When You Really Need To Avoid Laser Mole Removal

November 26, 2020

Updated: Thursday September 30, 2021
Dr Wan Chee Kwang
Est. Reading: 3 minutes

Moles are very common especially in sunny Singapore where the UV exposure contributes to mole formation. Mole removal is thus a very popular medical aesthetics treatment in Singapore. Laser mole removal can have fantastic results in many cases.

Despite their advantages, laser mole removal should not be performed for some moles. Why?

The Problem with Laser Mole Removal

There are two main types of lasers used to remove moles, ablative or pigment lasers. Different chromophores or skin components absorb laser energy depending on the wavelength of the laser used. Once absorbed, the laser energy is converted to heat, causing tissue damage to remove mole cells. This tissue damage comes in the form of heat damage for pigment lasers and physical vaporization for ablative lasers.

Laser mole removal has advantages for removing moles that are small or do not go too deep into the skin. Whilst lasers are very precise and selective, they physically destroy tissue leaving a wound and a variable amount of skin tissue behind.

This area of damaged skin would then have to heal from the surrounding skin tissue and stem cells in appendageal structures like hair follicles and sweat glands.

When Should Lasers Not Be Used For Mole Removal?

The very mechanism through which laser mole removals work means that they are ill-suited to some types of moles:

Big Or Deep Moles

If the resulting wound is too big or deep, it takes a long time to heal and can potentially result in a sunken scar that may be even more obvious than the original mole.

Potential Cancers

Since laser mole removal destroys the mole cells, the skin tissue will not be available for further testing and histological examination to confirm the presence or absence of cancerous cells. While laser treatment is unlikely to induce cancerous changes, lasering a skin cancer may alter its appearance making it more difficult to recognize or masking progression.

Recurrent Moles

Sometimes, despite prior laser mole removal, the mole grows back. At this point, it would be tempting to just laser it again. Sometimes, it may be okay to just repeat laser mole removal (I would recommend using a combination of ablative and pigment lasers for these).

However, it is important to be cautious and first examine the recurrent mole carefully. What could go wrong?

Well firstly, it is possible that what was thought to be a mole was in fact a skin cancer.

Secondly, a properly done laser mole removal would remove most traces of mole cells. Moles that grow back often have deeper 'roots' so repeat laser still may not clear them. Particularly, moles which grow back around hair follicles may have a nest of mole cells deep in the hair bulb, which is almost impossible to eradicate using laser alone.

Laser Mole Removal Has Its Place

Having said that, laser mole removal does work well for many moles. It is just not a panacea like many think. Rather than blindly choose laser treatment, it is important to have a medically trained expert who is experienced in mole removals to evaluate your mole and advise on the best way forward.

Would you like to find out more about mole removal? I’m always happy to share more! Please feel free to contact me.

References

  1. WOLF, R., RONAT, J., & FEUERMAN, E. J. (1983). Minor Aesthetic Blemishes. The Journal of Nervous and Mental Disease, 171(7), 452–453.
  2. Roh MR, Eliades P, Gupta S, Tsao H. Genetics of melanocytic nevi. Pigment Cell Melanoma Res. 2015;28(6):661-672.
  3. Alshami, M. A. (2013). Long-pulsed 532-nm Nd:YAG laser treatment for small acquired melanocytic nevi in a single session: an 8-year study on 350 Yemeni patients. Journal of Cosmetic and Laser Therapy, 16(1), 14–20.
  4. Kono, T., Erçöçen, A. R., Chan, H. H. L., Kikuchi, Y., & Nozaki, M. (2002). Effectiveness of the Normal-Mode Ruby Laser and the Combined (Normal-Mode Plus Q-Switched) Ruby Laser in the Treatment of Congenital Melanocytic Nevi: A Comparative Study. Annals of Plastic Surgery, 49(5), 476–485.
  5. August, P. J., Ferguson, J. E., & Madan, V. (2011). A study of the efficacy of carbon dioxide and pigment-specific lasers in the treatment of medium-sized congenital melanocytic naevi. British Journal of Dermatology, 164(5), 1037–1042.

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