Scars from removing moles is a topic that all prospective patients should be familiar with. While mole removal is one of the most common minor skin procedures performed, it should not be overlooked that all mole removal procedures are likely to leave a scar of some sort. Read on to learn everything you kneed to know about scars from mole removal procedures and whether this procedure is right for you.
Benign Versus Suspicious Moles:
Mole removal scars are intimately related to the technique chosen to remove the mole. The technique used is, in turn, related to whether the mole is assessed by your health care professional to be benign (safe) or suspicious in appearance. It’s important to know the difference between benign and suspicious moles in order to gain a deeper understanding of which mole techniques are likely to suit your situation.
Benign Moles
These moles are considered free of any appearance or behavior patterns (eg rapid growth, bleeding) suspicious for cancerous changes. Scars from removing moles of this sort have a “head-start” because they are amenable to a wide variety of treatment options that may not be available for suspicious moles. Here are a few examples of benign-looking moles:
Suspicious Moles:
These moles have appearances or behaviour patterns suggestive of cancerous changes. Some of the visual cues to suspicious moles include asymmetry, irregular borders, variable colors within the same mole, larger size, spontaneous bleeding, and itching. Below is an example of a highly suspicious looking mole:
When Is A Biopsy Necessary?
A strong argument can be made that all moles that are removed from the body should be sent for a biopsy. This is because any mole that doesn’t also undergo a biopsy may have harboured undetected pre-cancerous or even cancerous changes that will never be identified. This could put a patient at significant health risk down the road. On the other hand, some practitioners disagree with this concept and are comfortable using their own clinical judgment to decide if a mole should be sent for a laboratory biopsy analysis. Make sure to discuss the issue of a biopsy with your health care practitioner.
DISCUSS THE NEED FOR A MOLE BIOPSY WITH YOUR CHOSEN PRACTITIONER
Mole Removal Scars – Cosmetic Techniques:
Cosmetic techniques for mole removal apply to benign benign moles. With cosmetic mole removal, the main focus is on optimizing the mole removal scar. This can differ from suspicious mole excision which prioritizes other issues such as removing significant areas of skin around the mole which can exaggerate the mole removal scar. There are several options for cosmetic mole:
Scars From Removing Moles By Shaving
With this technique, the mole is shaved off at the skin level using a blade passed horizontally across the base of the mole. The result is a wound resembling an abrasion that heals on its own, usually over 7-14 days. A variation of shave excisions is called curettage which uses a scoop-shaped surgical blade to remove the mole. Shaving is generally reserved for moles that do not have deeper extensions into the skin. Shaving these types of moles can have a very high recurrence rate or be prone to leaving pitted, “ice-pick” type mole removal scars. Below is a summary of the pros and cons of shaving techniques with respect to scars from mole removals:
| Pros | Cons |
|---|---|
| can heal beautifully with very minimal visible scarring when performed technically well | can be prone to slow healing and pitted scarring |
| heal more as a blemish than a true scar | healed area may be lighter or darker than surrounding skin |
Scars From Removing Moles By Excision & Stitching
Some benign moles are best treated by a deeper excision and stitching technique. This procedure is often chosen for moles that are larger and/or flush with the skin surface. Excision with stitching may minimize the mole removal scar because the wound is stitched closed, thereby decreasing healing time, and narrowing the wound. Pros and cons of this technique with respect to mole removal scars is summarized below:
| Pros | Cons |
|---|---|
| stitching “narrows” the wound to a fine line | always forms a scar, the quality of which is very individualized |
| closure of the wound reduces the chance of an indented or “pitted” scar | can leave “hatch-marks” (dots along the side of the scar line) in some individuals |
Mole Removal Scars – Ablation Techniques
Ablation mole removal procedures destroy the mole on the surface of the skin as opposed to surgically removing it. Ablative techniques include laser, liquid nitrogen (freezing), electrosurgery (burning), and radio-frequency. Ablative mole removal leaves no useful tissue for a biopsy analysis to be performed, so these techniques are generally inappropriate for suspicious moles.
Mole Removal Scars – Suspicious Moles:
Suspicious mole removal procedures are surgical (shaves, curettages,, or excision with sutures). With suspicious moles, a lab analysis that can only be done with intact tissue is required for the laboratory to process and analyze. Techniques like freezing, lasering, and burning the mole are usually considered inappropriate for any mole that is considered suspicious.
As such, scars from removing moles of this sort are subject to the discussion presented above regarding shaving, curettage, and excision with sutures. A further consideration is that suspicious moles are generally removed with an additional margin of skin around the edges to ensure the completeness of the removal. The implication of this is that the mole removal scar for suspicious moles may be larger in size/length than for benign, suspicious moles. The precise amount of extra skin that will need to be removed around a suspicious mole is guided by the extent of abnormality that your doctor suspects or that a previously done biopsy has indicated.
What Will Your Scar From Mole Removal Look Like?
We’ve discussed how different techniques are applied to different types of moles and how this can effect scars from mole removal. But what will your own scar from mole removal look like?
Predicting exactly what an individual’s mole removal scar will look like is a huge challenge. This is because of the vast array of factors that contribute to the quality of a mole removal scar. These factors include the technique used (as outlined above), but also patient characteristics such as skin tone, genetics, and ongoing medical conditions as well as a complication-free healing process. When considering what types of scars from mole removal you may end up with, it’s worth looking at the main types of scars that any procedure or skin injury might produce:
| Type Of Scar | What They Look Like | Example |
|---|---|---|
| normal/mature | fine, flat and blend well “good scars” |  |
| hypertrophic | raised, red and thicker type of scar |  |
| keloid | considered the worst scars extensively raised, thick, discolored; grow far outside the area of the injury to the skin |  |
| widespread | flat, pale, wide, and stretched scars |  |
| “blemish” | minimal scar, possibly some discoloration; usually from a well-executed shave or ablative mole removals |  |
The pictures above depict the main types of scars that can be seen after any surgical procedure is done. The exact type of mole removal scar you will form will usually fall into one of these categories, more-or-less. A dilemma for patients and practitioners alike is that predicting precisely how any one person will scar from removing moles. Some clues are your skin type, ethnicity, and the scars you already have on your body.
Mole Removal Scars – Aftercare
Different mole removal techniques will have different aftercare protocols. Shave excision and excision with sutures are dealt with somewhat differently. Also, different practitioners might have slightly different protocols. Clinics will provide verbal and written explanations of best aftercare practices. Some common instructions after mole removal include:
- keeping the area dry for about 24-48 hours
- avoiding immersion of your face in water for 10-14 days
- being cautious or avoiding strenuous work and exercise for about a week
If non-dissolvable stitches are used for the procedure, you will need a follow up to have them removed. This will be scheduled for anywhere between 5-10 days after the procedure. Other follow-up visits, such as for bandage changes or routine wound care, will be determined by your doctor’s preferred routines and protocols.
Keep in mind that nearly any complication that slows or disrupts healing, such as an infection or stitches opening, can have deleterious effects on your mole removal scar. Dedicate the attention required to minimizing the chance for complications to occur in order to optimize your chances for excellent scars from mole removal.
Do Moles Grow Back?
Like any other surgical procedure, mole removal is not foolproof. Recurrence rates for mole removals can range from 1 to 10%. “Gentler”, less invasive procedures such as shavings or ablations can have a higher recurrence rate than deep excisions with stitching because of the increased chance that less invasive procedures leave some components of the mole behind. To that extent, lowering recurrence rates and minimizing mole removal scars can sometimes be somewhat “conflicting goals”.
LESS INVASIVE MOLE REMOVAL PROCEDURES MAY HAVE HIGHER A RECURRENCE RATE THAN MORE INVASIVE METHODS
Conclusion:
Removing a mole is generally a relatively simple procedure that can be highly gratifying to patients and practitioners. Always keep in mind, however, that even minimal surgical procedures will leave scars to some degree or another. The technique used, individual healing characteristics, and a smooth healing process will all contribute the final quality of your mole removal scar.
Medical References:
Zalaudek I, Docimo G, Argenziano G. Using dermoscopic criteria and patient-related factors for the management of pigmented melanocytic nevi. Arch Dermatol. 2009 Jul;145(7):816-26. doi: 10.1001/archdermatol.2009.115. PMID: 19620566; PMCID: PMC2856040.
Niamtu J 3rd. Esthetic removal of head and neck nevi and lesions with 4.0-MHz radio-wave surgery: a 30-year experience. J Oral Maxillofac Surg. 2014 Jun;72(6):1139-50. doi: 10.1016/j.joms.2013.10.015. Epub 2013 Oct 31. PMID: 24388180.
Hocutt JE Jr. Skin cryosurgery for the family physician. Am Fam Physician. 1993 Sep 1;48(3):445-52, 455-6. PMID: 8155114.
Chopra A, Sharma R, Rao UNM. Pathology of Melanoma. Surg Clin North Am. 2020 Feb;100(1):43-59. doi: 10.1016/j.suc.2019.09.004. Epub 2019 Oct 29. PMID: 31753115.
Silverstein D, Mariwalla K. Biopsy of the pigmented lesions. Dermatol Clin. 2012 Jul;30(3):435-43. doi: 10.1016/j.det.2012.04.013. PMID: 22800550.