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Removing moles – how much the procedure costs and how risky it is

We all have moles, whether congenital or developed over the years. They appear in a wide variety of body regions, shapes and forms and are usually harmless. Why you should still keep a close eye on them, when they can become dangerous and when they need to be removed, we learned from an expert.

What are moles and how do they develop?

Moles are more pigmented skin cells, benign growths of the skin that result from an overproduction of melanin,” says Dr. Clemens Fritsch, a specialist in dermatology, venereology and allergology in Dusseldorf. "They are also called Nävi or melanocytäre Nävi and are harmless in themselves. However, any birthmark can also degenerate in a bös-like manner." While pigment spots such as freckles and age spots do not pose a risk of skin cancer, birthmarks should be monitored continuously.

Übrigens it is a misconception that liver spots and birthmarks are different from a medical point of view. The term mole is merely a colloquial term for a pigment spot or a birthmark.

Which moles are dangerous?

"Regular control of your moles is essential for your skin health", says Fritsch. "The goal of the checkup is to detect melanomas, i.e. possible skin cancer, at an early stage. Melanoma is the term used to describe a bös-like growth of skin cells."

What happens at the dermatologist’s screening?

After anamnesis, all moles are examined with a special lamp and magnifying glass (dermatoscope). This examination is very thorough and covers the entire body, including areas that are more difficult for the sun to reach, such as the scalp, ears, but also the nails, toes, soles and mouth,” explains Dr. Fritsch. In the case of abnormalities, the birthmark is removed.

The costs for the screening are usually covered by the health insurance once a year. However, the patient must pay for the additional use of special reflected-light microscopes or photographic documentation if required.

How can I recognize a birthmark that may need to be removed?

Even if you have only a few moles, you should keep an eye on them. For this, you can use the ABCDE rule as a guide:

A = Asymmetrical shape: one half of the birthmark looks different from the other, it is not uniformly round or oval.

B = Boundary: uneven border, wavy, blurred, poorly defined to the normal tissue.

C = Color: uneven pigmentation or multicolor. This means the color varies from one area to another or has different shades. These can range from tan, brown or black to red or light colors like white.

D = diameter: rapid growth, often enlarged diameter of 5 mm or larger.

E = Elevation: raised growth or nodular.

An important warning signal is also when the birthmark begins to bleed or ooze. Then you should immediately see a doctor", Dr. Fritsch strongly recommends.

What criteria must be met in order to remove moles?

The removal of moles can be done for medical or aesthetic reasons, says Dr. Fritsch. "The important thing is that the patient is free of skin diseases or –inflammation in the affected skin area at the time of the procedure."

What types of removal are there?

If you have decided to have your birthmark removed, there are several options to consider. "Which method is most suitable for which patient depends on the size and prominence of the birthmark and the patient’s personal wishes, and is determined individually with the attending specialist", says Dr. Fritsch.

1. excision: the surgical removal of suspicious tissue.

Excision, surgical removal, takes about 10 minutes and is the most commonly chosen treatment method. In this procedure, the affected area of skin is cut out deeply under local anesthesia using a scalpel or punching tool and then closed again with sutures,” explains Dr. Fritsch. The disadvantage is that scars may remain and the wound may be uncomfortably tense during the healing process.

Excision is used in any case where a bös-like growth is suspected, as it is the only method that truly ensures that the entire growth is completely removed. The removed sample is then examined microscopically and, if skin cancer is suspected, sent to a laboratory for examination.

2. laser technique: only for benign growths

Removal with laser technology takes about 5 minutes. The affected area of skin is first removed superficially with a scalpel to ensure a histological examination. Then it is gently ablated (ablated). This treatment is effective, gentle, leaves little or no scarring, and is virtually painless due to the application of an analgesic ointment.

However, only the upper layer of skin is abraded and the root is not reached. For this reason, the laser method is only used if the removal is done for aesthetic reasons and there is no suspicion of a malignant degeneration, because it could be that pigment cells remain in the depth, which can not be examined microscopically afterwards, said Dr. Fritsch.

3. crythotherapy: icing

Crythotherapy is another method that is also used exclusively for benign growths. In this procedure, a small amount of liquid nitrogen is used to destroy the surface of the affected skin area by freezing it. This takes about 10 minutes and often leaves scars.

How much does the procedure cost?

Private and statutory health insurance companies cover the costs if the birthmark is removed for medical reasons. If there are aesthetic reasons, the patient bears the costs. These vary greatly from person to person, as they are made up of the procedure, the doctor’s fee, the location and any additional services. For a surgical procedure, one can expect to pay about 100 euros, and for a laser removal, 50 to 100 euros per procedure. If several moles are removed in one session, the price usually becomes much more attractive, e.g. 250 euros for 5 benign moles.

What are the advantages of removal?

Removing a suspicious growth significantly minimizes the patient’s risk of skin cancer. In addition, it offers optical and aesthetic advantages, since moles are often perceived as disturbing. In addition, the procedure does not take long and is generally simple, low-risk and relatively painless. A short recovery time and hardly visible scarring also speak in favor of it.

What do you need to keep in mind after the procedure?

Für gewöhnlich no complications occur with this simple procedure, provided it has been performed by a specialist. Depending on the technique used and the area of the body treated, you can usually return to sports after two days, but you may need to take a break for one or two weeks. With laser therapy, the crusts that form fall off after about seven to 10 days. However, you should avoid direct sunlight for at least three weeks, advises Dr. Fritsch.

Immediately after the treatment, there may be slight swelling in the affected area. Even if there are isolated sore spots, they usually disappear after a short time. If there is no improvement after two to three days, you should consult your specialist for follow-up treatment.

How do I choose the right doctor?

Make sure that you are treated only by qualified personnel with sufficient experience in the field. He should take enough time to explain to you in detail and in confidence the methods as well as their procedure, risks and advantages.

Can moles be removed by yourself?

"Unfortunately, one hears again and again about adventurous tips on how to remove moles at home by oneself. From applying apple cider vinegar, iodine or garlic to painful and risky scraping or even cutting them off with scissors. Hands off! None of these methods has been proven to be effective, on the contrary, they can even be dangerous, warns Dr. Fritsch.

And what about creams from the pharmacy that promise quick and gentle removal? "These ointments usually cause only a fading of the skin area and no removal. They carry some risks and no significant benefits, hence the urgent recommendation to trust a specialist when removing", advises Dr. Fritsch.

Can problematic birthmarks be prevented?

Check your moles regularly and record their development if they appear suspicious. To do this, you can place a tape measure next to the birthmark and photograph the area to record changes in size and color. Since UV radiation is considered to be the main cause of malignant degeneration, a cream with a high sun protection factor is recommended every day.


– with expert advice from Dr. Clemens Fritsch and Dr. Moussa, specialists in dermatology, venereology and allergology at "Skin & Laser" in Düsseldorf