Medical - Watch that mole!
by Brian P. Maloney, M.D.

Moles or angel kisses are collections of colored cells in our skin. While only 1 percent of the population is born with a mole, most acquire them by their twenties. Thank your parents, not your angel for the moles, as genes can influence their number.
Scientists think that exposure to sunlight may cause some people to form a mole, whose medical term is nevus. Nevi are identified based on their location within the skin and appearance. Names vary from the blue nevus to the less flamboyant simple nevus.
Since moles arise from the pigment cells of the skin, the same cells which can develop into skin cancer called malignant melanoma, they should be watched carefully for changes.

ABCD alert

The American Cancer Society suggests seeing a doctor if one of the following ABCD changes occur:

• Asymmetry - moles should be smooth.
• Border - uneven border.
• Color - changes, especially dark black.
• Diameter - larger than a pencil top.

Hairs growing out of a mole do not imply skin cancer.
If you have one of the ABCD changes it does not mean the nevus has turned into a melanoma, but you should have it checked out. Malignant melanoma is difficult to treat. With early diagnosis, though, more than 80 percent of malignant melanomas are treated by simple excision at the doctor's office.

Beauty mark or distraction?
Some have facial moles removed because they may be distracting to otherwise beautiful features. Others remove moles because they have hair growth. A mole with a rough outer surface may be mistaken for a wart. One mother had all the moles removed from her daughter's skin to avoid worrying about melanoma, which is the wrong reason to have all moles removed if there is no strong family history of melanoma.

Removal methods
No matter what your reason for mole removal, be it esthetic or medical, there are different techniques to remove moles. Most removals can be performed simply in a doctor's office. When the mole is on the face many people seek out a plastic surgeon in hopes of a smaller scar. A dermatologist who performs esthetic procedures would likely remove the mole with little scarring just as well.

If the mole is raised it can be shaved off, a procedure that is similar to a scrape. A mole with roots may grow back or heal with a slight depression. If the mole has hair growing out of it, or if there is a concern the mole may be changing, it should be removed. This will leave a scar, usually a small, flat one.

Both of these procedures can be performed under a local anesthetic in the office. Mole removal in a child may require a trip to the operating room.

I believe lasers should not be used to remove the pigment in a mole, since that is one of the ways we monitor the nevus for possible changes into a cancer. Low-tech methods are better. Can a beauty mark be transplanted? Yes, fairly simply. But applying permanent cosmetics may be even simpler.

Brian P. Maloney, M.D., F.A.C.S., is a nationally recognized facial plastic surgeon whose clients include celebrities from around the world. Director of The Maloney Center he appears on the Discovery Channel and is often asked to conduct research on improvements in surgical techniques. Visit www.maloneycenter.com or call 770.804.0007.

Dr. Brian P. Maloney
Facial Plastic Surgeon
Atlanta, GA