moles - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about moles or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
Moles
Treatment: surgical removal.
The word "mole" is a very broad diagnosis that in layman’s terms refers to any growth on the skin. In the medical field, "moles" are benign growths derived from the body's pigmented cells. However, moles can be brown, reddish-brown, or skin-colored. Moles are benign by definition. They may occur at any age, but most commonly do so in childhood, adolescence, and young adulthood.
Moles usually live in harmony with our bodies. If they are cosmetically unpleasing, they can be surgically removed, using shave excision, radiofrequency ablation, or complete excision. Only shave excision and radiofrequency treatment leave you without a noticeable scar, and there is a chance that over time the mole will grow back to its original size.
Complete excision will ideally leave a linear scar instead of the mole and assures no recurrence. If a pigmented growth does not fulfill the criteria for benignancy, it should be biopsied. Your skin examination will reveal which type of mole you have.
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I want my mole to be checked. I’m kind of scared about it because it’s big and dark. How much does this cost?
The medical terminology for mole is nevus. A nevus is made up pigment producing cells and may present in many different colors, shapes and sizes. In fact, one individual may have several different populations of nevi. It is important not to only look at a concerning nevus but to put a concerning nevus into perspective by examining the entire integument. If a pigmented spot is indeed unusual in the context of the remaining skin, a biopsy is indicated for microscopic analysis. Health insurances consider both the full body evaluation with a concerning mole as well as possible biopsy a medical benefit.
I was wondering if any of the doctors have experience treating Becker’s Nevus or Keratosis Pilaris with lasers? In doing my research, Q-switched ruby laser (694 nm), Er:YAG laser (n= 11) over a Q-switched Nd:YAG system (n = 11), or a long-pulsed 755-nm alexandrite laser how shown some results for Becker’s Nevus. Are any of the doctors familiar with the treatment and/or fading of these two skin conditions? Thank you.
Becker’s nevi consist of pigment change as well as of hair. Not everyone with a Becker’s nevus shows both features equally. If the pigment is of predominant concern, Becker’s nevi are best treated by Q-switched lasers such as Q-switched ruby in the past, and nowadays with the Q-switched Nd:YAG. They respond well but need a number of treatments to reduce pigment.
The ER:YAG may achieve results but I do not use it for this purpose. In my experience, the long pulsed alexandrite is the best to remove unsightly hair and it may erase some pigment in Becker’ nevus. The 810 nm diode laser can also reduce hair and may even work on some color change but is not the most efficient.
If hair is the most bothersome, we will be able to help you. We do not currently operate the Q-switched Nd:YAG. (The Q-switched ruby technology is great but a bit outdated and I am unaware of anyone reputable still using it.)
Keratosis pilaris is a common trait in 10% of the population. It is not commonly treated by laser. The alexandrite laser is the perfect choice to remove the rough, stubbly hair on the arms and thighs and thereby a lot of the redness resolves. Some type of daily exfoliation with glycolic or lactic acid in from of lotion may still be necessary to reduce the thickening of the skin around the hair follicles.
Franziska Ringpfeil, MD
I think I have Dermatosis Papulosa Nigra. I have read several articles and saw a few pictures of this condition and the moles that I have look and sound similiar to this condition. I have 25-30 small moles that I want removed. My insurance will not cover treatment because this is an elective procedure. How much will removal cost and is there a great chance that I will need more than one treatment to have these moles removed? My moles are small and raised, they appear around my eyes and on my cheek bones.
Dermatosis papulosa nigra (DPN) is a benign condition that can sometimes be aesthetically unpleasing. There are several safe and well tolerated methodologies to remove unwanted DPN on all skin types. Contraindications for removal are rare and will be assessed during an in-person examination.
We charge $400 to remove DPNs from one anatomic area, such as the entire face. The charge may be higher if removal of lesions from face AND neck AND/OR chest is desired. The charge may be lower if the total number of growths is less than 15. Usually only one treatment is required and the spots do not grow back once removed. However, when you have DPN, you may occasionally develop a few new spots over years than can also be removed. To date, we are unaware of a preventative treatment.
I have quite a few moles that have been very itchy. I scratch so much and lotions and creams with hydrcortisone in it and nothing is helping. Is it cancer? thought it could be allergic reaction but it’s been 2 weeks.
An evaluation by your family physician or a dermatologist is needed to make a diagnosis and recommend treatment. The term “mole” means many things to many different people. When many spots are itching on the skin, it is more likely that irritation or an allergic reaction occurred.
Franziska Ringpfeil, MD
I am an African American female with a large unsightly mole on my right breast in the areola area. I would like to have it permanently removed. I had it removed about five years ago and it has grown back. Is this procedure covered by insurance?
Removal options depend on the nature of the “mole”. A consultation is essential to make a diagnosis unless you have the pathology report from 5 years ago, when the “mole” was removed. Insurance coverage of a procedure depends most often on the diagnosis, and only sometimes on the technique used.
I had two moles removed from a cosmetic place. They use some kind of electro to burn off the mole. It has already been my fourth sessions but a lighter brown spot seems to remain where the mole used to be. I was wondering if there’s any procedure to fix that? (The mole is flat and brown about the size of a pencil eraser).
Thank you
Moles are made of pigment producing cells, called melanocytes. Their pigment production status is variable. When shave removal is performed for aesthetic removal of an elevated mole, half of this mole will remain behind and about half of the time the mole will regrow. The scar will be in the cut surface of the mole and is therefore barely visible. However, at the cut level, pigment production can be the same as at the original surface of the mole, stronger or lesser regardless of the technique used for shave removal (burning with radiofrequency or tangential cutting). This cosmetically superior technique should be chosen to reduce the elevation of a mole. This technique is not the right one if the color is greater concern. Complete excision is the only way to guarantee removal of color. The latter results in a visible scar but assures the removal of the mole for life. Laser treatment for moles (melanocytic nevi) is not considered safe at this time.
I have a large mole on my lower back and want it removed for cosmetic reasons. How much would complete excision cost?
Removal of large moles in areas of a lot tension and movement, such as the back, rarely results in good cosmetic results. Depending on the size of the mole, an undesirable mole can be primarily excised in an outpatient setting or may require preparation with tissue expanders and subsequent removal by a plastic surgeon in an operating room. Please provide the dimensions of the mole to determine the type of removal. If small enough for outpatient setting, I ca provide pricing.
I have a 4mm in diameter mole right beneath my lower lip, it is a little bit raised and it touches part of my lip, i think it has grow over time. How much would it cost for me to remove this mole? Can u just give me a range? And how much will it cost for the initial consultation visit?
Shave removal or complete excision may both be good cosmetic options in this location but examination will allow us to device the best removal plan. If complete excision is not cosmetically advisable, shave removal is the only option. There is a 50% chance for a mole to regrow after shave removal. We currently charge $130 for shave removal or $185 for excision for a mole up to 5 mm in diameter on the face. The initial consultation is usually submitted to your medical insurance. If you do not have insurance, the fee is currently $115.
I have many flat brown moles that I would like to get removed. Is there any treatment that can achieve this like IPL, CO2, lasers?
— Matilda
Flat brown moles could be sun spots, seborrheic keratoses or nevi. the first can be treated with laser or IPL, the second can be frozen or scraped off the skin and the last are excised. Evaluation is needed to be certain of the diagnosis, and to discuss the treatment plan should you want to remove these for cosmetic reason so that you are fully aware of the downtime and appearance of your skin after removal.
I have a small, flesh-colored mole on the tip of my nose. It bothers me because it is right on the tip of my nose and often turns pink when I am in the sun or blow my nose. It is not so noticeable to other people but I have been very self conscious of it. What is the best way you would treat something like this? Thank you.
Your description suggests that you could have an angiofibroma. It can be shave removed but this results in a small flat scar and there is a chance that it could return over time. A full excision is not recommended on the tip of the nose because the resulting linear scar is possibly more noticeable that the current spot.