You have a smallflat spot on your nose that you do not like. The first thing that needs to bedone is to have this evaluated by a board-certified dermatologist to determinewhat we are dealing with. Is it a mole? Is it a lentigo or a keratosis of somesort? Dermatologists can assess the best and then determine a treatment optionthat is least invasive.I would neverrecommend an elliptical excision here – too big of a scar for such a smalllesion. You could do a superficial shave excision and use a proper woundhealing hydrocolloid dressing to help the area heal, all with minimal scarringin skilled hands. Or you can use a punch excision, small, with one suture, andtreat any remaining scar later with silicone gel or lasers.Speaking of lasers,that also would not be my first choice – you need tissue for the pathologist,something you cannot get when a laser is used.
This is a difficult area because there are no places to 'hide' scars. These small dark moles usually do not respond completely to any sort of laser treatment and are best served completely removed. You will be trading the pigmented area for a small scar, but the trade off may be worth it for you. I would likely use a very small punch biopsy which would just require one suture to close. I would always recommend an in person examination prior to giving any final recommendations. Best of luck
