Moles and Skin Tags London

Moles checks can be arranged at Riverbanks Wellness® with an experienced Doctor.  Skin cancer rates are on the increase, due to wide spread over exposure to the sun’s UV rays and use of sunbed and tanning machines.  Moles that have irregular borders and irregular pigmentation should be checked by a Doctor, as should any mole that bleeds or has grown in size recently, or has suddenly appeared, or appears different to other moles on your body ( “an ugly duckling”).  If our Doctor has any concerns about a mole you will be referred to a specialist mole clinic run by the NHS and seen within two weeks, unless you specifically wish to remain in the private sector and be seen by a consultant dermatologist .

Why should I consider Mole removal?

Moles situated in awkward or highly visible areas such as the face or intimate parts of the body  can affect self-esteem and confidence.  Moles sighted on difficult to monitor areas, such as the back, may best removed for peace of mind. Very occasionally there is a risk of skin cancer developing so early detection can be vital in such cases.

Moles, also known as melanocytic naevi, are a collection of cells, called melanocytes, which produce the pigment in your skin. Moles are usually a brownish colour, although some may be darker or skin-coloured. They can be flat or raised, smooth or rough and some have hair growing from them. Moles are usually circular or oval with a smooth edge.

Moles can change in number and appearance. Some moles fade away and lose their colour over time, often without you realising it. They also sometimes respond to hormonal changes, for example during:

  • pregnancy: when they may get slightly darker
  • the teenage years: when they increase in number
  • older age: when they may disappear or fade from 40 to 50 years of age onwards

When do moles develop?

Some moles, known as congenital melanocytic naevi, are present at birth, or appear soon afterwards. However, most moles develop during the first 30 years of life. These are called acquired melanocytic naevi. People with fair skin often have more moles than people with darker skin.

Most moles have a genetic cause and are inherited. This is often the case with people who have a lot of moles. Where you were brought up may also make a difference, for example, if you have lived in sunny climes for many years you may have an increased number of small moles, or freckles, depending on your skin type.

People who spend a considerable amount of time in the sun, or who have  had sunburn in the past,  often develop brown marks on their skin, especially the face , shoulders and arms. These are called sun spots or solar lentigines and appear later on in life.

MALIGNANT MELANOMA

Most moles are harmless, but in a few rare cases they can develop into malignant melanoma, which is an aggressive form of skin cancer.

Malignant melanoma is the most serious type of skin cancer. The cause of melanoma is complex and is usually explained by a mixture of genetic and the environmental factors. Some families, or those with an excessive number of moles,  have a higher than average risk of developing melanoma , while over exposure to the sun, especially episodes of sunburn, can also predispose to melanoma. However, some melanomas may occur on parts of the body that have not been exposed to much sun ( eg soles of feet, or rarely, even within the mouth or vagina).

Malignant melanoma can appear anywhere on the body. It may be a dark, fast-growing spot where there was not one before, or a pre-existing mole that changes size, shape or colour, or bleeds, itches or reddens. However, the bleeding, crusting and itching are late signs and ideally melanoma should be diagnosed earlier. Itching is also not a very specific sign, as benign (non-cancerous) moles may itch occasionally. Some melanoma have no colouring at all (amelanotic melanoma), and appear red, pink or pale lumps. These usually appear suddenly from within normal looking skin and can grow alarmingly fast.

You should check all your moles every few months for any changes. A change in a mole may occur in weeks but in some moles it may occur in months. See Moles – prevention for information and advice about checking your moles and the changes to look out for. If there are no changes it is not a melanoma, as a melanoma will change with time.

What is the best method for Mole removal?

Ideally all pigmented moles should be excised. It is our policy to send all pigmented skin lesions for histology (examination under a microscope) to ensure that they are harmless (benign).

Surgical Excision of moles

• Elliptical Excision The cutting method of mole removal may be used for both normal and atypical moles. Potentially cancerous moles are nearly always removed using this technique. This procedure is often called elliptical excision because the mole, as well as the surrounding and underlying tissue, is removed in the shape of an ellipse, or oval. This involves numbing the area around the mole. The entire mole is removed, both above and below the skin. This whole portion is sent for histological examination to precisely confirm the  nature of the mole. Sutures (stitches) are used to close the incision if it is cut. After the procedure, a dressing is usually applied. Sutures are usually removed after about a week.

Some moles may be best removed simply by shaving off under local anaesthetic.

• Shave Excision (shaving it off) Moles with an elevated surface typically are removed cosmetically by a process called shave excision. This involves numbing the area around the mole and removing the top portion of it so it is flush with the surrounding skin. A small scar usually results, which is usually cosmetically acceptable. If the mole had hair or was dark in colour, these likely would remain. There is a chance that after this procedure the mole could re-grow.

The mole cells below the cut surface of the removal site can also cause re-pigmentation of the removal site to a shade much darker than that of the removed mole. This re-pigmentation side effect is particularly problematic for patients with olive skin or dark eyes and hair. Mole re-growth and re-pigmentation occur more commonly in young patients and may result in the desire for re-removal.

• Laser treatment Some moles can also be removed with lasers instead of scalpels. Because lasers seal blood vessels and evaporate the tissues they remove, the need for cutting and sutures is eliminated. This may reduce scarring in some cases. After laser surgery, a scab forms and falls off within 2 weeks. The slight redness that is evident after the scab is gone will disappear in time.

As with all surgical treatments there is a remote chance of unsightly scarring.

SEBORRHOEIC KERATOSES, also known as Seborrhoeic warts, are skin blemishes that can mimic moles. They are benign (non-cancerous) and are common in older people. They differ from moles and look like raised warts. Seborrhoeic keratoses can be skin-coloured, black, dirty-yellowish or a grey-brown colour. They can crumble away from the skin and are usually multiple, especially favouring the chest and tummy areas.

What treatment is needed to remove Seborrhoeic keratoses?

These can be frozen, shaved , or scrapped (curetted). The most appropriate method needs to be decided after consultation with the Doctor.

 

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What are skin tags?

A skin tag is a commonly acquired benign skin growth that appears as a small piece of hanging skin. They typically occur in characteristic locations including the neck, underarms, eyelids, armpits and under the breasts.  Although skin tags may vary somewhat in appearance they are usually smooth or slightly wrinkled and irregular.  They can be flesh-colour or slightly more brown and hang from the skin by a small stalk.  Some skin tags can be as large as a grape and vary dramatically in size.

What causes Skin Tags?

The definite cause of skin tags is unknown however they may be irritated from rubbing by clothing or other materials.  Skin tags can run in families and are more common in people who are overweight or who have diabetes. Skin tags are generally painless and do not grow past a certain stage or change in appearance.

What Treatment is needed to Remove Skin Tags?

Skin tags can be frozen using liquid nitrogen  or shaved or snipped off after numbing the skin. Larger ones may need to be excised if they have a broad base.

 

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