A mole, medically called a nevus, is a cluster of melanocytes, the cells that give skin its color. Mole removal always starts with an assessment of the mole itself. Some moles are present from birth and are called congenital nevi. Others appear over a lifetime, influenced by sun exposure and genetics. Large congenital moles may need lifelong monitoring, and any surgery is planned with the relevant specialists.

The vast majority of moles are harmless. Mole removal may be done for different reasons:

• Cosmetic reasons: Moles on the face or other visible areas that bother you.
• Physical discomfort: Moles that catch on clothing or jewelry, or bleed when shaving.
• Medical reasons: Removing moles that have changed in shape, color or size, or look suspicious, so they can be examined in a lab (pathology).

Skin tags are skin-colored, harmless growths on a small stalk. They are different from moles but can be assessed at the same appointment.

Every mole should be assessed before removal; only then is it decided whether a cosmetic method can be used. Warning signs are summarized by the “ABCDE” rule:

• A (Asymmetry): The two halves of the mole don’t match.
• B (Border): The edges are irregular, notched or blurred.
• C (Color): More than one shade within the same mole.
• D (Diameter): Larger than 6 millimeters.
• E (Evolving): Changes in size, shape or color over time; itching or bleeding.

A mole that looks clearly different from your other moles also needs attention. Moles with any of these features are referred for a dermatological assessment and, if needed after dermatoscopy, removed surgically and sent for pathology. Cosmetic methods such as laser or plasma are not used on suspicious moles, because they vaporize the tissue and leave nothing to examine. Regular mole checks are recommended for people with many moles, a family history of skin cancer or frequent sunburns.

The method is chosen according to the type and depth of the mole and where it is. Your medical history and medicines are reviewed first, and then the area is numbed. If you take blood thinners, tell your doctor beforehand, but don’t stop them on your own.

• Surgical excision: The mole is removed together with a thin strip of healthy tissue around it, and the area is closed with fine cosmetic stitches. It is used for deep-rooted moles or those that need examining; the tissue goes to pathology, which shows whether follow-up is needed.
• Laser: May be used for superficial, pigmented moles assessed as harmless.
• Plasma energy: For superficial moles and skin tags, the tissue is vaporized with limited effect on its surroundings. It may be preferred for delicate areas such as around the eyes. See plasma energy treatment.
• Radiofrequency and cautery: Used to remove small skin tags quickly.

Laser and plasma usually take a few minutes; surgical excision takes 15–20 minutes. Pathology results usually come back within a few days to a few weeks.

You can usually return to your day straight away. Mild redness and crusting may appear for a few days.

• Leave the scab alone: Don’t pick it off before it falls away on its own; otherwise the risk of a scar increases.
• Hygiene: Keep the area clean and dry as your doctor advises, and use the prescribed cream regularly.
• Sun protection: Healing skin is sensitive to the sun; without protection, a dark mark may remain.
• Stitch care: After surgery, stitches are usually removed within 5–14 days, depending on the area.

In the first days, keep the area dry and avoid pools, the sea and saunas. Once the scab falls off, the new skin may look pink; this color usually blends with the surrounding skin over weeks.

Any procedure can leave some mark, depending on your skin and the area treated. Noticeable scars can be treated with scar treatment, and any remaining darkening can be addressed with skin spot treatments.

A mole removed together with its root is not expected to return in the same spot, and the risk of recurrence after surgical excision is low. With superficial moles removed by laser or plasma, cells left deeper in the skin may make the mole visible again over time; in that case the procedure can be repeated.

Removing a mole doesn’t stop new ones from forming elsewhere; these are linked to genetics and sun exposure. Use sunscreen, avoid the midday sun and check your moles in the mirror once a month, asking someone to look at areas you can’t see, such as your back. If color returns where a mole was removed, come in for a check-up.