Melanoma may evolve within a mole but typically develops on normal skin. People with many large and irregular moles are at greater melanoma risk.
Melanoma screening in these patients is challenging as the difference between unusual moles and melanoma can be subtle. Deciding whether or not a mole is suspicious enough for biopsy is a delicate art and science. Removal of normal moles does not reduce melanoma risk.
Many people have unsuspicious but unwanted moles. Moles irritated by daily life are best removed. Cosmetically unwanted moles may be candidates for removal based upon cosmetic risk/benefit analysis. Moles are removed via excision or CO2 surgical laser. Treatment is individualized.
Because of these limitations, 'elliptical' excision of moles with underlying skin (to prevent skin puckering) is sometimes recommended. It is best considered in cases with high risk of mole regrowth, re-pigmentation, or uneven post-treatment skin contours. In younger patients, elliptical excisions may heal with widened scarring due to the tug of surrounding elastic skin.
Elliptical excision is time and resource intensive. Depending on the surgeon's technique and skill, the resulting linear surgical scar varies from barely visible to distracting. Excellent clinical judgment and meticulous surgical skills are the key prerequisites for optimal mole evaluation and removal results.
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