Some Pigment Left Behind After Mole Biopsy

I had a mole biopsied 4 years ago. The results came back that it was benign. It was a sort of shave biopsy on a flat mole and there is a little bit of pigment left behind in the scar. My question is: Do i have to worry about this pigment left behind turning into cancer? Can i leave it alone or should i have it "dug out" The biopsy was on my inner thigh. Thank you!

Doctor Answers 14

Pigment returning

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If a shave biopsy was performed on the mole, there is a chance for the mole to grow back.  I would not be too concerned with the pigment returning.  I would still have the mole evaluated by your doctor.  

Return of pigment after mole removal

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Some recurrence of pigmentation after a shave removal of a mole is very common, and usually nothing to be concerned about.  The pigmentation is often somewhat irregular appearing.  Since it was benign after the initial biopsy, it is unlikely to be dangerous, but I would still have the mole evaluated by a dermatologist. 

Alison Stallings, MD
Tarrytown Dermatologic Surgeon

Mole came back

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The is called a recurrent nevus (a mole that came back after removal). If the original biopsy showed a benign growth (not cancer), than the recurrent nevus is also benign. This can be removed for cosmetic reasons.

Gary Goldenberg, MD
New York Dermatologist

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Shaved mole leaving brown spot

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If a mole was shaved and read as benign then I would not worry about recurrent pigment. If the pigmentation bothers you it can be further removed or can often be faded with cryotherapty(freezing). 

Pigment after Mole Removal

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The goal of a biopsy is to determine if something that looked atypical to the eye during your exam, is in fact atypical -- cancerous or pre-cancerous.  If the pathology report shows a benign process, removal of the residual pigment is not necessary.  Many moles have some residual pigment, or pigment recurs, after a shave biopsy.  If the color begins to change or returning pigment continues to grow or change, then I would have it re-examined and probably excised.  Make sure your moles are evaluated and treated by a Board Certified Dermatologist, and that all pigmented lesion biopsies are read by a Board Certified in Dermatopathologist.

Shave biopsies of moles may leave some of the mole in the skin

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Shave biopsies of moles may leave some of the mole in the skin. By definition the shave only removes the part of the mole that is above the skin and anything left behind may grow. If the biopsy is not malignant the remaining mole is safe unless it turns colors, grows, or bleeds.

Edward Lack, MD
Chicago Dermatologist

What to do about residual pigmentation from a shaved off lesion

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If the pathology report definitively indicated that this mole was benign, then the residual pigment does not necessarily need to be removed. However, if you do see some changes occurring in it, I would recommend that it be removed in its entirety - and not just shaved off.

Your other option which should help allay your anxiety would be to have this residual pigmentation completely excised and then sent to pahtology. Then, you will have one less issue to worry about.

Benign mole does not need re-excision

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After a mole is removed, repigmentation may often occur. This occurs more frequently after shave biopsies, but I have seen it even after deep excisions. If the original biopsy was benign, the recurrent mole does not need to be re-excised. If the original biopsy showed atypical cells and the pigmentation recurs, then the mole may need re-excision.

Diane Orlinsky, MD
Towson Dermatologic Surgeon

Residual pigment after shave biopsy

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Dear Erin, this is one of the limitations of shave biopsy.  The mole may not be completely excised and residual pigment can be left.  The alternative is to have it formally excised, this will leave a slightly longer scar, but it will be narrower, hopefully a hairline scar.  It is swings and roundabouts really.

You can be reassured that the histology has come back as benign, so you do not need it re-excised, although you may choose to have it excised if you do not like the look of it.  As with all of your moles, you should keep an eye on them to look for changes that might mean cancer.

What to do about recurrent pigment in a removed mole

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If a mole is incompletely removed and there are some melanocytes remaining below the area of removal, it often recurs.  To remove a mole completely, it has to be cut out and stitched so that the deeper components are taken out.

If the mole was initially read by a pathologist as benign, no atypia of any sort, then a recurrence can be left alone. If there was some atypia, I would recommend removing the rest of it with an excision.

Have your dermatologist take a look at the mole and the results of the biopsy again.  If all is benign, then you need a once a year check during your full-body skin exam.

Emily Altman, MD
Short Hills Dermatologic Surgeon

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.