I Have Hundreds Upon Hundreds of Moles. I Want Them Gone!

Question

I have hundreds upon hundres of moles on my arms, legs, back, and chest. My derm won't remove them as they are benign and insurance won't cover the cost as removal is considered cosmetic. It is really affecting my self esteem and I don't like to go out in public. I am considering trying to get some liquid nitrogen to remove them myself. How well does it work to remove lots of flat, brown moles? Some are very large, slightly bigger than a pencil eraser. What about radiofrequency surgery?

Raffy Karamanoukian, MD, FACS · Answer

Mole removal begins with a comprehensive examination and consultation to determine the likelihood of a mole being worrisome. Excisional and incisional biopsies are reserved for suspicious moles. But it’s good news that most moles are not problematic and are only cosmetic, thus leading to the option of scarless or non-surgical mole removal with lasers and RF and plasma. Our office specializes in non-surgical mole removal.

Best,
Dr. Raffy Karamanoukian
Realself 100 Surgeon

Best,
Dr. Raffy Karamanoukian
Realself 100 Surgeon

Michael A. Greenberg, MD · Answer

What you are suggesting could be life threatening, especially if one of the lesions you self-freeze is a melanoma and you leave part behind.There is an old saying that any doctor who treats himself has a fool for a patient.  It  goes double for any patients who treat themselves.Taking off hundreds of moles is impractical and expensive.  Any removals you want should be done by a board certified dermatologist.Having said all that, the problem is not the moles, but your inner belief that somehow they make you look bad or ugly or weird.  It's your negative self-talk that is causing the pain, not your skin.I work with patients all the time on these inner emotional and spiritual issues.  I suggest you find either a doctor who can help you with the real problem -- your inner dialog -- or work with a therapist to reprogram your false beliefs about yourself.

Barry L. Eppley, MD, DMD · Answer

On a practical basis, it may be possible to get rid of many of your moles but doing it yourself is not the way to get there. Most importantly, using liquid nitrogen essentially is like burning them off and will result in white scars as their replacement. Is many hundreds of white spots better than many hundreds of black spots? Probably not. In addition, some of these moles may benefit by biopsy which you obviously can not do and even know which ones should be tested. It would be best to work with a physician experienced in mole removal and start on one body region at a time.

Michael A. Jazayeri, MD · Answer

If you have many moles on your body, I would recommend seeing a board certified dermatologist for a body check to make sure none of these moles are suspicious for cancer.  The greater the number of moles, the higher the risk.

	Depending on the type of "mole" on your body, some can be frozen, or shaved of.  However, for a standard mole, the only way to minimize chance of recurrence is to excise the mole and close the defect.  This may result in hundreds of tiny scars on your body, which may be just as noticeable as the moles.

Brent Spencer, MD · Answer

I would completely agree with Dr. Krant's advice.   First are they really moles or are they something different like seborrehic keratoses?  Here in the DFW area, there are a ton of "Medi-Spas" that will claim that they are skin experts.  Be very careful and make sure that you are seeing a board-certified dermatologist. 

	Do NOT try to freeze these lesions yourself.  First off, how do you know if that mole is a melanoma or not?  Second, while freezing appears to be an easy procedure to accomplish, there are subtleties that should be known to prevent damage (hypopigmentation [whiteness] and scarring). 

	I am not a fan of radiofrequency surgery.  I feel that with proper techinque, one can get just as good a result with a sharp blade.  Many surgeons and medispas will market radiofrequency for mole removal.  They will remove the mole with this techinque and not send anything for pathology.  This is another thing to watch out for. 

	Finally to address the financial issue, if indeed these lesions are benign, there is no insurance around that will pay for their removal.  Expect to pay out of pocket.

Jessica J. Krant, MD, MPH · Answer

Crowley.s,

	Please consider going for a second opinion to a BOARD CERTIFIED DERMATOLOGIST to see if there are other options for you. First of all, "flat brown moles" can describe many things, so I am not sure if you mean real "pigmented nevi" (moles) or possibly "seborrheic keratoses" (non-mole benign growths).

	Many laser spas and other types of practitioners may say it's ok to laser or freeze off these lesions, but if they really are pigmented moles from melanocyte cells this is not safe to do, because it is these harmless moles that have a risk of becoming melanoma someday, and if they are partially destroyed (moles have a root, so most will likely still have the cells below the skin surface), it may be hard to follow what is really going on with the cells over time.

	Also keep in mind that if they are real moles, removal will leave a small scar at every single spot. There is no way to magically erase them. It's really best to try to start thinking of them as beauty marks, so you don't torture yourself about them over the years. Find a way to have a dermatologist safely remove (and test) the ones that show most socially, and remove one or two here and there over time.

Michael Sullivan, MD (retired) · Answer

Please contact a reputable Board Certified Dermatologist in your area for a consultation and examination. DO NOT attempt to try anything at home as the outcome could be far far worse that what you are experiencing now. Your well trained Dermatologist will be able to recommend the treatment options to best address your concerns.

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