FREEZING (CRYOTHERAPY)

LASER

CAUTERIZATION (DIATHERMY)

SURGICAL EXCISION

Method:

Spraying liquid nitrogen (-196^o C) with a hand tool on the skin lesion creates ice crystals in the cells, thus the cells die. No need for local anaesthetics.

Focused laser beam is pointed towards the skin lesion, and the tissue is evaporated, burned away. Local anaesthetics needed.

Diathermic tool burns away the skin lesion with electric discharge. Local anaesthetics needed.

The surgeon performs an ellipse excision with a narrow safety margin, than removes the intact skin lesion and stitches the wound up. Local anaesthetics needed.

Safety area:

Safety margins cannot be clearly kept, because during freezing the physician is not able to determine the depth of freezing or to see where exactly the skin lesion (mole) ends. Residual cells could be left.

Safety margins cannot be clearly kept, because during laser surgery the physician is not able to determine the depth of the evaporation or to see where the skin lesion (mole) ends. Residual cells could be left and damaged.

Safety margins cannot be clearly kept, because during cauterization the physician is not able to determine the depth of the burn or to see where the skin lesion (mole) ends. Residual cells could be left.

During excision the surgeon applies a narrow safety margin. The histology report reflects to it whether the mole is completely removed or not.

Histological examination

There is no histological examination (it is impossible to have one), so neither the physician nor the patient can be absolutely sure about the nature of the skin lesion that has been removed (benign or malignant?).

Histological examination is conducted only if the physician collects a sample of the skin lesion before proceeding with the laser surgery. Only then it can be determined whether the removed lesion is benign or malignant, but there is no way to determine whether the removal was done with the correct safety margin.

Histological examination is conducted only if the physician collects a sample of the skin lesion before proceeding with the diathermy. Only then it can be determined whether the removed lesion is benign or malignant, but there is no way to determine whether the removal was done with the correct safety margin.

Histological examination is always conducted, thus the nature of the removed lesion and the range of the safety margin can be determined.

Risks

There are risks, because the nature of the removed lesion is not known. It might be a malignant tumour.Besides, it is hard to determine whether the growth was completely removed or not. Superficial scar formation is normal.

If histological examination is not conducted there are risks, because the nature of the removed lesion is not known. It might be a malignant tumour. Besides, it is hard to determine whether the growth was completely removed or not. There is also a slight chance for the residual tissue transforms to malignant due to damage caused by the removal method. Superficial scar formation is normal. (Even laser hair removal has its risks, if there are moles on the treated area).

If histological examination is not conducted there are risks, because the nature of the removed lesion is not known. It might be a tumour. Besides, it is hard to determine whether the growth was completely removed or not. Superficial scar formation is normal.

There is a minor risk of pathological scar formation or inflammation, but these are very rare. The nature of the removed tissue is clear from the histology report.

What happens if melanoma is removed with this method?

It might happen, because melanoma can look like an insignificant lesion at early stage. That is why it always a sensible decision to have a complete mole check before any invasive treatments. Neither the doctor nor the patient can find out that the patient had (has) melanoma, so he/she wastes precious time. Melanoma might appear in the same spot or might spread into distant organs and the patient will have to face the disease in late stage.

It might happen, because melanoma can look like an insignificant lesion at early stage. That is why it always a sensible decision to have a complete mole check before any invasive treatments. If histological examination was not conducted, neither the doctor nor the patient can find out that the patient had (has) melanoma, so he/she wastes precious time. Melanoma might appear in the same spot or might spread into distant organs and the patient will have to face the disease in late stage. If a histological examination was conducted and it turned out that the lesion was melanoma, immediate reoperation is necessary (wide surgical excision with repeated histopathology).

It might happen, because melanoma can look like an insignificant lesion at early stage. That is why it always a sensible decision to have a complete mole check before any invasive treatments. If histological examination was not conducted, neither the doctor nor the patient can find out that the patient had (has) melanoma, so he/she wastes precious time. Melanoma might appear in the same spot or might spread into distant organs and the patient will have to face the disease in late stage. If a histological examination was conducted and it turned out that the lesion was melanoma, immediate reoperation is necessary (wide surgical excision with repeated histopathology).

Diagnosis is immediately known and the necessary steps can be taken. If the safety margin was too narrow, reoperation might be needed in this case as well. The best and only treatment procedure for melanoma is surgical excision, in the earliest possible stage of the disease. That is why it always a sensible decision to have a complete mole check before any invasive treatments.

Aesthetic result:

In case of superficial freezing (viral warts) it is excellent. In case of mole removal, due to the fact that the freezing needs to penetrate deeper into the skin, there will be scar formation. Image of scar formation after cryotherapy.

In case of laser treatment on superficial skin layers (angioma) it is excellent. In case of mole removal, due to the fact that the laser beam needs to penetrate deeper into the skin, there will be scar formation. Image of scar formation after laser treatment with re-growing moles (Pseudomelanoma).

In case of cauterization done on superficial skin layers (angioma) it is excellent. In case of mole removal, due to the fact that deeper layers need to be burned away, there will be scars.

In optimal case there will be a scar that looks like a very thin line. Aesthetic result depends on the experience and the skills of the doctor, on the selection of the suturing technique and the location of the removed mole (face has a tendency to heal real well, other places, like the back, the spine area, the cleavage or places where the skin is more exposed to movement and strain, heal less well) as well as on the way the patient takes care of the operated area.

What it is recommended for:

Mainly for the removal of skin lesions of viral origin, or treatment of superficial lesions like angiomas and keratoses. Skin tag/war removal.

Mainly for the removal of skin lesions of viral origin, or treatment of superficial lesions like angiomas and keratoses. Skin tag/war removal. There are many kinds of laser treatments and the application areas vary from hair removal and skin rejuvenation to removal of tattoos and skin lesions. During treatment it is important to avoid moles on the treated skin surface.

Mainly for the removal of skin lesions of viral origin, or treatment of superficial lesions like angiomas and keratoses. Skin tag/war removal.

For mole and skin tumour removal. In cases when there is a diagnostic uncertainty and the physician is not sure about the nature of the skin lesion.

Is it recommended for mole removal?

NO

NO

NO

The only medically acceptable method for mole removal.