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Removing a mole without leaving a scar

I am often asked about removing a mole without leaving a scar.

There is a lot written on the Internet about this and YouTube seems to be full of videos of people demonstrating home remedies that can ‘quickly and easily remove your mole leaving no visible scarring‘.

The reality is that it is not possible to remove a piece of skin without leaving a scar of some sort.

However, often the scars fade so well that they are difficult to see and so people think that they are not there.

The question should not be ‘how do I remove my mole without leaving a scar?‘,

it should be ‘how do I remove my mole leaving the best scar possible?

There are many ways to remove a mole but the common theme is that the piece of skin that contains the pigment cells of the mole needs to be destroyed in some way.

  • You can burn it with heat or energy like a laser.
  • You can destroy it with acid.
  • You can scrape it off.
  • Or you can cut it out with a knife.

They will all remove your mole and they will all leave a mark or scar of some kind.

There are pros and cons of each method and so you need to weigh up what would be the best for you.

Perhaps the most important question is to find out whether there is anything suspicious about your mole. The best way to test this is to send it away for histological analysis.

This is only possible to do if your mole is removed by cutting it out with a knife because all the other ways will destroy the tissue and so it cannot be analysed.

This is particularly important for brown moles because even if there is no concern that they are cancerous, there may be reasons to get a histological report anyway.

If you were to develop signs of skin cancer later on in life such as enlarged lymph notes, your doctors would look closely at your skin for a potential source of the cancer.

If you tell them that you had a mole removed some years ago, then they would want to see a histological report to confirm that that was not the cause of your current problems.

If the mole was not sent away for histology, then there is no way to be sure that it wasn’t actually cancerous.

In terms of the scarring created, then it can be variable for all the modalities of treatment.

When destroying the skin with heat, laser energy or acid, it can be difficult to judge the amount of energy needed to completely destroy the mole.

If you do not use enough energy then there may be evidence of a residual mole left behind
…and if you use too much then this can increase the scarring.

It is more predictable when you use a knife, if it is being used in skilled hands.

My advice for patients who want to know the best way to remove their mole without leaving a scar is this:

  1. First of all, there is no way to remove a mole without leaving a scar
  2. Secondly that excising it with a knife is probably the most predictable and effective way, with the added benefit of allowing us to perform histological analysis if required.

If you have a mole that you are concerned about the first thing to do is to get it checked out by a doctor.

You can download our guide with five things you need to know about your moles here.

We offer free consultations if you would like an assessment and opinion by one of our fully trained plastic surgeons and we also offer a ‘see & treat’ service that will allow you to have your mole removed on the same day as your consultation if this is something that you would like to consider.

Please feel free to comment on my blog and if you want to get in touch you can email me at hello@staianoplasticsurgery.co.uk or call us on 0121 454 3680

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5 ways to treat keloid scars

Keloid scars are an abnormal form of scarring that occur in some individuals.

They are more common in certain skin types such as Afro-Caribbean skin and they are also more common in certain areas such as the earlobes, the shoulders or over the breast bone.

They are raised lumpy scars which are often itchy and are darker in colour to the normal skin colour so they can be red or purple in Caucasian skin or darker brown in pigmented skin.

They are difficult to treat because it is an abnormal response by the body and we don’t really know why they occur.

There are five main forms of treatment for keloid scars:

1. Moisturising and Massage

If your scar is only slightly raised and particularly if it is within the first year then you may have a hypertrophic scar rather than a keloid scar and these tend to be less severe and more likely to improve over time.

Moisturising and massaging the scar will help it to soften and may help with the itch.

2. Silicone

The next step would be to use silicone on the scar.

Silicone comes in 2 forms, a gel or a sheet.

Silicone sheets are useful on flat areas particularly underneath clothes because while the silicone sheets are sticky, they do not stay on well on exposed areas.

For keloid scars in exposed places like the face or the ears, silicone gel is more effective.

The silicone needs to stay on for 23 hours of the day and is only taken off to wash.

It can help with the red and raised nature of the scar and also the itch.

3. Pressure

Pressure is known to improve the quality of keloid scars although it is dependent on the area as to whether it can be used as a modality for treatment.

Keloid scars on the earlobes may be amenable to having pressure applied by using a custom-made clip which will press on the scar and can help it to flatten.

Other areas of the body can be more difficult to apply pressure to although it may be possible to have a custom-made garment depending on the size and location of the scar.

For severe scarring of the face, a custom mask can be made to apply pressure, although this is only for extreme cases.

4. Steroid Injections

The next step for troublesome keloid scarring is to use steroid injections.

Steroids are used to dampen down inflammation and it is presumed that the cause of the keloid scarring is an inflammatory reaction within the scar.

The steroid needs to be injected into the scar itself and this can be uncomfortable.

Steroid injection is a procedure that can be performed in the outpatient clinic and may need to be repeated.

5. Excision Of Keloid Scars

One of the last options we consider, but perhaps one of the first options that many people think about, is excision of the scar.

It may seem an obvious choice to excise and give a fresh neat scar. However because keloid scarring is due to your body’s reaction to forming scars, there is a high probability that if a fresh scar was made, it could be keloid again and it could come back worse because the new scar would be longer than the original one.

Excision of a keloid scar is sometimes performed if it is a very large and bulky scar that is unlikely to be significantly reduced with steroid, pressure or silicone.

When excision of a keloid scar is considered, we would usually perform what is known as an intralesional excision of the scar which involves leaving a rim of keloid scar behind so that fresh skin is not cut into.

This leaves a residual lump which can then be treated with one of the other methods above such a steroid injection, pressure clips and silicone dressings or a combination.

 

 

The treatment of keloid scar is challenging and as you go up the ladder of increasingly invasive methods then the potential risks also increase.

This is an outline of what is available for keloid scars but each patient needs to be treated on a bespoke and personal level with a package or combination of treatments which will give the best possible outcome.

If you would like a consultation with one of our Plastic Surgeons for an assessment of your keloid scar then you can call us on 0121-454 3680, alternatively email us a photograph if you would like us to give you an opinion.

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For more information about scar revision, visit our scar revision page.

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What is Life-Changing Surgery?

I was invited to a talk on the radio this morning about scar management following a story of a football supporter who had been attacked and had sustained a long laceration to his cheek.
The conversation revolved around the scarring and the emotional impact of scars and what can be done about it.

I am always cautious when talking about scar revision because sometimes people think that plastic surgeons can remove a scar but that is not true.
I think we get that reputation because when we make a scar, we choose where to put them and know how to hide them in natural skin creases or in areas of the body where there are concavities or shadows, so that they can blend in and once settled, can be difficult to see.

Of course, it is a different story with traumatic scars and they are usually a lot more obvious than surgically created scars.
There are things we can do to change the direction of the scar and to improve them if they are raised up or dented in, which is interesting, because the discussion moved onto the psychological impact of having scar revision. 
It is true that the surgery itself is often quite minimal and usually done under local anaesthetic on a walk-in, walk-out basis and the results really can be truly life-changing – except when the definition of a minor operation is one that is not happening to you.
We as surgeons can sometimes think that we are performing minor surgery, but for the patient it can bring tremendous relief from the emotional impact of having an obvious scar, particularly if it is on the face and people’s eyes are drawn to it and they keep asking you about it.
If we can do something to help it blend in and make it less obvious, it can allow you to be you and not to be defined by your physical features.

And this is true of all cosmetic surgery.

It is often deemed to be unnecessary or for vanity reasons, but I think people’s perception is far off the average person seeking cosmetic surgery.
It is usually done for them and not for anyone else and they just want to feel more confident and happier about their appearance.

It was interesting talking to Danny Kelly this morning on BBC WM because it really made me think about the impact that we have on people’s lives and sometimes we can lose sight of this and get caught up in ‘the what we are doing’ rather than ‘the why we are doing it’.

I truly believe that cosmetic surgery can significantly improve people’s quality of life and I am often upset by the adverse media attention, which happens to be part of the positive image of plastic surgery this morning, as this is always what we are trying to achieve because everyone deserves body confidence.

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