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Treated early, skin cancers can be cured by simple surgery. Hence the need to detect them as early as possible. On the occasion of Skin Cancer Prevention and Screening Week, Dr. Marie Sophie Gautier, dermatologist specializing in skin cancer, explains how the sampling and analysis of suspicious moles takes place.

In France, nearly 1.2 million ablations of superficial skin lesions were performed in 2021, according to a figure from Health Insurance. Intended to prevent skin cancers – and especially the most dangerous, melanoma – this surgery is most often quick and painless. How does it take place and how much is it reimbursed? On the occasion of Skin Cancer Prevention and Screening Week, which takes place from June 12 to 17, Dr. Marie Sophie Gautier, dermatologist specializing in skin cancer, provides her answers to questions about our moles.

On the same subject

Melanoma, interview with Caroline Robert, dermatologist

When should you consult for a mole?

Dr. Marie-Sophie Gautier. If there is appearance of a new mole different from the others or change in appearance of one of them. The lesions at risk present at least one of the following characteristics: Asymmetry (neither round nor oval), Irregular edges, Uneven color, Diameter greater than 6 mm, or Rapid evolution – in a few months – of their size, shape or color (rule “A B C D E”). Fact, 20% of melanomas derive from a nevus [autre nom du grain de beauté, ndlr] pre-existing and 80% of a newly appeared lesion…

How do you remove a mole?

This “surgical excision” takes place under local anesthesia and lasts about 30 minutes. The dermatologist begins by injecting the area to be operated on with Xylocaine®, a local anesthetic. The reference technique then consists of incising the skin around the nevus with a scalpel, removing it, then suturing the wound. Finally, the removed lesion is sent to a laboratory for anatomopathological analysis (under a microscope), in order to confirm or refute its malignant nature.

What about “local” CO2 laser destruction?

Used mainly to remove unsightly nevi without risk, this approach is strongly discouraged : it does not allow the anatomopathological examination of the mole. However, this examination is essential to guarantee the benign nature of the lesion.

What if it’s melanoma?

The doctor performs a new operation around the scar from the first excision, to remove a strip of healthy skin 1 to 2 cm wide depending on the thickness of the melanoma. If this is greater than or equal to 1 mm, it will also be necessary to remove the first lymph node as close as possible to the tumor in order to analyze it and determine if it is affected (sentinel lymph node technique). In the majority of cases, if the cancer has remained limited to the skin, theexcision will ensure complete recovery.

How to treat the scar?

In general, the patient can disinfect it himself daily, with soap and water, or an antiseptic. The sutures are removed on average 15 days later, by the doctor or a nurse.

Then, throughout the maturation period of the scar, namely 12 to 18 months, it must be protected from the sun with clothing and/or very high protection sunscreen (SPF 50+). Because if it becomes pigmented then, it will be definitive.

How much does mole removal cost?

If the intervention is medically justified, it is covered by social security and mutual funds. If the excision is for purely aesthetic purposes, the patient will have to pay the entire bill (on average €100).

Our expert: Dr. Marie Sophie Gautier, dermatologist and skin cancer specialist

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