Mole removal and histology: why every removed lesion should be examined

Dermoscopy and clinical judgement can suggest that a mole is benign, but only microscopic examination can confirm it. Some melanomas look harmless. If a lesion is removed or destroyed without histology, a melanoma may be missed or its depth unknown, which affects treatment and prognosis. Sending a sample is routine for dermatologists and surgeons, and it should be the default unless the lesion is clearly something other than a mole.

Some clinics and beauty providers offer mole removal as a cosmetic procedure, sometimes using lasers or cauterising devices. If a melanoma is present, it may be undertreated and the opportunity for accurate diagnosis lost. Poor technique can also cause scarring, infection and pigment changes. A person who is not a medically qualified, appropriately trained clinician should not assess a mole for removal.

You should receive a histology report, usually in one to two weeks, and an explanation of the findings. If the lesion is benign, no further treatment is usually needed. If it is atypical or malignant, further excision or referral to a specialist team may be recommended. Keep the wound clean and watch for infection, such as spreading redness, pus or fever. Scars mature over months.

• Who is performing the procedure, and what are their qualifications and registration?

• Will the tissue be sent for histology, and who will report it?

• What method will be used, and why is it suitable for this lesion?

• What are the risks of scarring and recurrence?

• How will I receive the results, and what happens if further treatment is needed?

• Is the clinic registered with the Care Quality Commission, where required?

Ask for an itemised quote that includes the procedure, histology and follow-up. Check whether histology is included in the fee, because omitting it to reduce cost is a warning sign. Read consent information carefully and avoid pressure to decide on the day.