Mole grew back after shave biopsy, is this normal? Do I need a second evaluation/biopsy? (Photo)

Question

I had a shave biopsy a couple months ago, and the mole grew back. I am concerned as it looks strange. The biopsy results were benign compound melanocytic nevus. Do I need a second evaluation/biopsy? Please help since I can't afford an appointment right now

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

Erik Peterson, MD · Answer

Hi! Dr. Peterson here &mdash;
What you’re describing is very common and called a recurrent nevus. After a shave biopsy, pigment cells can remain in the deeper layers of the skin and the mole can grow back, sometimes looking darker or more irregular than before.
The reassuring part is that your biopsy showed a benign compound nevus. That said, recurrent nevi can sometimes be hard to distinguish from melanoma on the surface, even for physicians. For that reason, it’s always best to have any changing or unusual-appearing lesion checked again by a board-certified dermatologist.
In some cases, we recommend a full-thickness excision if the spot is bothersome, changing, or cosmetically concerning, which also provides complete tissue for review.
Even though your prior biopsy was benign, I’d recommend an in-person recheck when you’re able, just for peace of mind and safety.

David Hansen, MD · Answer

Most pigmented moles are best treated by simple excision while flesh colored moles are best shaved.  Since the mole is benign, I would get it  simply excised so it is gone for good.

Anna Chacon, MD, FAAD · Answer

It is not uncommon for a mole to grow back after a shave biopsy. This occurs because the shave technique removes the top portion of the mole, but melanocytes (pigment-producing cells) can remain deeper in the skin and cause regrowth. This phenomenon is called recurrent nevus and is generally benign, especially since your pathology report confirmed a benign compound melanocytic nevus.

A recurrent nevus can sometimes appear irregular or darker than the original mole, which can understandably be concerning. In most cases, it does not require a repeat biopsy unless there are worrisome changes such as:

Rapid growth

Irregular borders

Multiple or very dark colors

Persistent itching, bleeding, or crusting

If none of these concerning features are present, it is usually safe to continue monitoring. However, if the mole continues to change in appearance, a complete excision (rather than a shave) may be needed in the future to both remove it fully and provide reassurance.

Since your initial biopsy confirmed the mole was benign, and regrowth is a known possibility, this is not unusual. Careful self-monitoring is important, and if changes occur, that would be the time to consider further evaluation.

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