MOLE REMOVAL

Laser mole removal is suitable for small, flat, benign pigmented moles that have been assessed as clinically non-suspicious. Raised,
irregular, or recently changed moles, those that itch or bleed, or those in high-friction areas are better managed by surgical excision. Dr
George performs dermoscopic and clinical assessment to determine the appropriate treatment for each lesion. Any ambiguous mole will be
excised and sent for histopathology.

Before treatment: skin check and referral
Before we can begin, you must have had a full skin check within the past 6 months, performed by Dr Robert George or your own GP. You will need to provide a referral as evidence that this has taken place. Treatment cannot commence without it.

Step 1: Consultation and mole assessment
Your appointment begins with a consultation with your doctor. They will review your skin check referral, your medical history, your skin type and any changes you have noticed in the mole. The mole is examined closely, which may include dermoscopy, a handheld device that magnifies the skin and allows the doctor to look at the mole’s structure and pigment pattern in detail. Your doctor will then decide whether the mole is suitable for removal and which method is most appropriate. You will have the opportunity to ask questions and discuss your goals, and you will be asked to sign a consent form before treatment begins.

Step 2: Choosing the removal method
The method depends on the type, size, depth and location of the mole, whether it is raised or flat, and your skin type. Your doctor will explain the options and recommend the safest approach for you. In some cases the first method planned may change once the mole has been assessed more closely or during the procedure itself. The options are surgical excision, shave removal, CO2 laser removal and Pico laser treatment.

Surgical excision may be necessary
Some moles need to be removed surgically, and your doctor may recommend this if:

• The mole is deep, large or extends below the surface of the skin
• The mole has features that need to be examined by a pathologist
• A complete removal is required to reduce the chance of the mole returning
• The mole appears unusual, or the diagnosis is uncertain

Surgical excision is a minor procedure carried out under local anaesthetic. It involves cutting out the mole, usually in a small oval or elliptical shape, along with a small margin of surrounding skin where required. The wound is then closed with fine stitches, and the shape of the cut is planned to help the scar lie along the natural lines of your skin. Surgical excision usually leaves a thin line scar, and the scar will be longer than the mole itself. Your doctor will explain this before you decide to proceed.

Shave removal
A raised mole is removed level with the surrounding skin using a fine surgical blade, and the area is treated to control bleeding. Stitches are usually not needed. The area heals as a graze, and a flat mark may remain.

CO2 laser removal
For suitable, raised benign moles, a CO2 laser may be used to remove the mole in thin layers. The area is cleaned and numbed with a local anaesthetic, and you will be given protective eyewear. The laser is then passed over the mole, gently vaporising the tissue layer by layer until it is level with the surrounding skin. Bleeding is minimal, and stitches are usually not needed. A small wound remains, which heals over [1 to 2] weeks and may crust or scab during that time. Because the tissue is vaporised, a sample can’t be sent for testing afterwards. If your doctor thinks a mole should be tested, they may recommend a different method, or may take a sample before laser treatment.

Pico laser treatment
Pico laser is a picosecond laser that delivers very short pulses of light energy. The energy targets the pigment in the skin and breaks it into fine particles, which the body then clears naturally over the following weeks. It does not cut or remove skin. Pico laser may be suitable for flat, benign pigmented marks, and it is not suitable for raised moles or for any mole that needs pathology testing. Your skin is cleansed, protective eyewear is provided, and the laser is passed over the treated area. You may feel a snapping or warm sensation, and a topical numbing cream may be used if needed. The treated area may darken or look slightly frosted straight afterwards, then form a fine scab or flake away over [7 to 14] days. Several sessions, usually spaced [4 to 8] weeks apart, are often needed, and the mark may lighten without clearing completely. A patch test may be performed before treatment.

Step 3: Preparing the skin and numbing the area
The area is cleaned with an antiseptic solution and marked where needed. A local anaesthetic is then injected to numb the area, which may sting briefly. Once the area is numb, you should feel pressure or movement but not pain. If you feel any discomfort during the procedure, tell your doctor straight away.

Step 4: Removing the mole
Your doctor removes the mole using the chosen technique, working carefully in a clean environment with single-use equipment where applicable. Bleeding is controlled during the procedure. If you are having a surgical excision, the wound is closed with stitches, and in some cases deeper stitches under the skin are used to support healing.

Step 5: Pathology testing
Where a mole is removed surgically or by shave, it is usually sent to a pathology laboratory to be examined under a microscope. This is an important safety step that confirms the type of mole and checks that it was fully removed. Results usually take around [7 to 14] days, and you will be contacted to discuss them. Any mole that is found to need further treatment will be followed up with you, and you may be referred for further care. Pathology fees apply and are separate to your treatment fee.

Step 6: Dressing and aftercare instructions
Once the procedure is complete, your wound is cleaned and dressed. Your doctor and the team will go through your wound care instructions with you before you leave, and you will be given a written copy. Most patients can go home straight away, and many return to normal activities the same day, but this depends on the location of the mole and the method used.

How long does it take?
Most procedures take around [15 to 45] minutes, although your appointment will be longer to allow time for your assessment, consent and aftercare. Surgical excisions generally take longer than shave or laser removals.

Stitches and follow-up
If you have stitches, they are usually removed after [5 to 14] days, depending on where the mole was. The face tends to heal faster than the back or legs. Your doctor will advise when to return for stitch removal, or to review your wound after laser treatment.

What to expect after treatment

• Tenderness, tightness or mild discomfort as the anaesthetic wears off, which can usually be managed with simple pain relief, as advised by your doctor
• Redness, swelling and mild bruising around the treated area
• A scab, crust or dressing over the area for the first [1 to 2] weeks
• A pink or red mark that matures over several months, and may be lighter or darker than the surrounding skin

Possible risks
All procedures carry risks, which will be discussed with you before you proceed. These can include bleeding, infection, delayed wound healing, wound opening, scarring (including raised, widened or thickened scars), changes in skin colour, numbness or altered sensation near the treated area, regrowth or incomplete removal of the mole or pigment, and the need for further treatment or a second procedure, including a wider excision if pathology results require it. Laser treatments carry additional risks of burns, blistering and pigment changes.

Before your treatment
Preparing properly helps your wound heal well and reduces the risk of complications. Your doctor and the team will give you personalised instructions, but in general you will be advised to:

• Bring your skin check referral. You must have had a full skin check within the past 6 months, by Dr Robert George or your GP, and we need to see your referral before treatment can commence
• Tell us about all medications and supplements, especially blood thinners such as aspirin, warfarin or anti-inflammatories, and do not stop any prescribed medication unless your doctor advises you to
• Let us know about any allergies, particularly to local anaesthetic, antiseptics, dressings, tape or latex
• Tell us if you have a history of keloid or raised scarring, poor wound healing, bleeding problems, diabetes, or if you smoke, as these can affect healing
• Tell us if you are pregnant or breastfeeding
• Avoid sun exposure, tanning, fake tan and solariums on the treatment area for at least [2 to 4] weeks before treatment, especially if you are having laser
• Avoid alcohol for [24 hours] before treatment, as it can increase bleeding
• Avoid shaving, waxing or applying products to the area on the day
• Eat a normal meal beforehand, and wear comfortable clothing that allows easy access to the treatment area
• If you are having a mole removed on your back, shoulders or legs, consider bringing a support person, as you may feel uncomfortable driving afterwards
• Let us know if you have a history of cold sores if the mole is near your mouth, as laser treatment can trigger them

On the day of treatment
Your doctor will review your skin check referral, examine the mole and go through your consent form with you before starting. Treatment may be postponed if the area is sunburnt, irritated or infected.

Immediately after your treatment
Your wound will be cleaned and dressed before you leave. The area will be numb for a few hours, so take care not to knock, burn or injure it. Once the numbness wears off, you may feel tenderness or tightness, which can usually be managed with simple pain relief, as advised by your doctor.

Caring for your wound: stitches (surgical excision)

• Keep the dressing clean and dry for [24 to 48] hours, or as advised
• Follow your doctor’s instructions about when and how to change the dressing
• Avoid soaking the wound in baths, spas, pools or the ocean until it has healed
• Avoid strenuous exercise, heavy lifting, stretching and movements that pull on the wound until your stitches are out, especially for moles on the back, shoulders, chest or legs
• Do not pick at the stitches or the wound
• Attend your appointment to have your stitches removed, usually after [5 to 14] days, depending on the location

Caring for your wound: shave removal

• Keep the area clean and dry for the first [24 to 48] hours, or as advised
• After this, gently clean the area as directed and apply the ointment and dressing recommended by your doctor
• Keep the wound moist and covered as advised, as this helps healing and may reduce scarring
• The area heals as a graze and may take [1 to 3] weeks, depending on its location

Caring for your wound: CO2 laser removal

• The area will look like a graze and may weep for the first few days
• Follow your doctor’s instructions about cleaning and applying ointment or dressings
• A scab or crust will form and should fall away on its own, usually within [1 to 2] weeks
• Do not pick or peel the scab, as this can cause scarring and pigment changes
• Avoid makeup, creams and active skincare on the area until it has healed, unless advised

Caring for your skin: Pico laser treatment

• The treated area may look darker, frosted, red or slightly swollen straight after treatment
• A fine scab or flaking may form and fall away over [7 to 14] days. Do not pick it
• Apply any soothing or healing products recommended by your clinician
• Avoid hot showers, saunas, spas and swimming for [24 to 48] hours
• Avoid exfoliating products, retinoids and active ingredients until the skin has healed
• Several sessions are often needed, and you should not have another treatment until the skin has settled

Sun protection
Treated skin is more vulnerable to pigment changes and poor scarring. Once the wound has closed, protect the area from the sun using a broad-spectrum SPF 50+ sunscreen and clothing or a dressing, as advised. Do this daily for at least [6 to 12] months while the scar matures.

Scar care
Once your wound has fully healed and your doctor says it is safe, they may recommend scar care such as silicone gel or sheets, or gentle massage. Scars continue to change over several months and may look pink or red at first. Individual results vary, and scarring cannot be completely avoided.

Pathology results
If your mole has been sent for pathology, our team will contact you when the results are ready, usually within [7 to 14] days. Please make sure we have your correct contact details. Do not assume that no news means a normal result, and contact us if you haven’t heard from us within the time we advised. If further treatment or review is needed, we will talk you through your options.

What is normal after treatment?

• Mild tenderness, tightness or an itching sensation as the area heals
• Redness, swelling and mild bruising around the wound
• Clear or slightly yellow fluid on the dressing in the first few days
• A scab or crust forming over the area
• A pink or red mark that settles over several months

When to contact us
Please contact the clinic promptly if you experience:

• Increasing pain, swelling or heat around the wound
• Bleeding that does not stop after [10 to 15] minutes of firm, continuous pressure
• Pus, a bad smell, spreading redness or red streaks
• A fever or feeling unwell
• The wound opening or stitches coming loose
• Any change in the area, or regrowth of pigment, after healing