In any treatment, scarring will occur if the surgery extends into the deeper layers of the dermis. However,we will perform the treatment so the scar will be less noticeable as possible.