Facial nevi, also referred to as moles or “birthmarks”, are benign lesions on our skin that are rarely a cause for concern. They are typically brown or black and can be present since birth or develop over time. Many patients are not bothered by their appearance and no intervention is required. Sometimes however, these lesions can be unsightly or in prominent locations that draw attention away from the rest of our face. They can even be irritating or uncomfortable which prompts the patient to seek care. In these cases, patients can elect to have the lesions removed.
With any lesion on our skin, it is of utmost importance to ensure that it is not cancerous or cause for concern. Dr. Hall, along with the experts at Golden State Dermatology, is well versed in the various skin conditions and their treatment. If there is any concern, the lesion will be sent for pathological analysis.
Common skin conditions that can be treated include pre-cancerous lesions, nevi or moles, seborrheic keratosis, epidermoid cysts, sebaceous cysts, mucoceles, lipomas, skin tags and syringomas.
These lesions can be removed in the office with only local anesthesia. Patient’s go home the same day with minimal discomfort. If a patient prefers, or if the lesion is in a sensitive location, IV sedation can be utilized as well.
The size, shape and pathology of the lesion often dictates how it is removed. Most commonly, complete surgical excision is performed. This entails carefully orienting an incision along relaxed skin tension lines, the natural lines and creases of our body, which creates a scar that is barely perceptible once healed. The lesion is then completely excised and the wound is meticulously closed. This procedure takes anywhere from fifteen minutes to one hour.
Another option for removal of raised lesions in particular is shave excision. This entails slicing the lesion off so that it is flush or even with the surrounding skin. This often does not completely remove the lesion but can provide an excellent cosmetic result with no obvious scar.
A laser can be used for some skin lesion but it often entails multiple treatments with incremental improvement. Surgical excision can often be a more effective treatment option. Other times, laser treatment is warranted. At your consultation, Dr. Hall will be able to go over both options and determine which is better suited for you.
If there is any concern by the physician or if the patient prefers, the lesion is sent for pathology. Once the pathology comes back, the patient is informed of the results and if any further treatment is necessary.
If your lesion comes back as cancerous you may need an additional excision to ensure complete removal. A margin of tissue will be excised around the previous lesion and sent for further pathology. Typically, the wound is repaired at the same setting.
Recovery depends on how the lesion is removed. If you undergo surgical excision you will have sutures in for one week. You may return to work if you would like as long as there is no heavy physical labor or significant sun exposure. Once the sutures are removed, you can resume all physical activity. If you have a shave excision, there are no sutures. You will just need to avoid sun exposure.