Congenital Melanocytic Nevus

Frequently asked questions

• OVERVIEW

  Moles are often removed for cosmetic reasons, especially if they are located on an area of the body that is visible to others. However, there are times when they need to be removed for practical reasons in order to rule out any malignancy. Mole surgery is usually a safe and simple procedure, but most patients have many questions to ask prior going ahead for surgery.

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• What is a Mole?

  Most people refer to a mole as any irregularity on the skin that can be present from birth or can develop over lifetime. They can be pigmented or fleshy coloured. Most moles are harmless and can be left alone, but moles that change colour, shape, or size, should be checked for abnormal cells.

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• What causes moles?

  Some people are born with moles. Other moles appear later in life. Sun exposure seems to play a role in the development of moles and may even play a role in the development of abnormal moles. The role of heredity cannot be overemphasized. Many families have a type of mole known as dysplastic (atypical), which can be associated with a higher frequency of melanoma cancer.

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• Is skin cancer inherited?

  Often we are looking at family members who have also inherited factors that increase baseline risk, like fair skin and a tendency to sunburn. Family members are likely to share environmental risk factors as well: outdoor activities, vacations to the beach, and a shared value for “wearing” a tan. If we develop skin cancers like our parents, it is likely that it’s because we inherited their skin type, and have taken on their habits as well.

  There is an increased risk of skin cancer in first degree relatives of patients who have had Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanoma.

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• How to Examine a Mole & Should I Get it Removed?

  For patients, it is often not easy to tell just by looking at a mole whether it is benign or needs further attention. If it is a new mole, you should have it checked by the doctor as the mole might need to be removed. If it is an existing mole and you think that the mole has changed rapidly, the ABCDE rule could be a good and easy way to examine your mole. If your existing mole becomes suddenly A (Asymmetrical) or B (gets Border irregularity) or C (changed Colour) or D (Diameter/increased size) or E (surface Elevation), then the mole needs to be examined by a skin cancer specialists and biopsy removal is usually performed.

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• How is the surgical procedure performed?

  There are a few methods that can be used in removing a mole. Factors such as depth, size and location will help determine the most effective removal method. Moles that are flush to the skin may be able to be removed using a simple shave or a laser. Although this is not the method of choice for deep moles because the laser light doesn’t penetrate deeply enough, and there is no tissue remaining to examine pathologically. For deep-seated moles, excision is the only way to remove it safely and effectively. The procedure will be done under local anaesthetic and would only take 30 minutes. The skin needs to be incised and the lesion cut away with a small margin of the surrounding skin. The lesion will placed in a biopsy bottle and sent for testing. The wound will be closed with sutures and a dressing will be applied on. It will leave a linear scar that usually fades away over the years. Finally you will be asked to make an appointment to have your stitches removed.

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• Can I eat before the procedure?

  Yes, you do not need to fast.

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• Can I drive?

  It is more comfortable to have a companion driving you to and from the surgery, especially if your surgery is close to your eyes or on your hands/legs. Your companion may wait with you in the waiting room, but may not accompany you into the exam room during surgery.

  It is also important to get in touch with your car insurance company to let them know the type of surgery you are having and see if they are happy for you to drive.

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• Does it hurt?

  Injecting the anaesthetic stings or burns a bit for few seconds but then the area goes numb and you will not feel any pain. You might feel touching or a pulling sensation without pain . In spite of being less painful, mole removal can test the tolerance power of the people with low pain threshold. You can use numbing cream to reduce your pain before your surgery.

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• How Long Does It Take to Heal & Will It Leave a Scar?

  Anytime an incision is made into the skin, the patient can expect there to be some type of scar. The scar takes mainly from 10-21 days to heal as the first three stages of the wound healing process occur within the first three weeks after surgery. However, the fourth and last stage of the wound healing called “Remodelling” start at the third week after surgery and last eighteen months, therefore it is said that you will not see the final result of how your scar look like till one year after surgery. The final scar after mole removal is usually small and tends to fade away.

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• Can the mole grow back (recur)?

  The goal of surgery is to remove your mole while preserving your normal healthy surrounding skin. Taking adequate margins with the lesion guarantee complete excision and therefore usually the recurrence rate is low.

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• What are the risks of surgery?

  Although minimal, the risks with this minor surgery include: Allergic reaction to local anaesthetic, bleed, bruising, pain, wound infection, scarring, wound breakdown, nerve damage.

  It is always prudent to choose a skin surgeon specialist, this will lower the risks associated with this procedure.

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• What should I do if I experience bleeding after my surgery?

  We recommend that you apply steady pressure to the wound for a minimum of 15-20 minutes. If bleeding continues after that amount of time then you will need to go to the nearest A&E if you are far away or call our office if you live nearby.

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• What to Do After Mole Removal Surgery?

  Recovery is usually very easy and uneventful. Most patients are able to return to work and normal activities shortly after surgery. However, you will need to follow carefully the physician’s instructions on what to do, what to avoid, how to care about the wound and when to remove the sutures, everything will be written on your post-operative instructions leaflet.

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• Will I need to be off work for an extended period of time?

  The amount of time a patient needs to take off work is completely individualized. Patients will be advised for time off at the time of surgery. For most cases, the patient can return to work the next day, but are asked to hold off on any heavy lifting, bending over or physical exercise.

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• How much does it cost to remove a mole & what is included in the price?

  Costs vary from £ 180 – 450 per removed mole. The fee is based on the type of method used and other factors such as the mole size, depth and location. If the mole is noncancerous, the treatment is considered cosmetic and no specimen will be sent for analysis. If the skin lesion is suspicious then it will have to be sent to Histology for analysis and this service costs an extra £95.

  When the patient goes ahead for surgery, the price would include the consultation, the surgical procedure, the post-operative care pack and the post treatment review if requested.

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• Sun Safety Tips & Skin Cancer Prevention

  • Protect your skin with clothing and do not forget to wear hat, sunglasses and long sleeves.
  • Spend time in the shade between 11am to 3pm when it is sunny.
  • When choosing a sunscreen look for a high Sun Protection Factor (SPF 30 or 50) to protect against UVB. Look also for 4 or 5 UVA stars to protect against UVA.
  • Generously apply sunscreen to all exposed skin, including lips. Sunscreen should be applied 15-30 minutes before going out in the sun. Reapply every 2 hours and straight after swimming and towel-drying.
  • Avoid tanning beds.
  • Keep babies and young children out of direct sunlight.
  • Monthly Self-Examination

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