Surgical Mole Removal: When Is Excision Necessary?

Moles are common skin growths, and most of the time, they’re harmless. But some moles—especially larger or atypical ones—can cause worry. If a mole changes shape, grows rapidly, or looks unusual, surgical removal might be necessary. Understanding when excision is recommended can help you make informed decisions about your skin health.

Understanding Moles: What’s Normal vs. Atypical

Most people have a mix of small, round, or oval moles that don’t change much over time. These are generally normal. But some moles stand out—they’re irregular, larger than average, or even multicoloured. These are called atypical moles, and they require closer attention.

An atypical mole may have:

• Asymmetry (one side doesn’t match the other).
• Uneven or blurred borders.
• Multiple colours, including dark brown, red, or even black.
• A size larger than 6mm (about the size of a pencil eraser).

Changes in a mole’s size, shape, or texture over time are also red flags. If it starts to itch, bleed, or grow suddenly, it could be a sign of something serious. Spotting these signs early can help decide if surgical excision is the right move.

When Is Surgical Excision Necessary?

Surgical removal of a mole, called excision, is recommended in specific cases. A doctor might suggest it if a mole looks suspicious under examination or if it causes physical discomfort. For example, if a mole is painful, bleeds often, or catches on clothing, removing it can prevent further irritation.

Doctors also recommend excision if:

• The mole shows signs of rapid growth.
• Its edges look irregular or jagged.
• It changes in colour or has multiple tones.

Atypical moles may carry a higher risk of developing into melanoma, a dangerous form of skin cancer. If you have a family history of melanoma or a large number of moles, your doctor may suggest removing suspicious ones as a precaution. Surgical excision helps reduce risks by removing the mole completely and allowing for further testing.

Benefits of Excision for Suspicious Moles

Excision isn’t just about removing a mole—it’s about peace of mind and prevention. When a mole is removed, doctors can examine it thoroughly to check for malignant cells. This process is key to catching early signs of skin cancer.

For people with atypical moles, surgical removal eliminates the worry of “watching and waiting.” Once the mole is gone, you’ll no longer need to wonder if it’s getting worse. Additionally, excision leaves clean skin margins around the mole, making it less likely for any abnormal cells to remain.

The Surgical Excision Procedure: What to Expect

If your doctor recommends surgical removal for a suspicious mole, it’s helpful to know what happens during the procedure. Surgical excision is straightforward and usually done in a clinic or outpatient setting.

Before the Procedure

Your doctor will assess the mole and surrounding skin to determine the extent of removal needed. You might also discuss any medical conditions or medications you’re taking to avoid complications. Before the excision begins, a local anaesthetic is used to numb the area, so you won’t feel pain during the process.

During the Procedure

Once the area is numbed, the doctor will use a scalpel to remove the mole along with a small margin of healthy skin. This ensures that any potentially abnormal cells are completely removed. If the mole is deep or large, stitches may be required to close the wound.

The procedure typically takes less than 30 minutes. Your doctor will send the removed tissue to a lab for histopathological analysis, which is a critical step for determining if the mole contains any malignant cells.

After the Procedure

After the excision, you’ll be given instructions on how to care for the wound. Most patients experience minor discomfort, which can be managed with over-the-counter pain relief. Healing time varies, but in most cases, the site heals within a few weeks, leaving a small scar.

Histopathological Analysis: The Key to Early Detection

One of the most important steps in surgical mole removal is histopathological analysis. After the mole is excised, it’s sent to a specialised laboratory where a pathologist examines it under a microscope. This detailed analysis helps determine if the mole contains cancerous or precancerous cells.

Histopathology can identify:

• Melanoma, the most dangerous type of skin cancer.
• Other types of skin cancers like basal cell carcinoma or squamous cell carcinoma.
• Precancerous changes that could worsen if left untreated.

This testing is invaluable for catching melanoma at an early stage, when it’s much easier to treat. If malignant cells are found, your doctor can guide you on the next steps, which may involve further treatment or monitoring to ensure the cancer hasn’t spread.

Aftercare and Follow-Up

Proper care after surgical removal is essential for smooth healing and accurate results. Once the mole is removed, keeping the wound clean and protected reduces the chance of infection. Your doctor may recommend:

• Using an antibiotic ointment to prevent infection.
• Covering the area with a clean bandage.
• Avoiding strenuous activity that could stress the stitches.

It’s important to monitor the healing site for any signs of unusual redness, swelling, or discharge, as these could indicate complications.

Once your biopsy results come back, your doctor will explain the findings. If the mole was benign, no further action is needed beyond regular skin checks. If malignant cells were found, your doctor will discuss next steps, which might include additional excision or regular follow-ups to monitor for new moles or skin changes.

Staying Proactive About Skin Health

While surgical excision can address suspicious moles, staying proactive is the best way to protect your skin health. Regular self-checks are a simple yet effective habit. Examine your skin every few months, paying close attention to moles that are new or changing. Use the “ABCDE” rule to assess moles:

• Asymmetry: One half of the mole doesn’t match the other.
• Border: The edges are uneven, blurred, or jagged.
• Colour: The mole has multiple colours or unusual tones.
• Diameter: Larger than 6mm (about the size of a pencil eraser).
• Evolving: The mole changes in size, shape, or texture over time.

If you notice anything unusual, consult your doctor right away. Early action can make all the difference.

Beyond self-checks, protecting your skin from sun damage is critical. Use a broad-spectrum sunscreen with at least SPF 30 whenever you’re outdoors, and reapply every two hours. Avoid tanning beds and try to stay out of the sun during peak hours (10 a.m. to 4 p.m.). Preventing sunburns reduces your risk of developing more atypical moles or skin cancer over time.

Surgical mole removal is a straightforward procedure that plays a big role in preventing and diagnosing skin cancer. If you have larger or atypical moles, or ones that show signs of change, consulting your doctor can be life-saving. Excision not only removes potentially dangerous tissue but also allows for histopathological analysis, a key step in detecting malignant cells early.