What is Nevus (Mole, Birthmark)?
A nevus is a dark spot on the body caused by clusters of overactive coloured skin cells. Sometimes there is also hair protruding from the nevus. It is more colloquially known as a mole or birthmark, and usually appears after birth anywhere on the body. Sometimes, these nevi may develop into skin cancer, so it is important to regularly monitor any changes to it. The risk of a nevus turning cancerous is related to its size, colour, location and shape. Your doctor would be best at determining if a nevus is vulnerable.
What are the signs and symptoms?
You can typically recognize a nevus from its much darker colour compared to the surrounding skin. Variations on nevi include the size, the presence or absence of hair, regular or uneven borders, or a texture that can feel either smooth or flaky. Make sure you and your family doctor regularly monitor your nevus, and report any changes to it such as bleeding, colour change, inflammation, itching, ulcerations, pain, or a change in size and texture.
The ABCs for the signs and symptoms of skin cancer (melanoma)
If your skin lesion or mole exhibits any of the following traits, you should go and see your doctor who would be able to correctly assess whether it is malignant or be able to send you to a specialist who can.
Asymmetry – the skin lesion is not round and symmetrical
Border – the border of the lesion is uneven
Colour – the lesion has multiple colours including brown, black and/or tan
Diameter – the size of the mole is larger than 6mm
Enlarging – the lesion is rapidly growing in size
What kind of tests can I undergo?
As a precaution, you or your doctor might measure the mole and/or take pictures of it every year to check if it is increasing in size. A sudden size increase could indicate that the mole has turned into skin cancer, and it would need to be excised if it had. A skin biopsy, where a section of the mole is removed for testing, could also help to determine if there are any cancer cells present.
What are the treatment options?
Usually, no treatment is needed if the nevus is not changing and your family doctor does not consider it to be harmful. Careful monitoring and the use of strong sunscreen when outdoors are sufficient preventative measures. However, if your doctor thinks that it may pose a cancer risk, or if it is causing emotional issues because of its appearance, then surgery is an option. Lasers and dermabrasion are also alternative treatment options, but these may not remove the root of the mole and would also make it more difficult for a doctor to detect skin cancer. Multiple treatments of laser or dermabrasion may also be necessary to achieve the desired result.
What can I expect from surgery?
The surgical procedure to remove a smaller nevus is quite easy. The surgery itself would typically take approximately 15 minutes. Local freezing would be used, and about 20-30 minutes would be added to the surgery time to allow for the freezing to set in. However, because of the local freezing, the patient would be fit to drive home afterwards. Once the specimen has been excised, it will be sent to a lab to be tested for any malignancy. Stitches will be needed, and will typically be removed 5-14 days later, depending on the size and location of surgery. Redness is normal even after the stitches have been taken out, but after 4-6 months the scar should be hardly visible. There should be minimal to no pain after the local freezing has worn off, but Tylenol Extra Strength can be taken if there is.
What are the risks?
The risks of excising a nevus are very rare but can include infection, suture reactions, bleeding, bruising, and scarring. Please speak to your doctor about any medications you are taking and if you have had abnormal scarring (keloids or hypertrophic scars) in the past.
How much will it cost?
Unfortunately, the surgery to remove a benign nevus is not covered by OHIP. A consultation with Dr. Hong is recommended to find out the exact price for your procedure. Without a referral from your family doctor, an $95 consultation fee will be required, but it will be applied towards the cost of the surgery. There is no additional fee for follow up appointments such as the removal of sutures.
Nevus: Before Treatment
Nevus: After Treatment
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Frequently Asked Questions
If you are concerned with the appearance of fine lines, wrinkles, acne and other form of skin damage caused by environmental factors or aging.
Chemical peels can leave the skin to look more youthful, radiant, fresh and healthy. A mixture of chemicals is applied onto the skin and it strips off dead/damaged skin cells to allow for new and healthier skin growth.
Any form of treatment comes with the risk of infection. Patients will experience a burning sensation, redness, and sensitivity to the sunlight. If you are no protecting yourself from sun exposure and not using bleaching agents you may develop hyperpigmentation. Some patients may have an allergic reaction to the chemical peel and swelling.
Microdermabrasion and IPL (Intense Pulsed Light), laser and RF devices are possible alternative.
Surgical options are mostly effective for reducing fine lines/wrinkles, such as different types of laser resurfacing, face-lift and autologous fat grafting. It is best to discuss this during your consultation.
It is not mandatory and patients will not experience serious adverse effects, therefore it is dependent whether the patient is willing to take time off from their daily routine and set aside a week to avoid any contact with other people.
The chemical peel will be done in my office.
Yes and it is dependent on the sensitivity of your skin, skin colour/pigmentation, age, the severity of skin damage, and degree of chemical peel.
Photos previous patients that have undergone different types of chemical peels are provided and can be found on my website or through consultation.
Photos (before & after) of previous patients are provided and can be found on my website or through consultation.
The results usually last for months to years, however the duration is dependent on how well the patient is able to follow preoperative and post operative skin care instructions and their efforts to avoid excess exposure to sunlight.
This will depend on the amount of sessions needed and the degree of chemical peel needed.
The first week, there will be redness and possible scabbing but it will go down as time goes by.
The procedure can vary from 30 minutes to 3 hours.
There is no pain but patients will feel a burning sensation.
Patients can return to their normal routine right away, however to look presentable (reduce in redness), it may take up to a week or even longer if the peel is deeper.
It is suggested patient comes in 30 minutes before the scheduled appointment time, and that the patient has set aside some time for the procedure and recovery.
The contact information is available on my website.
- Call your doctor if you think of other questions
Please email or call my office.
- Make sure you have the doctor’s contact information
- How long will my procedure take?
It can range from 30 minutes to 3 hours.
- Make sure your procedure has been confirmed
- Confirm any allergies and side-effects you might have
- Make sure you understand and have signed the informed consent forms
Patients should strictly follow all postoperative care instructions.
Patients should take all efforts to avoid sunlight and avoid swimming.
Patients are allowed to shower as soon as they wish.
Patients should book an appointment to return in 10 days.
- You have a fever higher than 100.4 degrees Fahrenheit
- You notice increased redness, swelling, warmth, or pain around your procedural area
- You have persistent stiffness, numbness/tingling, or weakness of your face
- You have pain that your existing pain medications cannot control
Apply lotions and sunscreens to sun-exposed areas until the healing process is complete Please follow our post treatment instruction and cream. Follow your doctor’s instructions on resuming normal daily activities