What Is The Best Way To Remove Moles?

Moles are skin growths that form when pigmented cells in your skin grow in clusters. You probably have more than one mole on your face and body; on average, most people have about 10 to 40 moles in their lifetime.

The cause of new mole growth

In Singapore, the cause of most moles and pigment spots are due to genetics and the sun. I cannot emphasise this enough — sun protection is extremely important, and it’s better to be safe than sorry. Even if you don’t mind some moles and freckles on your skin, excessive sun exposure can still lead to skin cancer. Specifically, individuals with lighter skin are more prone to sun damage and skin cancer — so please invest in sunscreen. I recommend using a product with at least SPF 30 protection.

Should I remove my moles?

Most moles are harmless and do not need to be removed unless they bother you. After all, in Singapore, clear and flawless skin is considered a prized asset. The moles that you should absolutely consider removing, however, are those that have changed or look abnormal. Any differences in a mole’s shape, colour or size could be a sign of skin cancer, and you should definitely see a dermatologist to get it checked out.

Types of moles

To tell if your mole is cancerous, let us first understand how to differentiate the types of moles.

Congenital moles

• Present since birth and considered a type of birthmark 
• Flat or raised, can have hair growing out 
• May become hairier, darker or bumper as you undergo puberty 
• Seldom become cancerous

Acquired moles

• Moles that develop later in life due to sun damage or genetics 
• Flat or raised, range in colour i.e. red, brown, black
• Can appear anywhere on your body 
• Do not undergo significant changes in shape or size. 
• Rarely become cancerous; but having over 50 of them on your body could put you at a higher risk of skin cancer

Atypical moles

• Larger and appear more misshapen compared to congenital and acquired moles 
• Borders not well defined 
• Higher risk of developing into cancer

How to evaluate your moles

Doctors usually refer to the ABDCE of moles before deciding if a mole is potentially harmful. 

• Asymmetry: The mole is non-symmetrical and rather irregular 
• Border: The mole does not have well defined borders, or bleeds
• Colour: The mole does not have just one colour throughout; has varying shades 
• Diameter: The mole is over 6mm in size 
• Evolution: The mole is growing at a rapid pace 

Simply put, you should be concerned if the mole has: 

• Increased in size 
• Changed in colour 
• Bleeding 

If you have a family history of skin cancer, then all the more you should visit a skin and/or aesthetics doctor to get the mole checked out. They would perform a biopsy to confirm if the mole is cancerous. It would help to also photograph the suspicious moles regularly to compare and monitor changes.

Mole removal in Singapore

In Singapore, mole removal methods are classified broadly into surgical and non-surgical options. 

For surgical, there are two main options: shave excision and punch excision.

Shave excision

Shave excision means shaving a mole or cutting it off right at the skin’s surface. Hence, this method is particularly useful for raised moles. Simple shave excision is normally done with a scalpel and very quick. The downside of a simple shave excision is that there is a higher chance of some mole cells being left behind and the mole recurring in the long run, and some risk of scarring and discolouration. More advanced methods of shave excision may utilize radiofrequency or ablative lasers to free up the mole bit by bit, achieving maximal removal of visible mole cells while minimizing wound depth and scarring risk.

Punch excision

Punch excision involves cutting around the entire diameter of the mole and stitching back the skin. This means that scarring is inevitable, but with microsurgical techniques and meticulous surgical skills, scarring can be minimised. The mole is also less likely to recur. 

For non-surgical, laser treatments are the way to go. They are less invasive and destroy the mole tissue entirely; hence they are not suitable for moles that require evaluation. Non-surgical laser treatments generally leave less scarring and are usually the procedure of choice for patients removing their moles for aesthetic reasons.

Ablative lasers

Popular ablative lasers for mole removal in Singapore are the Erbium-YAG laser and CO2 laser. This is due to the precision of their laser wavelengths which allow for moles to be removed more intricately without damaging other skin layers. Between the two, the Erbium-YAG laser works more effectively for more superficial moles but the CO2 laser may be better for deeper moles as it coagulates as it vaporizes.

Non-ablative lasers 

Non-ablative lasers are better for treating flat moles without causing scarring. They are very specific for mole cells hence reducing the risk of scarring but they do not clear mole cells as deep as ablative lasers.

Which is the best way?

The best mole removal method is the one that suits your goals and condition (if any) the most. Your doctor might suggest that you combine treatment methods for optimum results; these are usually still fuss-free and can be done in 1 or 2 visits. 

In general, mole removal in Singapore is very safe and can be done in a single session.

References

1. https://pubmed.ncbi.nlm.nih.gov/10495387/
   Gupta, S., Handa, S., Kumar, B., & Rai, R. (1999). Surgical pearl: punch excision and grafting for removal of mole. Journal of the American Academy of Dermatology, 41(4), 635–637.
2. https://pubmed.ncbi.nlm.nih.gov/29077988/
   Eggen, C., Lommerts, J. E., van Zuuren, E. J., Limpens, J., Pasmans, S., & Wolkerstorfer, A. (2018). Laser treatment of congenital melanocytic naevi: a systematic review. The British journal of dermatology, 178(2), 369–383. https://doi.org/10.1111/bjd.16094