What is the best way to remove the mole at the tip of my nose? (Photos)

Question

I have a mole right at the tip of my nose ever since I was a kid. Over the years it has slowly grown bigger, and I'm looking to remove it for the sake of determining if it's benign (and if not take corrective) action as well as for cosmetic reasons. Given the size, location, and depth of it, what is the best way to remove it such that pathology can be determined and that will yield the best cosmetic outcome. I'm prone to hypertrophic scarring / keloid formation + hyperpigmentation scarring given my East Asian background.

Anna Chacon, MD, FAAD · Answer

You’re asking exactly the right questions, especially given the location, your skin type, and your history of hypertrophic scarring and post-inflammatory hyperpigmentation. The tip of the nose is one of the most cosmetically sensitive areas of the face, so the goal here is diagnostic accuracy first, with the lowest possible risk of a noticeable scar.

Based on your photos and history, here’s how this is usually approached thoughtfully:

Why pathology matters

Because the mole has slowly grown over time, it’s important that any removal allows for full histologic evaluation. That immediately rules out destructive methods like laser or cautery as first-line options, since those can destroy tissue and prevent accurate diagnosis.

Best removal method in your situation

For a raised or dome-shaped mole on the nasal tip, the option that balances safety and cosmetics best is typically a shave excision performed at the level of the dermis, with careful technique.

Why this works well:

Provides tissue for pathology

Avoids a full-thickness incision through the nasal tip, which has a higher risk of visible scarring

Can often heal with a flat, subtle mark rather than a linear scar

Lower risk of hypertrophic scarring compared to a punch or elliptical excision in this location

If the lesion appears deeper or atypical on exam, a very conservative excisional biopsy may be necessary—but this is usually reserved for cases where melanoma or deeper involvement is suspected.

Considerations for East Asian skin & keloid risk

Your concern about scarring and pigmentation is very valid. In patients prone to hypertrophic scarring or PIH:

Shave removal tends to be safer than sutured excisions on the nose

Healing by secondary intention often gives a better cosmetic blend on convex areas like the nasal tip

Strict sun protection during healing is critical to reduce pigmentation changes

Early scar modulation (silicone gel, topical anti-inflammatories) can help minimize thickening

True keloids are uncommon on the nose, but hypertrophic scars and darkening are more likely if the skin is under tension—which is another reason sutures are avoided when possible.

What to expect cosmetically

Initially, the area may appear pink or slightly depressed. Over several weeks to months, it typically flattens and blends in. In many cases, the final result is far less noticeable than the original mole—especially when healing is managed carefully.

Bottom line

For a long-standing mole on the nasal tip with cosmetic concerns and a need for pathology:

A conservative shave excision offers the best balance of diagnostic accuracy and cosmetic outcome

Laser removal should not be done until pathology is confirmed benign

Sutured excisions are usually avoided unless absolutely necessary

Your caution is well placed, and with the right technique, it’s very possible to get a clear diagnosis while preserving a natural appearance.

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