News & Features


Facial Moles: Not Such a Mark of Beauty, After All

Mole Removal Explained


Untitled Document

Medically Reviewed by Paul Steinwald, M.D.

Mole
Asymmetry Check

As people become more and more aware of the damage too much sun exposure does to skin, consumers are going to dermatologists concerned about the health of their skin, including facial moles which many want removed. Standard mole removal with a scalpel and laser mole removal is also often performed at the offices of plastic and cosmetic surgeons.

In the late 1990s, Susan Somers worked at a radio station and, being totally tuned into pop culture, thought facial moles were pretty cool. After all, Madonna and Cindy Crawford had already made beauty marks the equivalent of fashion statements.

And why not? In addition to Marilyn Monroe, classic beauties like Elizabeth Taylor, Julia Roberts, Gwyneth Palthrow and Scarlett Johansson sport moles on their radiant faces. A few leading male actors -- like Robert DeNiro, Matt Damon and Arnold Schwarzenegger -- appeared in films with prominent facial moles.

“When I was younger, I loved having a large mole, near my lip,” says Susan. “I thought the blemishes added beauty and character.”

Mole
Border Check

Actually, Susan had three moles on her face which grew as time passed. Some sprouted hairs and if she injured or brushed one against something, it bled.

Finally, a girlfriend urged Susan to see a doctor about her largest mole, next to her lip, which had grown to the size of pea. Two others, one close to her nose and another near her eye, were also growing.

“Many more patients are having ‘beauty marks’ removed,” says Brent Moelleken, M.D., a board certified plastic surgeon who is also an assistant clinical professor at the University of California, Los Angeles. “Moles that become large and unsightly are prime candidates for removal.”

Facial Moles in History

But throughout most of history, facial moles were not considered objets d’art on faces of lovely faces. Rather most moles were considered hideous growths that appeared mostly on the noses and chins of witches, frogs and other low creatures.

In the 16th century, Richard Sanders (1613 - 1687) invented a popular pseudoscience that supposedly described how every facial mole had a corresponding birthmark (the so-called “moleosopher”) somewhere else on the body. Once you knew where both moles were, the theory went, you had the inside track on what made the person tick. For instance, if a man had a mole on the bridge of his nose, he supposedly had another on his right thigh. Taken together, Sanders opined, the moles meant the owners were persons of good moods and would eventually receive healthy inheritances.

Mole
Color Check

Mole Removal

Of course, moles are no longer considered precursors to one’s personality.

Dermatologists, along with cosmetic and plastic surgeons often remove them, either with a scalpel or a laser because the blemishes can turn into skin cancer (melanomas) which can invade other internal organs. The lymph nodes may be invaded by cancer cells if the melanoma becomes invasive. Of course, melanomas don’t always spread and certainly can become a problem from any location, not just the face. After the lymph nodes, vital organs like the liver are affected.

The most common type of mole is raised above the level of the skin; the second most common is darker and raised like the ones on the face of Susan Somers. Now older and wiser, she heads her own public relations firm in Las Vegas and had all of her moles removed by a doctor who applied a freezing solution and then shaved the moles with a scalpel.

“My skin healed up nicely and you can barely see the scars,” Susan says.

Mole
Diameter Check

Natural Mole Removal

Basically, the most common types of moles are:

  • Skin tags - That is a small growth that may have a narrow stalk. Skin tags are usually flesh-colored or a little darker. A physician can easily clip them off.
  • Raised moles - These can be a variety of colors and run deeper into the skin than flat moles which are usually taken off (excised) with a scalpel.
  • Flat moles - Any dark spot or irregularity in the skin is a flat mole. One to three laser treatments can remove them.

Mole removal patient, 26-year-old K.S. (who asked to be anonymous,) explained she recently had about 20 moles removed from her neck, body and legs because the moles started showing commonly recognized -- at least to doctors -- danger signs.

“If a mole starts changing in color, size or shape, especially, if the border develops ragged edges, see a dermatologist,” says Douglas Taranow, M.D. a New York City plastic and reconstructive surgeon. “And make sure what’s removed is sent to the pathology lab to check for skin cancer (melanoma.”)

Explains K.S.: “My family and I have a condition, dysplastic nevi syndrome, which causes rapid growth of moles all over the body. So I must be checked every three to six months. During the check, suspicious moles are taken off and biopsied. Afterwards, I do everything possible to stay out of the sun, least I grow even more moles.”

Adds Brent Moelleken, M.D., a Los Angeles plastic surgeon and University of California assistant professor: “When a dermatologist or plastic surgeon determines that a mole should be removed, the decision on how to remove it depends on which type of cancer is suspected. Many clinical judgments go into deciding how to remove a mole and whether a frozen section is required for the pathologist.”

Laser Mole Removal

Cindy Crawford
Experts think that Cindy Crawford’s beauty mark is probably benign.

If the surgeon shaves off a mole level with the skin, he or she uses an electrical instrument afterwards to burn (cauterize) the stump. But, in cases where the surgeon needs to remove some healthy skin next to and under the mole -- ensuring any cancerous cells are captured -- he makes an incision around the mole in the shape of an eye. Self- absorbing stitches are placed deep in the wound while several non-absorbing sutures are used to close the upper surface and are removed later.

When a laser is used on a flat mole, it often requires two to four appointments to completely remove all the dark pigment.

In cases of suspect moles, if the lab finds any unusual features, the patient would see her physician for a follow-up check of the area and full body exam. A positive sample would also result in a quick check of the patient’s lymph nodes, probably while all concerned hold their collective breath.

“The easiest way to tell a mole needs some medical attention is to remember the mnemonic, A-B-C-D,” says Joel Schlessinger, M. D., a board certified dermatologist and incoming president of the American Society of Cosmetic Dermatology and Aesthetic Surgery (ASCDAS.)

The letters mean:

  • Asymmetry - One half of the mole is different than the other.
  • Border Irregularity - At the edge, or border, melanomas are usually ragged, notched or blurred.
  • Color - Benign moles can be any color, but melanoma often has a variety of hues and colors within the same mole.
  • Diameter
Melanomas are usually larger than a pencil eraser in diameter but can be smaller. If a mole is different from others and if it changes, itches or bleeds, even if it’s smaller than a pencil eraser, see a doctor.

While experts declare that most moles are benign, the National Cancer Institute says melanoma is the most serious type of skin cancer with more than 53,600 new cases reported yearly in the United States.

Publicist Morgan Futch, 26, in Rockville Centre, New York, noticed a mole on her eyelid. And then it started feeling like an eyelash was constantly brushing her eye.

“Minimal scarring and how the eyelid looked afterwards were very important to me,” says Futch who started her search for a dermatologist online. She was referred through two other physicians until landing at the office of Peter J. Wong, M.D., a New York City ocular plastic and reconstructive eye surgeon who removed a wedge-shaped piece of the eyelid where the pesky mole sat.

“I missed a day and a half of work and looked fine two weeks later,” Futch says. “I later found out I was referred around so much because the mole was in very critical position.”

Adds Dr. Taranow: “Eye-shaped incisions on suspicious lesions are often necessary because a circle is harder to close with sutures.”

But when it comes to beauty marks in general, perhaps we should remember the wise observation of 1940s writer, musician and politician “Kinky” Friedman who once wrote “beauty is often in the eye of the beer holder.”




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