Moles, skin tags, warts and more
Removing unwanted or unsightly skin lesions are easy at Medicetics with our one-stop service. You can have a consultation, diagnosis and treatment all in one appointment with the latest mole removal techniques, laser, surgical excision and radiosurgery. Many moles can be removed leaving little or no scar.
Skin surgery for unwanted moles, warts, lumps and bumps is very common in the UK, however, this is no longer available for non-suspicious moles on the NHS.
Moles, freckles, skin tags and lentigos.
We have many different types of pigmented spots on our skin nearly all of which are benign.
A mole (naevi) is a small nest of pigment-producing cells (melanocytes) that instead of sitting evenly in the skin have collected in a small cluster or nest of cells.
There are lots of different types and sizes of moles:
1.Congenital naevi (mole) – these are present at birth in 1:100 people and have a slightly higher risk than normal moles of becoming abnormal or cancerous. Congenital moles are described as small naevi, medium naevi, giant naevi and hairy congenital naevi.
2.Epidermal moles (naevi) are warty like lines of moles usually found on the trunk but very rarely on the face. They are nearly always benign and can be removed by radiosurgery or by laser.
3.Sebaceous naevus is a type of epidermal mole. They are benign moles that often occur in the scalp, again it is an overgrowth of the upper epidermis. They can be removed by surgery, radiosurgery or laser. A pathologist should check all specimens to make sure that no new growths have arisen inside the mole.
4. Comedo naevus is a hair follicle naevus. Pigmentation arises around a dilated hair follicle and when these are multiple it gives the appearance of a mole, the dilated follicles fill with keratin. It is possible to improve the appearance with tretinoin, salicylic acid or using laser treatments. In some treatments, excision is required to remove the lesion.
5.Becker naevus This is a late onset naevus that occurs mostly in males. Due to an overgrowth of pigment and hair follicles. It is a single large pigmented patch that can become quite hairy after puberty. The cause is not well understood but may have a link to testosterone as it appears just after puberty.
- Junctional naevus:
A flat mole with cells at the junction of the epidermis and dermis.
- Dermal naevus:
A dermal naevus or mole has cells in the dermal layers and a nodule on the skin surface.
- Compound naevus:
A compound naevus has nests of naevus cells at the epidermal-dermal junction as well as within the dermis.
- Combined naevus:
Pigmented combined naevus showing 2 distinct areas of pigmentation.
What is a skin tag/ polyp?
Skin tags are small fleshy bunches of skin that are found in areas of friction. They are commonly found around the neck area, underarm or in the groyne. They are benign however can be bothersome if they grow larger in the thigh area in cyclists they can rub and then become irritated or infected.
Skin polyps are sometimes present from birth and are a little larger, they have a stalk with a blood vessel that will need to be sealed when the polyp is removed.
How can they be treated?
Most skin tags are best removed by radiosurgery and are a very quick and painless procedure.
Removal of skin tags and skin polyps are done under a local anaesthetic if they are large. When they heal they very rarely leave any mark or scars.
Will it come back?
Skin tags do not grow back however if you are prone to these then it will not stop new ones forming. They are easiest to treat when they are small and healing is very quick in this case.
What is a wart? A papilloma is another name for a wart as they are caused by HPV the human papilloma virus.
When the virus gets into the upper layer of the skin it causes rapid growth of the skin cells in a haphazard way causing a hard lumpy bump- the common wart.
We come in contact with the HPV virus every day on surfaces or skin contact with others. They are usually only a problem where the skin barrier has been damaged ie the hand, shaving areas or anywhere the skin has a little cut.
Other strains of the virus cause genital warts and have been linked with cervical cancer, Gardasil is a vaccine against types 6,11,16 and 18. Common warts are usually caused by 2 and 4.
Small warts are easily treating by freezing them or using over the counter products. Larger warts may need to be surgically removed using radio surgery or laser.
If warts are being treated it is important to treat all of these at once to reduce the chance of recurrence.
Warts are found on everyday surfaces and we carry them on our skin most of the time. Usually, they cannot penetrate the outer skin area unless there is a little cut or scratch. Taking extra care with nail care and using a moisturiser on your hands keeps the skin barrier healthy and warts out.
If you have to pick your skin and already have warts there is a high risk of self-infecting other areas. This is why it is often easier to keep the skin covered during the healing process to avoid further skin damage.
Will they go away on their own?
25% of warts disappear on their own within 1-6 months, 65% disappear within 2 years and the other 10% can linger on for longer.
What is a seborrheic keratosis?
Seborrhoeic keratosis is very common and 90% of us will have at least one by the age of 60. They are well defined warty spots that appear on the top layer of skin and look as if they are stuck on. They can often grow from an area of sun damage (solar lentigo).
We do not understand what causes them however there is a link to
sun exposure and a hereditary disposition. There is currently no evidence to suggest they are caused by viruses.
How can a seborrheic keratosis be treated?
There are a number of ways to remove seborrheic keratosis: shave excision, electrosurgery, laser or TCA acid treatment.
At Medicetics we have found that radiosurgery gives the best cosmetic result and avoids the risk of leaving hypopigmentation (white skin). Depending on the size we can treat up to 30 of these at once.
Will it come back?
Seborrhoeic keratosis can recur, sun protection and early treatment are advised.
Pigmented spots on the skin, hands and chest are very common in areas that are exposed to the sun or UV rays from a sun bed.
Persistent exposure to UV causes excess melanin production in clumps forming darks spots on the skin. This uneven pigmentation can make the skin look aged.
How can sun spots be treated?
Once a clear history has been taken and the spots examined you doctor will decide the best way to treat your age spots:
• Increased skin turnover- prescription creams such as Retin-A (tretinoin/ topical vitamin a) help to remove pigmentation by a process of increased shedding of the skin (desquamation) reducing the clumping of the melanin. This is particularly effective when used in conjunction with a product that slows melanin production such as kojic acid/ arbutin or hydroquinone.
• Laser and Intense Pulsed Light IPL treatments are extremely good at removing this pigmentation. Treatments are fast with little recovery time and are usually done in a course of 3-4 treatments.
• Cryotherapy- if you have a single spot then freezing it off can be a fast and cost effective way to remove it and they have a very low recurrence rate when done in this way however the healing period can take a few weeks.
Will they come back?
Sun spots are a sign that the underlying skin has been damaged to a degree if adequate sun protection is not used they will recur with time, specialist advice can avoid this from happening.
A sebaceous cyst is formed by the overgrowth of the sebum gland in the skin, they are often filled with yellow/ white sebum which can have an offensive odour if the cyst erupts.
They appear as bumps on the skin and often will have a punctum (small opening) on the surface of the skin.
Cysts can go through quite stages where they shrink and size. Others continue to grow and can become tender if they become infected. The back and scalp are very common places to find sebaceous (epidermal cysts).
Sebaceous cysts are not dangerous to your health and are removed when they become bothersome.
How can sebaceous cysts be treated?
At Medicetics sebaceous cysts are treated by surgically removing the whole cyst from the skin under local anaesthetic. It is important that the surgeon is careful about removing the cyst in one whole piece if some of the cysts are left behind it can cause a recurrence.
The procedure will require sutures. The scar heals to leave small neat line however it will be about 2.5 times as long as the cyst is wide.
There are multiple ways to treat warts:
• Salicylic acid; this can be bought over the counter in a pharmacist and is useful for very small warts or for stopping recurrence when a wart has been treated. For larger warts that have been there for a long time, it is unlikely to work.
• Cryotherapy/ freezing; at Medicetics we use liquid nitrogen to freeze warts. This has the advantage of not breaking the skin barrier but penetrating deeply into the skin to kill the virus. After some stinging, the wart crusts up and falls off within a week. With persistent warts, this can sometimes require multiple treatments. It is the safest way to remove warts that have formed around nail beds, surgery in this area can affect nail growth.
• Laser removal; lasers can be used to remove moles, however, repeat treatments 2-3 treatments are often required.
• Radiosurgery; for large persistent warts surgical removal with radiosurgery gives the best results, however, having physically removed the wart it means that there is a healing period.
Warts can be persistent and recur.
Ways to avoid recurrence:
• Treat all warts at the same time
• Avoid abrasions or scraping the skin
• Keep the wart covered when it is healing, duct tape has been shown to reduce the reoccurrence!!
• Take zinc sulphate, studies have shown it reduces recurrence and aids wound healing
• Use salicylic acid on large warts to avoid recurrence.
1. Warts are caused by the human papillomavirus and there are over 100 different types of the virus although 2 and 4 are the most likely to cause your common wart.
2. Verrucas found on your feet are just another type of wart caused by the same virus the HPV type 1 is the most common here.
3.Treating the mother wart and all the small ones that have sprung up around it is important, or else non-treated warts will keep sending out virus’ that will grow the wart back again as the skin is damaged.
4. Zinc sulphate tablets can help reduce the reoccurrence of warts.
5. You don’t’ catch warts from warty toads, the lumps on their skin are caused by glands, not by a virus.
6. If you look at a wart under a magnifying glass you can see little black dots, these are blood vessels the wart has recruited to help bring it nutrition to survive and grow.
A lipoma occurs as a small, painless, soft and mobile lump under the skin. There is no punctum (small hole in the skin) present and when it is pressed it appears to move under the skin.
They are not harmful or painful unless they are pressing against a nerve or in an awkward position or have grown to a large size.
There are hereditary versions of lipomata (plural of lipoma) that can be associated with other conditions like neurofibromatosis where a gene defect causes an overgrowth of these lumps.
There are different types of lipoma that are much larger and behave in a slightly different way, in very rare cases lipomas can form a very rare type of cancer liposarcoma.
Can a lipoma be treated/ removed?
Depending on the size and location lipoma are usually very easily removed by a small incision in the skin and forcing the lipoma through the incision. Although a stitch may be required these tend to heal very well and is a very common procedure at Medicetics.
Basal cell carcinomas/ Rodent ulcers
Keratosis/ Actinic keratosis/ Solar keratosis
Other common skin bumps:
Dermatosis papulose Nigra
Mole removal before and after
There are numerous mole removal procedures that can be used depending on the type of skin lesion that is being removed. We have all of these available at Medicetics and your Doctor will examine your skin lesion with a special instrument called a Dermatoscope he can then let you know which type of removal is appropriate.
Before and afters
Mole removal performed at Medicetics using radiosurgery
Moles should be checked regularly for any changes or if they start to itch, crust or bleed.
By definition, a mole is as any dark spot or irregularity in the skin. However, skin marks such as birthmarks, hemangiomas (abnormal blood vessels) and keratoses (benign or precancerous spots that usually appear after the age of 30years) are not removed using the methods discussed here.
Some people are born with moles. Other moles appear over time. Sun exposure plays a significant role in the development of moles and may accelerate the progression of dysplastic (atypical) moles.
The role of heredity cannot be underemphasized. Some families have a higher incidence of dysplastic moles, a type of mole which can be associated with a higher frequency of melanoma or skin cancer.
Asymmetry any mole that is irregular in shape suggest it is growing in a haphazard or possibly unregulated way
Borders: irregular borders mean that the mole may be growing in an irregular way or a certain part of it has transformed
Colour: Many normal moles have more than one colour, however, a patch of irregular pigmentation can indicate a change. If the area is getting darker the melanocytes may be growing more densely and forming more pigmentation or if the area is getting lighter the body may recognise that there are abnormal cells and start to kill that part of the mole. Either sign is a reason to have a Doctor examine it better
Diameter Moles that are larger than the blunt end of a pencil should be checked regularly HOWEVER skin cancers can occur in small moles as well.
Evolving size, shape or colour
Moles that are difficult to see ie on the back are difficult to assess over time, it is important to have these watched carefully!
There are many factors that have been identified that can lead to an increased risk of skin cancers, we list a few of them below:
- If you have more than ten moles
- If you have burnt your skin badly twice before the age of 18
- A family history of skin cancer
- Excess sun exposure and use of sun beds
Living in regions with poor ozone protection like New Zealand means a higher level of UVC can penetrate through and this accelerates skin damage and skin cancers.
Mole/ skin lesion removal methods
Skin surgery has moved on a lot in the last few years. Many skin lesions that may have left unsightly scars in the past can now be safely removed and leave barely a skin blemish.
At Medicetics we use radiosurgery, laser, cryotherapy (freezing), surgical excision, shave excision and plasma to remove skin lesions. As a specialist centre, we will be able to offer the best treatment available in the UK to you.
This is the gold standard for removing many types of skin lesions and with most, it will not even leave a skin blemish.
Medicetics is one of the few clinics in London that perform radiosurgery.
Unlike normal electrosurgery, the ultra-high frequency reduces thermal damage of the lower layer of skin and therefore the risk of any scarring.
The area is numbed with a small injection of anaesthetic. If the lesion is very large or if we need to send off the specimen for histology your doctor may shave off a piece of the lesion. The rest of it will then be removed with radiosurgery.
After treatment a small dressing is applied for 2 days and post care advice is given.
It is worth checking if a clinic has real radiosurgery rather than electrosurgery.
Using a laser to remove your skin lesion can also be an excellent way to avoid any scarring.
At Medicetics we use a number of different lasers depending on the type of skin lesion.
The most commonly used laser is our erbiumyagi laser. This is also suitable for the removal of areas of pigmentation and solar lentigos (freckles). It removes the upper layers of the skin whilst avoiding damaging lower layers hence reducing the risk of causing a scar and giving a rapid healing time.
With laser removal, the skin is numbed by a small injection of local anaesthetic to make this a painless procedure.
The skin lesion will then be lasered away in a number of passes.
Post-treatment a dressing is applied for 2 days and post care advice given.
This may be more appropriate if your mole or skin lesion is flat and is superficial.
We are able to remove most moles by this procedure, which does not require stitches and so gives excellent results with minimal scarring. A small amount of local anesthetic is required so that each mole can then be painlessly removed using a specially designed blade.
There may be a number of reasons to extract a mole. In darker skin types moles tend to be deeper. If we use radiosurgery or laser to remove these there may be a risk of scarring, therefore, a neat scar may be preferable.
If there is any concern with a skin lesion we advise to have a full excision as this allows proper diagnosis of the skin lesion. It is more important to know the depth of any abnormal skin lesion than the width. Your Doctor will take a careful history and examine your skin lesion with a special device called a dermoscope to determine the type of skin lesion you have.
Surgical excision is performed by injecting a small amount of local anaesthetic to number the area. The mole is then surgically removed and any bleeding stopped with radiosurgery.
The excision will then be sutured in one or two layers depending on the area of skin that has been treated.
The length of time that the sutures will remain in depends on the area of the body as different areas heal at different speeds. The face tends to heal the fastest and we only leave sutures in this area for 5-7 days whereas the limbs heal at a slower rate and sutures may be left in for 14 days.
As the scar heals it can often become red and itchy although this usually settles after the sutures have been removed.
We give all patients post care instructions. This includes advice on scar creams, camouflage and keeping the wound protected from the sun to allow it heal and fade as quickly as possible.
We do not advise to use cryotherapy to remove moles, however, there are many skin lesions that can be removed very effectively by freezing after your Doctor has diagnosed which skin lesion you have.
Warts, pigmentation spots, and some seborrhoeic keratosis lesions may be suitable for cryotherapy.
At Medicetics we perform cryotherapy with liquid nitrogen in a special cryogen device with specific nozzles that control the depth of the treatment. For treating age spots the area is sprayed for a few seconds. The area has a tingling sensation for a few minutes post treatment and will crust over in the next few days. The pigmentation will crust and fall off leaving a red mark (post inflammatory pigmentation). It is important to use sunscreen at this stage on exposed areas as this will aid the healing skin to recover quicker.
Mole and Skin Tag Removal: Post Treatment Advice
- To help to heal the wound should be kept clean and hydrated. This will help the even formation of new collagen.
- When bathing or showering try to keep the wound dry, applying a large amount of petroleum jelly/ vaseline forms a semi-protective layer if it does get a little wet.
- After 2-3 days: gently clean the wound with some warm water. A slight crust/ yellowish sludge appearance is entirely normal. If there is any bleeding, apply firm pressure with some clean tissues for 4-5 minutes. Apply Vaseline each day until the wound is completely healed. If you have to use a plaster make sure that they are breathable.
- When to apply scar creams? Scar creams can break down healing tissue. They should only be used once the skin has healed over fully, this is usually after 2-3 weeks. To use, massage the scar firmly with silicon gel or vitamin(such Kelo-cote), both of which can be bought from any chemist. Daily massage over a 2 month period can help healing and improve results. Silicon sheets have been shown to give the best results however they can be difficult to apply.
- The wound may initially be red and slightly raised, but this generally settles in 2-3 months and fades to a flat, white area over 6-12 months. The red mark that forms when a scar is healing is post-inflammatory pigmentation (PIP) and use of sunscreen will help this to fade.
- Skin healing can never be guaranteed and areas of thin skin or over joints, where the skin is constantly being stretched, are at higher risk of scar formation. If you do form a scar there are a number of treatments that can be performed to improve the scar such as scar excision, steroid injections, and laser treatments.
- Do not hesitate to contact us if you experience any problems or signs of infection such as increasing pain after 3-4 days, redness or green discharge.
- If your skin lesion was sent for lab tests (histology) we will write to you with the results in 2-3 weeks or contact you directly.
These prices are a guide. Moles that require more complex procedures are priced accordingly.
Shave excision £240
Shave excision & (hist) £330
Shave excision (additional) £150
Full-thickness excision £370
Full-thickness excision (hist) £420
Full-thickness excision (additional) £180
Complex Lesions £450
Skin tag (up to 5) £150
Wart removal Dr’s Discretion how many they want to do £150
Shave with Radiosurgery £295
Histology £99 and additionals £35
* As a general rule all lesions will be examined by a Doctor with a special device called a dermatoscopy. The majority of lesions are sent for histology however it is important this would need to be clarified by your Doctor at consultation
Find out what treatment suits you best!
I was really surprised how easy the whole process was. I had been agonising over whether to have a mole on my face removed but was scared of leaving a scar. Although Dr. Mullan told me it might take 2-3 months for my scar to settle down it has already disappeared after 6 weeks and it didn't hurt at all.
* I was really surprised how easy the whole process was (Mole Removal)
Claire H., Notting Hill
I was always very self-conscious of the mole on my face and I never realised until now how much a mole can impact your level of confidence. Although I had seriously thought about having my facial mole removed on several occasions, unfortunately my fear of an injection was too big a fear and I always managed to talk myself out of the whole situation- by trying to convince myself it was part of me and that there were other individuals/ professionals that lived with their facial moles,so why couldn't I? I finally plucked up the courage and contacted Medicetics, which offer a free consultation (which lessened the pressure on me, if I decide not to go ahead) with Dr. Mullans (Surgeon) which was really important to me, as opposed to seeing a sales person or manager etc... Despite Dr. Mullans being a highly regarded Surgeon (within his sector) he seriously exceeded my expectations as a Surgeon. Dr. Mullans is a very charismatic and professional Surgeon (with a personality) that makes you feel completely at ease and was genuinely happy to spend the time to discuss every aspect of the surgery in details (different types of moles, the procedure involved, expectations, possible implications etc) prior to surgery. I asked every possible question you could think and was never made to feel stupid at any point and furthermore I was NOT pressurised into having surgery. Dr. Mullans constantly reassured me and repeated the steps whilst conducting the surgery, which created greater reassurance and peace of mind on my part! Following my surgery (2-3 days later), I received an email to ensure that I was happy with the procedure and there was no scarring along with confirmation from that the lab that the mole was not malignant. Approximately a week after my mole was removed it was completely healed with no visible scarring so that you would never have guessed that I had a mole in the first place! I would like to take this opportunity to say "thank-you" to Dr. Mullans and his staff as they were absolutely and I'm going back to have a 2nd mole removed!
* I never realised until now how much a mole can impact your level of confidence... (Mole Removal)