Mole and skin cancer removal

Skin cancers are very common in New Zealand due to high levels of sun exposure, and the particularly high levels of UV radiation found in New Zealand.

Fair skinned people are most affected by the sun's radiation and often skin cancers appear later in life, particularly if the individual has had a lot of sun exposure over their lifetime. They tend to appear in areas that are most exposed to the sun; such as the face, arms, and legs, and while moles and skin cancers are not hard to remove it is important that a good cosmetic result is achieved when operating on areas such as the face.

Common types of skin cancer

The three common types of skin cancer are melanoma, basal cell carcinoma, and squamous cell carcinoma. If you have a mole that seems atypical in any way - one that changes in size and appearance, bleeds, is asymmetrical, is not uniform in color, has ragged edges, or seems unusual in any other way, it is important to have it examined by a doctor. They may recommend that you have it excised, and if diagnosed early, skin cancer can often be completely removed. Not all moles are cancerous, and you may choose to have non-cancerous moles removed if they are in an annoying area that rubs them, or if you are not happy with the way they look.

If your doctor determines that a mole is potentially cancerous, than it is most likely that they will recommend that you have it removed. This can be done using liquid nitrogen, lasers, or by surgical excision, however, it is generally accepted that there is a lower chance of recurrence if the mole is surgically removed. Also, having the mole removed surgically leads to a better cosmetic result, which is especially important in the head and neck region. Considerable care and skill is required to ensure that scarring is kept to a minimum when moles are removed from the face and neck, and special methods of closing the wound are used to ensure that scars are maximally hidden.

The procedure

Initially, a biopsy is usually performed to determine whether or not the mole is cancerous. This is done by either by cutting a small piece of the mole out with a scalpel, or with a small tissue punch, which takes a sample through the mole. The specimen is then sent to a laboratory and looked at under a microscope to see whether it is cancerous.

The mole can be removed then using liquid nitrogen, or by shaving with a scalpel blade. If the mole is on the face or neck, however, then it is usually removed surgically so that a better cosmetic result is achieved. Also, this method ensures that the deeper layers of the mole and the surrounding tissue are removed appropriately. The method of closing the incision depends on the size of the mole, and how much surrounding tissue needs to be removed. If a larger area is taken out, then a skin graft or local flap (where tissue is borrowed from the area surrounding the incision) may be used. For smaller moles the incision is closed very carefully with sutures.

The procedure usually takes less than an hour to perform and is done under local anaesthetic. You will be able to leave immediately after the surgery, but should take care to avoid getting the wound wet. The Long

Term outcome

The scar will fade with time and is often hidden in natural skin crease, making it very hard to detect. The chance of the mole or cancer recurring depends on the type of mole/cancer that was removed. In the case of deeper, and therefore more serious, melanoma the area is usually rechecked every couple of years. Sunscreen should be used to prevent further damage to the skin.

Risks

The risks associated with mole removal are minor and include:

  • If the shaving method is used, there is a risk that the mole will grow back within several years following the removal.
  • Surgical excision can sometimes produce scarring, especially in younger children. However, if scarring does occur, it can be eliminated by cosmetic surgery or skin resurfacing techniques.
  • Bleeding
  • There is a chance that not enough of the skin is removed, and then another wider excision will be necessary.

Costs

The cost of the operation varies depending on the amount of tissue that is taken, the method of closure of the wound (direct, grafting or using a flap), and the surgeon who is operating. Mole removal can cost between $600-$1200.

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