Mole and Melanoma

Melanoma is the most serious and aggressive skin cancer.

It accounts for 1-3% of all cancers in the Western population, the sixth most common cancer in men and the seventh most common cancer in women.

It can develop on healthy skin de novo or on a pre-existing mole.

The development of melanoma is prevented by self-examination of moles at regular intervals, sun protection and skin examination by a specialist physician.

Spots are any area exposed to the sun such as the trunk, face, upper and lower extremities, as well as the soles or palms.

Conversely, spots hidden by swimwear very rarely show melanoma.

The possibility of melanoma occurrence depends on factors such as reckless exposure to ultraviolet radiation, sunburns especially during childhood, phototype (skin type, hair and eye color) but also heredity (Dysplastic Mole Syndrome).

The rapid evolution of a mole and the suspicious changes in its characteristics are two points that need further evaluation by a specialist doctor.

When is a mole suspicious and what should we be concerned about?

A mole is considered suspicious (suspected of developing melanoma) when it shows a change in one of the following five places:

Points ABCDE (rule)

A= nevus asymmetry – change along one axis

B= irregular, indistinct boundaries

C=color change, variety of colors

D=diameter >6 mm


When and how should a suspicious mole be removed?

A mole is removed when it develops rapidly and its changes are characterized as suspicious. It is forbidden to remove the mole with laser or cryocoagulation. The mole is only surgically removed and the lesion examined histologically (biopsy).

People with many moles (or Dysplastic Mole Syndrome) and frequent sunburns are more likely to develop melanoma. Childhood burns are particularly to blame as the body seems to ‘remember’ and retaliate years later.

Dysplastic Mole Syndrome is characterized by the presence of 2 or more dysplastic moles. A mole that appears asymmetrical with varying color and irregular borders is characterized as dysplastic. Its evolution is slow over a period of years. People with DMS are considered to be at increased risk for developing melanoma and should be seen by a specialist more often than the rest of the population. Also of great importance is the monthly self-examination for early diagnosis and prevention.

In the early stages of melanoma, the disease is curable. Read more about moles.


Scar correction

What scars do we correct?

We correct: 

  • atrophic scar (scar with imprint due to lack of collagen and elastin),
  • hypertrophic scar (scar caused by excessive collagen growth, remaining at the edges of the incision),
  • keloid (a very raised scar that extends beyond the boundaries of the incision from excessive collagen growth).

Scar correction

A scar has healed well when it is of normal width, color and depth. A scar cannot disappear, but it can be replaced by a better quality scar. The plastic surgeon intervenes surgically (scar restoration, scar revision) when the scar has matured. That is, a year has passed since its creation. This happens because the scar until it matures has a dynamic to change.

How can we fix a scar?

A scar is repaired by:

  • the color (correction of dark or red color),
  • the depth (correction of scar atrophy or hypertrophy),
  • the width,
  • the direction.

Scar Treatment:

There are many possibilities for the plastic surgeon to correct a scar.

We distinguish between conservative treatment and surgery.

In the conservative treatment, we have at our disposal pressure with silicone sheets, steroid injections, hyaluronic acid injections, lasers of the latest technology type erbium fractional.

Surgical treatment consists in removing the scar, creating a new scar with better healing conditions.

Skin tumors

Sebaceous cysts are caused by inflammation of the sebaceous glands of the skin. The duct of the glands becomes clogged and does not drain the sebum. They appear on oily skin and very often on the scalp. When the cyst forms, it should be removed in its entirety and not drained. If not removed, it will continue to be inflamed, especially during periods of stress (with symptoms of pus, redness and pain).

Treatment: surgical removal of the cyst along with its lining to prevent it from forming again.

By the term skin tumor we refer to any lump originating from the epidermis, the appendages of the epidermis (hair, sebaceous glands), the dermis and the subcutaneous tissue.

Skin tumors are divided into:

  • Benign, with the most common being lipoma and sebaceous cyst
  • Malignant, with melanoma, basal cell and squamous cell carcinoma being the most common.

They come from the subcutaneous fatty tissue. They are of unknown etiology but do not cause discomfort or inflammation. They are removed for cosmetic or medical reasons when they are large enough to press on adjacent tissues. When their size increases rapidly, a test should be done to rule out liposarcoma, a rare malignant tumor.

Treatment: surgical removal of the tumor (+ biopsy).

Basal Cell Carcinoma of the skin (BCC, Basal Cell Carcinoma)
It is the most common skin cancer, but with a very good prognosis. In Australia (light-skinned, with a lot of sunshine), the largest percentage of the population (90%) develops basal cell cancer. It is directly related to the harmful effects of the sun, and develops in the areas of the body that are exposed to the sun. It is very slow growing, and manifests as a plaque or lump that often bleeds, while a wound that does not close is created. It never metastasizes.

Treatment: surgical removal of the lesion along with 5 mm of healthy skin around it (+Biopsy).

Squamous Cell Carcinoma (SCC)
It is the second most common skin cancer after basal cell. Squamous cell carcinoma occurs in damaged skin. Lesions (ulcers, burns) may be due to:

  • to the harmful effects of the sun,
  • in constant injury,
  • in places of constant pressure (such as heavy glasses that often press and injure the nose).

There is also an association with smoking (SCC is common in the oral mucosa) and with the human HPV virus.

Treatment: surgical removal of the carcinoma (+biopsy) along with at least 5mm of healthy skin around the lesion. Squamous cell is a more aggressive cancer than basal cell. It metastasizes, and its removal must be timely when diagnosed.

Melanoma is discussed in the chapter on moles.


When should a mole be removed?
A mole should be removed when:

  • is clinically suspected,
  • presents with itching, bleeding, as well as when it is in a place that is mechanically irritated by friction,
  • his presence creates a lot of anxiety for the person concerned.

Definition of Moles

Moles (olives) are divided into congenital moles (appearing at birth or the first months of life) and acquired (appearing throughout life).

These are flat or swollen lumps of brown or blue color. A large increase in their number is observed during puberty (due to hormonal changes). During puberty, moles darken and increase in size. Changes can occur after years, as well as during pregnancy.

It needs attention, because all changes are not always innocent.

When is a mole suspicious and what should we be concerned about?

A mole is considered suspicious (suspected of developing melanoma) when it shows a change in one of the following five places:

Points ABCDE (rule)

A= nevus asymmetry – change along one axis

B= irregular, indistinct boundaries

C=color change, variety of colors

D=diameter >6 mm


Risk factors – increased risk for developing melanoma

There are some factors that are more conducive to the development of melanoma.

These factors are:

  • fair skin phototype (type 1 or type 2),
  • number of moles (those with a large number of moles are more likely to metastasize),
  • sunburns, mainly during childhood or adolescence,
  • the dysplastic mole syndrome (atypical moles with irregular borders),
  • large congenital nevus (present at birth).

When is the best time to remove a mole?
Whenever necessary, the mole should be removed. During the summer months, it is recommended to apply sunscreen to the scar.

Mole removal process – Olive
The process is very simple. The removal is done under local anesthesia, and the mole is sent for histopathological examination (biopsy).

The mole should be removed in its entirety along with healthy skin around it, and sent for histological examination no matter how innocent it appears. Do not use a laser to remove it.

Recovery – Recovery Time after Mole removal
There is no abstinence from activities. The person concerned does not need to take any precautions. He returns to the doctor’s office to have the stitches removed and receive the histology response.  

Additional Information – Frequently Asked Questions about moles

What is dysplastic mole syndrome?

Dysplastic mole syndrome is characterized by the presence of 2 or more atypical moles on the body.

Atypical moles have the following characteristics:

  • are larger than common moles,
  • εthey are colorful,
  • they have irregular borders and shadow around them.

They appear during childhood, and their characteristics change during adolescence. Dysplastic nevi have a 6% higher chance of developing melanoma, while if there is a family history the chances increase to 15%. When the syndrome of dysplastic moles occurs, it is mandatory to self-examine the moles with the help of a mirror every month, but also to have them examined every year by the plastic surgeon or dermatologist. A lot of sun protection is also recommended. Apart from the common moles, congenital moles and dysplastic moles, are there other types of moles?

We mention them:

  • Cyan mole. This is a deep blue mole with clear borders that is unique and appears during childhood, with greater frequency on the extremities and dorsum of the hands. It does not present a possibility of transformation into melanoma.
  • Spitz’s mole. It appears on the face of young children as a lump of reddish or pink color.


Moles should be examined by a plastic surgeon or dermatologist once a year, because early diagnosis is crucial. Protection from the sun’s UVA and UVB rays is also important. Sunburns, especially during childhood, are responsible for the development of melanoma. Long exposure to the sun during life is responsible for the remaining skin cancers.

When a mole looks suspicious, we should immediately contact a Plastic Surgeon. Mole removal is a very simple and frequent minor surgery in Plastic Surgery.