Moles most frequently develop in young adults until about the age of 40. Depending on their location, moles may go unnoticed, or they may become a nuisance by rubbing against clothing and getting in the way of shaving. Moles can also lead to dangerous health problems. Many skin cancers, including melanoma, begin in the shape of a mole.

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 in any other way seems unusual -- it is very important to have it examined by a doctor with experience in treating moles, related skin conditions, and skin cancer.

Not all atypical moles turn out to be cancerous, but they are more likely than typical moles to develop into cancer. If a cancerous mole is diagnosed early, it can often be completely removed. You may also want to have normal moles removed, especially those that rub against clothing or get in the way of shaving. Prominent moles may also be removed to improve appearance.

In general, the best candidates for mole removal are:

• Fair skinned
• In good physical and psychological health
• Wanting to improve their appearance and/or comfort
• Realistic in their expectations
• Not users of marijuana or anabolic steroids
• Not heavy users of alcohol

Because moles can be cancerous, Dr. Ratliff will usually examine them carefully by performing a biopsy or microscope analysis. A small portion of the mole will be removed for this purpose. It may be removed with an instrument that quickly punches out a small section of the mole, or it may also be cut with a scalpel or scissors. This tissue is then sent to a pathology lab to be examined.

If lab examination shows the mole to be normal, Dr. Ratliff can remove it either by shaving or cutting it. The shaving method works by removing the protruding surface of the mole so that it is flush with the surrounding skin. This technique is common for patients who have moles that become irritated by clothing or movement. However, it can leave some of the mole cells beneath the skin, and the mole may grow back again over the next several years.

The cutting method of mole removal may be used for both normal and atypical moles. (Potentially cancerous moles are nearly always removed using this technique.) This procedure is often called elliptical excision because the mole, as well as the surrounding and underlying tissue, is removed in the shape of an ellipse, or oval. All of the mole is removed, both above and below the skin. A small medical blade may be used, or a laser may be chosen to reduce bleeding and allow for quicker healing time. If a blade is used, sutures (stitches) are used to close the incision. If a laser is used, sutures will not be needed. After the procedure, a bandage is usually applied.

Most doctors use a local anesthetic to reduce pain and discomfort. You should feel little or no pain during the procedure itself. Often, when a laser is used, no anesthetic is needed because there is not pain, just a tingling sensation.

The amount of pain afterward varies, and depends on the method used. After a mole is removed, a scab will develop and then heal within one to two weeks. Any redness around the area should disappear within two to four weeks.

The risks associated with mole removal are minor. If the shaving method is used, there is a risk that the mole will grow back within several years following the removal. Elliptical 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.

Immediately after surgery, you should avoid swimming, dishwashing, and other activities that might dampen the treated area. Follow Dr. Ratliff's instructions carefully to avoid any possible complications or delayed healing.

Most scars slowly fade with time. Applying sunscreen to the treated area may help keep any scarring remaining from darkening. Using sun-protection lotions and reducing exposure to the sun can lessen the risk of melanoma (a type of mole/skin cancer).