Skin Tag and Mole Removal: When Is a Check Needed?

What is the difference between a skin tag and a mole?

A skin tag is a small, soft piece of skin hanging from a thin stalk, skin-coloured or slightly darker. Tags usually appear on the neck, armpits, eyelids, under the breasts and in the groin folds, where skin rubs against skin. They become more common with age, weight gain, insulin resistance and pregnancy. They are benign and do not turn into cancer.

A mole is a cluster of pigment cells in the skin. It can be flat or raised, brown, black or skin-coloured. Most moles are also benign, but a small number can change over time, so moles need closer monitoring than skin tags.

When is removal optional, and when is it necessary?

Removal is an optional, cosmetic choice when a tag or mole has been examined and found benign but bothers you. It becomes medically useful in other situations, including:

• A tag or mole that catches on clothing, necklaces or bag straps and keeps getting irritated or bleeding.
• Growths that interfere with shaving or vision, such as tags on the edge of the eyelid.
• A mole that changes in size, shape or colour, or a new mole after about age 40 that looks different.
• A mole that bleeds, itches or ulcerates without a clear reason.
• Any growth the doctor is unsure about and wants analysed to be certain.

Which removal methods do doctors use?

Removal is usually done in clinic under local anaesthetic and takes minutes. The doctor chooses the method based on the type, size and location of the growth, and whether it needs analysis:

Any removal can leave a small mark or a change in skin colour, depending on skin type and location. People with darker skin are more prone to post-inflammatory pigmentation and need careful wound care and sun protection.

• Snipping with fine surgical scissors: suitable for small skin tags on a thin stalk.
• Freezing with liquid nitrogen: for very small tags, sometimes needing more than one session.
• Electrocautery or laser: for some raised benign tags and moles, but not used when the doctor wants the tissue analysed.
• Shave excision: removes the raised part of a benign mole and allows it to be analysed.
• Full surgical excision with stitches: for suspicious moles, because the whole mole and its edges can be examined.

Why is tissue sometimes sent to the lab?

A biopsy means the removed tissue is examined under a microscope by a pathologist. It is the definitive way to know what a mole is, and whether it is completely benign or shows changes that need follow-up or further treatment.

This is why removing a mole by laser or burning without prior examination is not advised: these methods destroy the tissue so it cannot be analysed, and they may hide a problem that needed early detection. The doctor usually gives you the result within days to two weeks, depending on the lab.

How should you care for the skin after removal?

Good aftercare speeds healing and reduces marks. Always follow your doctor's instructions for your case, which usually include:

• Keep the area clean and dry, and use the ointment your doctor recommends.
• Do not pick off the scab; let it fall off by itself.
• Protect the area with high-protection sunscreen once healed, as the strong Eastern Province sun increases the chance of dark marks.
• Avoid swimming and saunas until the wound heals, especially if you have stitches.
• See your doctor if redness spreads, pus appears or pain becomes severe.