I have several small, flat moles that I would like to lighten. They are not raised at all--they are literally brown dots. I went to see a dermatologist today who recommended that I not use laser to treat them, as the effects of laser on moles is unknown at this time and could prompt cancer later in life. Do you agree with this recommendation? Thanks.
Laser Removal of Small, Flat Moles
Doctor Answers (6)
Lasers should not be used to treat moles
I would agree with your dermatologist considering he/she has already seen your moles and made this determination. Certain pigmented lesions and moles should not be removed with a laser. Lasers are thypically used to remove age/sun spots. Depending on their features, certain moles should be carefully evaluated and removing them with a laser will make it difficult to do that. If the mole were to change in size, color, border, texture, or begin to look asymmetrical, a biopsy would be indicated for diagnosis but would be impossible with the mole having been already removed with the laser.
Remember, lasers only remove the top most layers of the lesions so there would be no way of knowing what is going on in the deeper layers once we cannot see it, yet it can still be dangerous since it still persists deeply.
Good luck and happy holidays!
Lasers for skin lesions
One of the biggest mistakes that can be made in terms of skin lesions is to treat them improperly. Moles and other pigmented lesions are best treated with excision and if there is any question as to the potential for malignancy, a biopsy specimen can be sent for pathological diagnosis. Treatment of moles with laser will give no such specimen. Trust your dermatologist and take a pass on the laser. If the excision site is difficult to close, consult a surgeon with experience in facial reconstruction.
Lasers for skin lesions
Moles and certain pigmented lesions should not be treated with laser until they have been biopsied. Skin lesions should be carefully evaluated prior to doing any treatment.
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Moles need to be cut out.
I think you got very good advice. Treating moles with a laser is not a good idea, because they come back, and because you cannot get a biopsy. Flat moles are actually the most dangerous.
Laser removal of moles
I would agree with this assessment. A laser typically removes the top layers of skin and in that way minimizes scars. However, the "roots" of the mole are typically located in the deeper layers of the skin (dermis). Therefore, it is rare that a laser will completely remove the lesion and it is prone to recur not unlike clipping a dandelion without taking out the tap root. Furthermore there are no specimens to evaluate if the mole is malignant or not.
Why I don't recommend laser treatment for mole removal
I agree with your dermatologist. In general, we don't like to laser unknown lesions. The danger is not so much that it might cause the mole to turn into a cancer later as much as destroying it prior to a definitive diagnosis.
Moles can either be benign, pre-cancerous or cancerous. If we went around lasering everyone's moles, some of them would be cancerous, and we would never know.
Thus, the safest thing to do with moles of unknown etiology (that is, unknown diagnosis) is to remove them surgically and have it evaluated by a pathologist.
Hope this helps! Good luck!