Mole & Skin Lesion Removal

How it works

For small benign lesions, a CO2 laser vaporizes the tissue layer by layer under local anesthesia, with the doctor controlling depth. Other routes include electrocautery, shave removal and surgical excision with stitches. Laser leaves a shallow wound that heals as a small scab, while excision allows the specimen to be sent for laboratory examination. The suitable method depends on the lesion type, size, depth and location. Healing leaves a pink mark that fades in some people and may leave a mild scar or a lighter or darker patch in others.

Who it may suit

• Small, flat or slightly raised benign moles the doctor judges suitable
• Skin tags and seborrheic keratoses that rub or look bothersome
• Small clusters of similar spots on the face or neck
• People who want a quick procedure and accept a short healing period

The treatment day

1. Examine the lesion. The doctor checks its shape, color, edges and history, and may use a dermatoscope; suspicious features lead to excision and testing instead of laser.
2. Numb the area. Local anesthetic or numbing cream is used before removal.
3. Remove the lesion. The tissue is vaporized or cut out using the chosen method.
4. Dress the wound. An ointment and protective patch are applied, with care instructions for the following weeks.

Aftercare

• Keep the area clean and covered with the patch or ointment as directed until the scab falls off naturally.
• Do not pick the scab, which can raise the risk of scarring or pigment change.
• Protect the new skin with sunscreen for several months to reduce dark marks.
• Contact the doctor for pus, spreading redness, bleeding or a lesion that seems to regrow.

Things to know first

• Any mole that is changing, bleeding, irregular or darkening needs medical assessment and often excision for pathology rather than laser.
• Possible side effects include scarring, lighter or darker skin, infection and regrowth, especially of moles with deep roots.
• Keloid tendency, active infection and pregnancy call for a doctor's review.
• Laser removal does not provide a tissue sample, so it is not appropriate when the diagnosis is uncertain.

How mole and lesion removal compares with nearby options

The most important contrast is with pigment lasers. Pico laser, toning and IPL target flat pigment such as freckles and sun spots and do not remove raised moles or growths. Treating a mole as pigment can delay a correct diagnosis, so a spot that has a raised edge, changes over time or has uneven color should be examined first.

Within removal, CO2 laser suits small, clearly benign lesions and tends to leave a flat healed area. Excision suits lesions that may need testing or are deeper, and it leaves a line scar that can be small. Cautery is a quick option for tags and some keratoses. The choice depends on what the lesion is, not on preference alone.

Removal is also different from resurfacing. A fractional laser for scars treats many tiny points, while removal treats one lesion completely. If you mainly want smoother skin tone, a pigment laser may be the better category, but only after a doctor confirms the marks are not moles.