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Conditions · Lesions & Growths

Moles

A melanocytic nevus is a benign proliferation of pigment-producing cells. Most are exactly what they appear to be — but appearance alone does not separate the ones that are from the ones that are not.

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Moles — assessed at IN Eternity Clinic Singapore
In short

Most moles are benign clusters of pigment cells, but appearance alone does not prove it. A mole that is new in adulthood, changing, bleeding or unlike your others is examined first, and removed whole for testing where needed. Benign moles can be removed by excision or laser, each with a different trade-off between scar and recurrence. See mole removal in Singapore.

Reviewed by Dr Sin Yong, Medical Director, IN Eternity Clinic · Updated
Key facts
  • What they are: melanocytic naevi — benign clusters of pigment-producing cells in the skin.
  • Flat or raised: flat moles usually sit at the junction of the outer and inner skin; raised moles usually extend deeper into the dermis.
  • What is checked: asymmetry, border, colour, diameter and, most importantly, change over time (the ABCDE signs).
  • Key rule: a mole that is changing, bleeding, itching or looks unlike the person's other moles is examined before any cosmetic removal.
  • Removal options: surgical excision, which keeps the tissue for testing, or laser for moles already judged benign.
  • Assessed by: Medical Director Dr Sin Yong at IN Eternity Clinic, 9 Scotts Road, Singapore.
Reviewed by Dr Sin Yong, Medical Director, IN Eternity Clinic · Last updated
Mechanism

What is actually happening

Melanocytes cluster at the dermo-epidermal junction (junctional), deeper in the dermis (intradermal), or both. Depth is why some are flat and some are raised, and why a surface-limited removal leaves cells behind.

The distinction

How it is told apart

A mole is not a skin tag and not a seborrhoeic keratosis, though all three present as raised lesions. The distinction matters because destroying a lesion eliminates the tissue that could have answered the question.

Assessment

What is established first

Fitzpatrick type, the pattern and border of the lesion, whether it is junctional or intradermal, any recent change in size, colour, symmetry or sensation, and personal or family history.

Approach

What is typically done

Surgical excision clears most reliably and leaves the most visible mark. Ablative laser leaves the better cosmetic result and recurs more often. The lesion decides which trade-off is appropriate — not preference alone.

When treatment waits

When it is deferred

Any lesion that has recently changed in size, colour, border or symmetry, or that bleeds, itches or is newly raised, is evaluated before anything cosmetic is considered.

Full guide: mole removal in Singapore →

Flat mole removal Singapore — why depth changes the method

Flat mole removal Singapore

A flat mole is usually junctional, with melanocytes concentrated at the dermo-epidermal junction, whereas a raised mole is typically intradermal. Flat mole removal Singapore therefore addresses a lesion largely at the surface — but flat does not mean harmless, and any lesion showing change in size, colour, border or symmetry is assessed before any cosmetic method is considered.

In practice

How a mole is assessed at IN Eternity

Each mole is looked at with the naked eye and under magnification, and compared with the person's other moles. A mole that stands out from the rest, sometimes called the ugly duckling sign, gets closer attention even when it looks harmless on its own.

The history matters as much as the appearance. A mole that is new in adulthood, or one that has changed in size, shape or colour, is treated as a reason to examine and, where needed, to remove it whole for testing. What to check for a mole on face is set out separately.

Choosing a method

Excision or laser

Excision removes the mole with a margin of skin and allows it to be examined under the microscope. It leaves a fine line scar. Laser removes the mole layer by layer and leaves no tissue to examine, so it is kept for moles already judged benign.

Deeper moles treated by laser can partly return, because cells below the treated depth may remain. That trade-off is explained before a method is chosen.

“Laser removes the mole and the evidence together. That is why the decision about what a mole is comes before the decision about how to remove it.”
— Dr Sin Yong, Medical Director, IN Eternity Clinic

Frequently asked

What are moles?

A melanocytic nevus is a benign proliferation of pigment-producing cells. Most are exactly what they appear to be — but appearance alone does not separate the ones that are from the ones that are not.

How are moles told apart from similar conditions?

A mole is not a skin tag and not a seborrhoeic keratosis, though all three present as raised lesions. The distinction matters because destroying a lesion eliminates the tissue that could have answered the question.

What is assessed before treating moles?

Fitzpatrick type, the pattern and border of the lesion, whether it is junctional or intradermal, any recent change in size, colour, symmetry or sensation, and personal or family history.

When is treatment deferred?

Any lesion that has recently changed in size, colour, border or symmetry, or that bleeds, itches or is newly raised, is evaluated before anything cosmetic is considered.

Is laser mole removal suitable for every mole?

No, and this is the most important limitation to understand. Laser mole removal destroys the lesion, which means there is no tissue left to examine. Where a mole shows any feature that warrants assessment — recent change in size, colour, border or symmetry, bleeding or itch — excision is appropriate precisely because it preserves the tissue that could answer the question. Laser is considered for lesions already judged clinically benign, and that judgement comes first.

What is the difference between flat and raised mole removal?

It follows the anatomy. A flat mole is usually junctional, with melanocytes at the dermo-epidermal junction; a raised mole is typically intradermal, with cells sitting deeper. Flat mole removal in Singapore therefore addresses a lesion that is largely at the surface, while raised mole removal involves tissue extending into the dermis. That depth difference is why the two are approached differently and why a surface-limited method on a deeper lesion can leave cells behind and recur.

Will mole removal leave a scar?

Some mark is realistic and should be expected rather than promised away. Any removal breaches the skin, so the question is what kind of mark, not whether there is one. Surgical excision clears most reliably and leaves a linear scar. Ablative laser generally leaves a less conspicuous mark but carries a higher chance of recurrence. Mole removal scar appearance also depends on site, tension across the skin, your Fitzpatrick type and your individual healing — which is why the trade-off is discussed before a method is chosen.

Which moles should be checked?

Any mole that is new in adulthood, changing, bleeding, itching, or looks different from your other moles. The ABCDE signs are a guide, not a substitute for an examination.

Can a removed mole grow back?

It can, especially after laser removal of a deeper mole, because some cells may remain below the treated layer. A regrowing mole is examined again rather than simply re-treated.

References

  1. Tsao H, Olazagasti JM, Cordoro KM, et al. Early detection of melanoma: reviewing the ABCDEs. J Am Acad Dermatol 2015;72(4):717-723. doi:10.1016/j.jaad.2015.01.025
  2. Damsky WE, Bosenberg M. Melanocytic nevi and melanoma: unraveling a complex relationship. Oncogene 2017;36(42):5771-5792. doi:10.1038/onc.2017.189
  3. Singapore Medical Council. Guidelines on Aesthetic Practices for Doctors (2016 edition). healthprofessionals.gov.sg/smc

These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.

Have this assessed properly

Every assessment at IN Eternity Clinic is carried out personally by Medical Director Dr Sin Yong at 9 Scotts Road, #12-01 Pacific Plaza. If the honest answer is that treatment should wait, you will be told that.

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