The Numerous Methods of Treating Facial Moles

Methods involving destruction of the mole tissue include:

Methods that preserve the mole tissue for analysis

If the tissue is to be sent to the lab for analysis, a tissue specimen is necessary. This means the tissue cannot be destroyed. Surgical excision or at least a "punch biopsy" (used by dermatologists) is necessary. Plastic surgeons prefer to remove facial moles using small elliptical excisions. This way the full thickness of the skin is removed, there is a good specimen for the pathologist to examine, and closure yields a fine line that is oriented to blend in with existing skin wrinkles. This treatment is also likely to permanently eliminate the lesion (unlike a punch biopsy).

Other techniques that do not involve surgical closure tend to leave small divots, like chickenpox scars, at the sites. These can be objectionable because subtle contour imperfections can be highly conspicuous. It's preferable to avoid a saucer-shaped divot and leave an inconspicuous linear scar. Plastic surgeons are used to making small incisions and being meticulous with suturing technique to obtain the best cosmetic result.

Recurrence of Moles

If the mole is not completely removed, it may persist and grow back. This is called a recurrence. Nevus cells extend deeply into the dermis and may not be completely removed by a partial-thickness treatment. Full-thickness excision provides the greatest assurance that the mole is completely removed, and also allows a superior cosmetic result.

Removal of Sun-Related Spots

There are other pigmented lesions that are not really moles although they look similar. They are sun-related spots that eventually develop on the skin of most Caucasians in sun-exposed areas such as the face, shoulders, back and arms. The medical name is "seborrheic keratoses." These superficial pigmented lesions may be removed by being "scraped off." Although they are ugly, they are benign and can be removed by "tangential excision" using a scalpel blade. The full-thickness of the skin is not penetrated. The wound is treated with silver nitrate, a chemical cautery agent that stops bleeding. A black crust forms. Gradually, the wound heals under this biological dressing. The crust usually separates on its own in about a week, revealing pink freshly-healed skin underneath.

These lesions may be removed under local anesthetic in the office or at the time of other surgical procedures under a general anesthetic.