Can a mole return after it is removed?

Moles are a common occurrence on the skin.

They are usually benign, but may sometimes present as a physical obstacle in daily life (for clothes, jewelry, etc.) or become an aesthetic issue.

The latter happens when a mole is in a prominent location or it has a peculiar size or shape.

People who have moles that are bothering them in any way, often look for ways to remove them.

Modern medicine has plenty of solutions, but one question remains: Can a mole return after it is removed?

This article has the answer.

Overview

Moles can come back after removal. That is a realistic risk, and it does not happen due to a doctor's mistake or some health-hazardous process.

It is difficult to predict if all the mole cells are removed from the skin, despite the best efforts. If there are still some, the mole retains its growth potential.

However, when the mole removal procedure is done right, the mole is unlikely to return.

But, if it does, don't assume it is something dangerous. However, you should visit your doctor to examine the new growth and discuss further actions.

What makes a mole grow?

Moles are made of skin cells. More specifically, the cells that produce pigment (hence the darker color).

When these cells are highly concentrated in a certain location, they constitute a mole.

The usual shape and color of a mole are – circular and brown.

Although, these can vary too. Moles do not affect your health, but they can look unattractive or be positioned in an undesirable location.

The reason why some moles come back is the incomplete removal procedure.

Doctors, unintentionally, fail to extract, freeze or destroy (laser) all the mole cells.

So, a tiny amount of remaining cells continues to multiply and grow, until there is a new mole at the same location.

The mole cells act like tree seeds and as long as they are inside the skin, the mole can grow back.

Some people worry that the new growth is cancerous.

That is usually not the case, but an additional removal procedure is nevertheless necessary if the regrown mole becomes an aesthetic or functional issue.

Mole Removal Techniques

There are several mole removal techniques.

All are performed by highly-trained, certified, dermatologists. From a patient's perspective, the mole removal procedures mainly differ in convenience.

Some require incisions, stitches, and a longer recovery, while others are quicker and simpler.

The risk of a mole returning exists with all mole removal treatments, but it is not the same.

It is vital to understand that (non-cancerous) mole removal has no medical indications.

It is usually an aesthetic procedure.

Therefore, a cosmetic outcome plays an essential role in picking the removal technique.

• Surgical Excision

Surgery is a traditional but reliable technique for mole removal.

The procedure is safe, quick, and simple, but it involves cutting the mole out.

So, people who have a strong dislike for sharp surgical tools and incisions, tend to look for less invasive mole removal options.

Here's what a surgical mole excision procedure looks like: A doctor will first use a local anesthetic to numb the part of the skin where the mole is located.

After a short time, the area goes numb, so the doctor can safely use surgical scissors to cut the mole out.

It is not easy to predict the depth of the mole. Some may reach deep into the skin, and for successful surgical mole removal, the incision must go deep too.

That makes stitches necessary. They have to remain until the wound heals completely.

Surgical excision rarely allows for a mole to come back. However, you may end up with a small scar after the procedure.

• Shaving

We can say that shaving is a lighter version of surgical excision.

That means there are still sharp tools involved, but there is no proper cutting.

A surgeon again uses a local anesthetic to numb the skin around the mole.

Then they use a scalpel to shave the mole until it is just a tiny pink blemish on the surface of the skin. The main advantages include:

· No excision

· No stitches

· Shorter recovery

· No scars

The shaving technique often leaves some mole cells inside the skin. So the risk of a mole returning after the procedure is higher.

• Electrosurgery

Electrosurgery combines electrocautery and radiofrequency to remove skin growth, such as moles, freckles, or wisdom spots.

Electrosurgery devices “burn off” the mole without leaving prominent scars. However, it remains possible for the mole to return.

• Freezing

Benign (non-cancerous) moles that are not deeply rooted in the skin can be frozen with liquid nitrogen.

Freezing is a quick and painless mole removal technique.
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There is no need for anesthetics or incision. You may temporarily have a small tender blister at the treatment site after the procedure. It is not likely a mole will return after freezing, but it is possible.

• Laser Treatment

Laser treatment is a modern approach to mole removal. It is a minimally invasive technique, so there is no need for incisions.

Here's how laser mole removal works: A doctor uses a laser device to destroy skin cells that make up the mole.

The energy of light from the laser targets only mole cells and does not damage any surrounding tissues.

Laser treatment does not create a wound and it does not require stitches.

That is why it's particularly convenient in exposed areas, such as the face or ears. However, the risk of a mole returning after laser removal is higher than with surgery.

The Bottom Line

A mole can return after removal, regardless of the technique.

All it takes is a few mole cells remaining in the skin, and the growth potential is there. The new mole can be smaller, larger, or similar in size to the one that was removed. However, none of this is a reason to worry. Chances are you’ll only need another mole removal procedure.

References:

1. Reddy Bandral M, Gir PJ, Japatti SR, Bhatsange AG, Siddegowda CY, Hammannavar R. A Comparative Evaluation of Surgical, Electrosurgery and Diode Laser in the Management of Maxillofacial Nevus. J Maxillofac Oral Surg. 2018 Dec;17(4):547-556. DOI: 10.1007/s12663-018-1081-8. Epub 2018 Feb 6. PMID: 30344399; PMCID: PMC6181846.

2. Sardana K. The science, reality, and ethics of treating common acquired melanocytic nevi (moles) with lasers. J Cutan Aesthet Surg. 2013 Jan;6(1):27-9. PMID: 23723601; PMCID: PMC3663172.

3. Zager JS, Hochwald SN, Marzban SS, Francois R, Law KM, Davis AH, Messina JL, Vincek V, Mitchell C, Church A, Copeland EM, Sondak VK, Grobmyer SR. Shave biopsy is a safe and accurate method for the initial evaluation of melanoma. J Am Coll Surg. 2011 Apr;212(4):454-60; discussion 460-2. DOI: 10.1016/j.jamcollsurg.2010.12.021. PMID: 21463767; PMCID: PMC4505798.

4. Vittoria, M.A., Kingston, N., Kotynkova, K. et al. Inactivation of the Hippo tumor suppressor pathway promotes melanoma. Nat Commun 13, 3732 (2022). https://doi.org/10.1038/s41467-022-31399-w