I have a bunch of moles on my back that I would Like to have removed. A couple of them are raised and a bunch of them are flat. I spend a lot of time out side in the sun without a shirt on. My goal is to have them removed with little to no scaring and for the spot to have the same skin tone as the rest of my skin.
Does Laser Mole Removal Work?
Doctor Answers 13
Removing moles with a laser
Moles are a general term for a growth on the skin, but often they are made up of non-cancerous pigment cells called melanocytes or nevocellular cells. The problem is that these same cells can sometimes be cancerous. We call this type of cancer melanoma. Melanomas are curable when found and treated early, but can be deadly when they are found at a later stage or when they spread to lymph nodes and internal organs.
When a mole is removed with a laser, the tissue is destroyed and cannot be examined to be sure that it is not a melanoma.
Also, sometimes people present with melanomas in internal organs (metastases) and the source of the melanoma on the skin (the primary lesion) is not apparent. If a mole is removed and not tested, and at some future date you develop a metastatic melanoma without a primary lesion, we will always wonder whether one of those moles that were burned off with a laser was really a melanoma.
Don’t have your moles removed with a laser.
Lasers for Mole Removal
I feel that lasers are a bad method of mole removal for two reasons.
1. The scars that remains after laser treatment are at least as noticeable as those which results from shave removals. Sometimes they are worse.
2. Laser removal will destroy the mole and there will be no tissue left to have microscopically examined to make certain it was benign. This would delay a second surgical procedure that would be necessary for a precancerous or cancerous mole.
It is also unrealistic to expect to have moles on your back removed with little to no scarring. There is usually some residual hypopigmentation (lighter color) and occasionally thicker scars can result.
Mole on the back may be "shaved" for best cosmetic result
Pigmented moles should never be treated in a way that does not allow biopsy, as there is always a chance that there could be some abnormal cells in them that need more than cosmetic consideration, ( they may have malignant or pre-malignant characteristics). Because "moles", medically known as nevi, originate deeply in the skin, there will always be some knid of "scar". The skin on the back is quite thick, and "full thickness" excisions often heal in an unsightly manner, (they tend to "spread" and not stay in a "fine" line). For lesions that are presumed benign, shave excision is the best cosmetically, but there will be physicians whom are uncomfortable with this removal method becuase of the small possibilty that, if the cells in it turn ot to be a malignent lesion, the shave biopsy does not allow as definitive determination of how likely the lesion is to have "spread", and therefore exactly what treatment regimen is appropriate.
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Shave removal is best for benign moles
You first need to see your dermatologist to determine if any of your moles have the potential to be worrisome. If they are all considered benign and cosmetic, then shave removal would probably be your best bet. Remember that there will always be a small chance or recurrence. This also generally gives the best cosmetic appearance after removal.
Laser is not a good idea for mole removal
Lasers can be used for mole removal in two ways: removing the pigment, which still leaves the mole intact and does not reduce the danger of the effect of sun exposure on that mole, and burning the mole off the skin, which would leave an unsightly scar.
In addition, moles partially removed by laser look atypical both clinically and under the microscope, so if a mole needs to be removed later, it would be difficult for a pathologist to tell the difference between a mole that was affected by laser and an abnormal mole.
The question is whether the lesions to which you are referring are moles or freckles or seborrheic keratoses. Freckles induced by the sun, which just have increased pigment in the epidermis, would do fine with laser treatment. Seborrheic keratoses are benign skin growths that can be removed in a variety of ways including liquid nitrogen, cauterization and laser.
I recommend that you have an evaluation of these spots by a dermatologist to decide which treatment is best for you.
Start with a Dermatologist for Mole Removal
Unfortunately, you are a prime candidate for skin cancer. Your first goal should be to determine that none of these are suspicious and the best person to evaluate this is a Board-certified Dermatologist.
Lasers for mole removal
A laser can remove pigment (color) from a skin lesion, but it won't make a raised lesion flat, and it won't allow for any type of diagnosis. You mention that you spend a great deal of time in the sun without a shirt, which puts you at greater risk of developing a skin cancer on your back--you should have a dermatologist or plastic surgeon evaluate and follow you, and remove only the lesions which are questionable (and, yes, you will have scars from the excisions).
Best way to get rid of Back Moles
Regarding: "Does Laser Mole Removal Work?
I have a bunch of moles on my back that I would Like to have removed. A couple of them are raised and a bunch of them are flat. I spend a lot of time out side in the sun without a shirt on. My goal is to have them removed with little to no scaring and for the spot to have the same skin tone as the rest of my skin."
A "mole" is NOT a "mole", is NOT a "mole".
Dermatologists and Plastic surgeons spend years developing the experience to tell which skin lesions are obviously cancerous and which are benign and even they can be wrong on both accounts mistaking a cancerous lesion for benign and vice versa. When it comes to sun exposure related skin "moles", the safest thinking is that if it is worth removing, then it is worth removing well (leaving the least conspicuous scar) and having a pathologist declare the true nature of the "mole".
Thousands of American die every year from misdiagnosed and neglected melanoma; a very aggressive skin cancer. It behooves you to make sure you will not be one of them.
As regards mole removal and scarring. Your goal - "My goal is to have them removed with little to no scaring and for the spot to have the same skin tone as the rest of my skin" is completely unrealistic. Every moderately deep skin scratch leaves a scar. This is a fact of nature. A laser is essentially a very expensive hot stick which burns the mole and adjacent skin AND will also leave a scar. The problem with freezing, lasering "moles" is that no tissue can submitted to pathology for your doctor to know WHAT the lesion was and if cancerous, if all of it was removed. Another method favored by Dermatologists, scraping the lesion, is not a good way to treat melanoma in which case its ARCHITECTURE and DEPTH of penetration are destroyed by the scraping.
An excisional biopsy of all suspected lesions should be done and you should be followed yearly by the surgeon.
Dr. Peter Aldea
Laser, moles and scars
Skin lesions should first be assessed by a knowledgeable physician, then evaluated for removal. You are describing several different types of lesions, and they will be likely need to be addressed in different ways.
- All lesions should be considered for biopsy.
- Fast growth, irregular edges, changes in color can be concerning.
- some types of "moles"- (lesions)- need a special type of excision, and biopsy
- some are benign and can be shaved off
- some can be addressed with cryo-freeze
And last...removal of any mole will always leave a scar. the goal is to make that scar less noticeable than the lesion, and hopefully not noticeable at all.
Laser is very useful in general, but you should have your moles evaluated before considering treatment.
Moles are not created equal
No, lasers are not an effective or wise way to remove moles. I find the word mole used by many patients to describe true moles, skin tags, seborrheic keratoses, etc. While lasers are a means to remove some of these benign lesions, the issue is determining which lesions are benign and which ones may be more problematic. You would never want to remove a lesion with a laser, and not have a pathological assessment in case it is a growth that has some malignant potential or displays worrisome signs. In those cases, it is necessary to remove the entire lesion and have it evaluated to ensure a proper diagnosis and that proper removal has occurred. Dermatologists spend years studying moles, melanoma and other growths to develop the expertise to tell the difference. Don't sacrifice your overall health for a cosmetic concern. Learn about the dangers of the sun and tanning, perform periodic exams to monitor for changing moles and establish a relationship with a dermatologist who can effectively evaluate your moles and determine which ones are in need of further assessment.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.