Nevus is a localized skin pigmentation abnormality, which can be present at birth or acquired. Usually 15 to 20 moles can be found on the skin of healthy people. Most of these moles are benign and do not require treatment. However, some moles appear on the face and affect the appearance. Different methods can be used to remove them. Commonly used mole removal methods include the following: laser method, freezing method, electrocautery method, spot scanner method and chemical agent method for mole removal.

Black hairy nevus is a type of mole that often attracts special attention due to its local blackening, rough and raised skin, and long hard short hairs. Pay attention to moles that occur in parts of the body that are susceptible to friction or damage. For example, the mole body grows rapidly, becomes lighter or darker, the short hair on the mole falls off, the area around the mole becomes red, and blood streaks are vaguely visible on the surface. There are scabs that may break down and even form ulcers that won't heal for a long time. Swelling of nearby lymph nodes, or the appearance of some small satellite-like moles around a large mole, etc., all indicate that the mole has a tendency to become malignant. You should go to the hospital to ask a dermatologist or surgeon for diagnosis for timely treatment. For the treatment of black hairy moles, small moles with a diameter of less than 0.5 cm can be cauterized with laser or high-frequency electrocautery. The advantages are easy operation, less damage to normal tissue, and small scars after healing; the disadvantage is that it is difficult to remove the mole tissue for pathological examination and is difficult to remove. There are also freezing and chemical corrosion methods to remove moles, but they should not be used because they may cause incomplete removal and stimulate the malignant transformation of mole cells. Using a trephine to remove moles can make up for the above shortcomings. Use a trephine 0.2 cm larger than the diameter of the mole to drill the entire mole after local skin anesthesia. The incision only needs to be sutured with a very thin silk thread. Since the long axis of the incision is consistent with the skin lines or expression lines, there will be no postoperative scars. Obviously, the cosmetic effect is better.

What kind of mole should be removed?

Dr. Li pointed out that in addition to aesthetic factors, in order to avoid turning into malignant melanoma, the following types of moles should be removed:

1. Moles that will be stimulated by long-term friction, such as Moles on the bra area and waist.

2. Moles with atypical changes. Moles with atypical appearance may become malignant, such as very dark moles with uneven pigmentation (variegated colors), uneven or irregular edges, unclear boundaries, left and right asymmetry, and statistically greater than 5 mm in diameter.

3. A single mole changes suddenly and rapidly. If the moles all over the body change at the same time due to changes in hormones, there is no doubt. If a single mole changes suddenly and rapidly, it is worth noting.

4. Moles growing in special parts. For example, moles that grow on the extremities (hands and feet) must be carefully observed, because moles in these places have a greater chance of becoming malignant melanoma than moles in other places.

5. Moles on the mucous membrane. Moles on the oral mucosa, conjunctiva, vagina, and foreskin.

6. Moles in nail grooves. The nail groove is connected to the skin under the nail. It may grow under the nail and be blocked by the nail. It is not easy to see the change. Moreover, if it grows on the extremity, it will have a greater chance of becoming malignant in the future.

7. Some moles themselves are inherently high-risk moles. Moles that are visible when a baby is born are called congenital moles. There are not many congenital moles. According to statistics, 1% of newborns have moles. Not all congenital moles are dangerous at birth. Size is an important factor. Generally speaking, larger moles have a greater chance of becoming malignant in the future, so doctors recommend that they be removed as soon as possible.

Some people have keloids, and scar tissue will proliferate abnormally, resulting in hypertrophic scars. Crabfoot is common in earlobes, shoulders, upper arms, chest and back, and is not a common site on the face. If people with this kind of constitution want to remove moles for cosmetic purposes, they should inform the doctor about their constitution first to prevent moles from causing big scars.

Dangerous malignant melanoma

Ou Shengyun, a plastic surgeon at Taipei Mackay Hospital, said that the conditions when benign moles turn into malignant melanoma are: raised, extremely melanin, and itchy , pain, bleeding and ulcers.

There are three main types of skin cancer: malignant melanoma, basal cell carcinoma and squamous cell carcinoma.

Malignant melanoma accounts for 4% of all skin cancers, but causes nearly 80% of skin cancer mortality rates. It has one of the worst prognosis among all cancers. 10-15% of patients with malignant melanoma have a family history of hereditary disease. Yellow people are less likely to develop malignant melanoma than white people.

Studies have pointed out that 70 to 80% of malignant melanomas in Chinese people are acral nevus type, which is characterized by their tendency to occur in areas not necessarily exposed to sunlight, such as the palms and soles of the feet, as well as in mucous membranes of the body. Acral malignant melanoma often invades the basement membrane of the skin vertically when the tumor is still very small, and invades subcutaneous blood vessels or lymphatic vessels to metastasize. Once metastasized, the prognosis is extremely poor, with a three-year survival rate of only about 10%.

Nevus may change. Some changes are warning signs that they may become malignant, while other changes may be benign. Whether the mole has become malignant can be determined through biopsy.

Many Western customs do not equate moles with destiny. The moles on the cheeks of veteran Hollywood actress Elizabeth Taylor and sexy goddess Marilyn Monroe are described as "marks of beauty."

However, many Chinese people have a superstitious belief that moles are related to fate. Some patients even request or refuse to remove moles based on their fortune-telling, which troubles doctors. There are also fortune tellers who claim on TV that moles on the soles of the feet are good moles, and moles on the soles of the feet are brave and fearless.

The doctor’s regret and embarrassment

Ou Shengyun, who has been practicing medicine for 32 years, emphasized that moles on the feet should be closely observed because long-term friction has a higher chance of turning into malignant melanoma. I have seen more than 10 such cases. Not long ago, he removed a malignant melanoma from a mole on the sole of an 85-year-old man's foot. The mole must have been with the old man for decades, and it has recently become malignant.

“Once a mole turns into a malignant melanoma, it will get worse quickly,” said Ou Shengyun. The youngest case he has seen is a 40-year-old mother. There was a 0.5-centimeter mole on the knuckle side of her little toe. A biopsy revealed that it had turned into malignant melanoma. He suggested that she operate immediately and cut off the entire little toe, but the patient was hesitant and delayed her return to the hospital for a month before having her little toe removed. Half a year later, her cancer cells metastasized to her groin, and about a year later she died. Apparently the cancer cells had metastasized in the short month she had been hesitating.

"This incident has made me sad and regretful for the rest of my life. Seven or eight years after the incident, I still often think about it. Sometimes I wonder, if I had cut off the entire sole of my foot, would it have been possible to save the life? Didn't the doctor God, your heart will be soft. The patient was scared to run away when she heard that her little toes were cut off. If she were advised to cut off the soles of her feet, would she be even more afraid to come back?" Ou Shengyun lowered his head and said slowly.

Dr. Ou emphasized: "Mole on the feet often rub against shoes and are more likely to turn from benign to malignant. If there are moles on the little toes and soles of the feet, it is best to remove them as soon as possible."

< p>Another example also impressed Dr. Ou. A mole about 1 centimeter in diameter on a female patient's upper arm turned into malignant melanoma. To prevent cancer cells from remaining, he cut off 5 centimeters in diameter. Unexpectedly, three years later, the patient came back safe and sound and angrily accused him of causing big scars on her arms and being afraid to wear short sleeves, which made him feel that it was very difficult to be a doctor.

Dr. Ou pointed out that the extent of the incision is based on statistics from medical experience. Considering that smaller incisions may result in incomplete incision and possible recurrence in the future, he would rather incise larger areas, but there are no cancer cells. Metastasis is sometimes difficult to tell. When some patients hear that their fingers must be chopped off, they react violently and say, "If I have to chop them off, then I would rather die."

How to remove moles?

The method of mole removal usually depends on the type, size and location of the mole. Generally speaking, if the mole exceeds 3 mm, it must be removed.

1. Excision: As long as there is suspicion of malignancy, it should be excised and a biopsy should be performed. Laser may not be used to clean it completely. Compound nevus and dermal nevus are too deep and protruding. If they want to be removed, excision is required. Larger moles need to be sutured after being removed, and even skin grafting (transferring a piece of skin from elsewhere) and skin flap transfer (taking over the adjacent flesh) are required.

2. Laser Laser is a treatment method that converts electrical energy into light. It is suitable for smaller and shallower moles, such as flatter moles.

3. High frequency electrocautery uses heat energy to destroy cells.

4. Liquid nitrogen freezing is destructible at minus 196 degrees Celsius, but is rarely used.

5. The disadvantage of chemical cauterization is that it is difficult to control the depth and scope of cauterization. If the burner is damaged, holes will appear, some of which are very deep. This method is not used in the medical field, but some beauty salons and night market spots Mole stalls are popular.

Almost most moles can be removed, Ou Shengyun said, but if not handled properly, most will leave obvious scars. Moles on the eyelids and nose are more difficult to remove; eyelids are more difficult to sew, and moles on the nose are more difficult to repair, requiring skin grafting or skin flap transfer; mole removal surgery for nasolabial folds is easier to do because there is a lot of tissue around it.

Precautions before and after surgery

Do not apply any skin care or cosmetics before mole removal and laser surgery. These surgeries require anesthesia, and epidermal anesthesia is used for laser. Injectable anesthesia is used for resection, and a consent form is required for both. You must protect yourself from the sun after laser surgery, and follow the doctor's instructions to apply antibiotic ointment or apply artificial skin before the wound scabs fall off to ensure the best results. After the surgical removal of the sutures, a cosmetic patch should be applied for 3 to 6 months.

Who to call for help

Ou Shengyun pointed out that mole removal and laser can be performed by plastic surgery and dermatology, and the surgical methods are the same. Some patients go directly to plastic surgery.

Beirong Li Dingda suggested that for moles that are suspected of being malignant, they should first see a dermatologist. Those who can judge with the naked eye based on clinical information should make a judgment first. If they cannot be judged with the naked eye, a dermatologist should do a biopsy and Interpret to determine whether it is malignant.

Most dermatology departments in large hospitals can perform skin biopsy surgeries and interpret the results themselves. If you want to use laser to remove moles for cosmetic purposes, there is no problem; but for larger-area excision surgeries, you may even have to do For skin grafting surgeries, or those involving facial aesthetics and function, it is more appropriate to be referred to a plastic surgery department. However, every hospital does it.

The average person should pay attention to whether there are any changes in moles on the body. If you have any concerns, you should see a doctor as soon as possible.

The doctor said that people with moles can take photos of their moles at regular intervals for comparison and tracking, or take the photos to the hospital to show the doctor!