Should You Remove Moles on the Genitals? Expert Insights and Advice

Q: Should You Remove Moles on the Genitals? Expert Insights and Advice

Here are some key points： 1. <br>The vast majority of moles are benign; 2. <br>Each mole should be observed individually; having multiple moles does not necessarily increase the risk of malignancy; 3. <br>For individuals of Asian descent, the risk of malignancy in moles located o

Moles: Should they be treated?

I have over 30 moles on my penis and scrotum, which look quite alarming.
I noticed them more than a year ago, but I'm not sure when they appeared.
They are all smooth, painless, and itch-free.
I previously consulted a doctor who said they are likely hereditary and not concerning, suggesting that I just observe them.
However, no biopsy was performed.
Since they look quite frightening, I researched online and found conflicting opinions.
Some doctors recommend removing pigmented moles on the genitals to prevent skin cancer, while others suggest that observation is sufficient.
I'm unsure which advice is correct.
Additionally, I have a history of scrotal eczema that occasionally flares up, and sometimes I unconsciously scratch it.
Could this have any impact? If I decide to remove the moles, is there a risk of developing keloids or scarring? What do you recommend? Should I consider removal?

Lio, 30~39 year old female. Ask Date: 2012/03/25

Dr. Wu Yuxin reply Dermatology

Here are some key points: 1.
The vast majority of moles are benign; 2.
Each mole should be observed individually; having multiple moles does not necessarily increase the risk of malignancy; 3.
For individuals of Asian descent, the risk of malignancy in moles located on the genital area is not higher; similarly, each mole should be observed individually; 4.
If you are considering surgical removal due to concerns about malignancy, the issue of scarring should be relatively less important, shouldn't it? 5.
Scrotal eczema is very prone to recurrence; during flare-ups, a standard eczema cream can be applied, and if there is no itching, the medication can be discontinued, and there is no need to continue applying it.

Reply Date: 2012/03/25

More Info

When it comes to moles on the genitals, particularly in sensitive areas such as the penis and scrotum, there are several factors to consider before deciding whether to remove them. Moles, or nevi, can vary widely in appearance, and while many are benign, some may warrant further investigation or removal, especially if there are changes in size, shape, color, or if they become symptomatic (itchy, painful, etc.).

Expert Insights on Moles in Genital Areas
1. Observation vs. Removal: The advice you received from your physician to observe the moles is a common approach, especially if they are asymptomatic (not causing pain or discomfort) and have not changed over time. Many dermatologists recommend a "watchful waiting" approach for benign moles, particularly if they have been stable for a long period. However, if you have concerns about their appearance or if they are causing psychological distress, discussing removal options with a dermatologist is reasonable.

2. Risk of Skin Cancer: The concern about moles potentially becoming cancerous is valid. While most moles are harmless, certain types, particularly atypical moles or those that exhibit changes, can have a higher risk of developing into melanoma, a serious form of skin cancer. The genital area is not immune to skin cancer, and any new or changing moles should be evaluated. If your moles have been stable and your doctor has assessed them as benign, the risk may be low, but it’s essential to remain vigilant.

3. Genital Moles and Hygiene: Given your mention of experiencing eczema in the scrotal area, it’s important to consider how this condition might interact with the moles. Eczema can lead to scratching and irritation, which may affect the moles. If you find yourself scratching the area frequently, it could potentially lead to changes in the moles or even secondary infections. Managing the eczema effectively may help reduce irritation and the urge to scratch.

4. Removal Considerations: If you decide to pursue removal, it’s crucial to consult with a qualified dermatologist or urologist who specializes in skin lesions in sensitive areas. They can provide options for removal, such as excision or laser treatment. Both methods have their pros and cons:
- Excision: This method involves cutting out the mole and some surrounding tissue. It can provide a definitive diagnosis if the mole is sent for histopathological examination. However, it may leave a scar, and there is a risk of keloid formation, especially in sensitive areas.

- Laser Treatment: This method can be less invasive and may result in minimal scarring. However, it may not be suitable for all types of moles, and there is a risk that the mole may not be completely removed.

5. Scarring and Keloids: The concern about scarring, particularly keloids, is valid. Keloids are raised scars that can occur after skin injury, and individuals with a history of keloid formation should discuss this with their doctor before proceeding with any removal. A dermatologist can assess your skin type and history to provide tailored advice.

Recommendations
- Follow-Up Consultation: Schedule a follow-up appointment with a dermatologist to discuss your concerns about the moles and the eczema. They can perform a thorough examination and possibly a biopsy if there are any suspicious features.

- Monitor Changes: Keep an eye on the moles for any changes in size, shape, or color, and report these changes to your doctor.

- Manage Eczema: Work with your healthcare provider to manage your eczema effectively, which may help reduce irritation and the urge to scratch.

- Consider Psychological Impact: If the appearance of the moles is causing you distress, discuss this with your doctor. They may provide options for removal that can improve your comfort and confidence.

In conclusion, while the initial assessment by your physician was to observe the moles, it’s essential to remain vigilant and proactive about your health. Regular check-ups and open communication with your healthcare provider will help ensure that any potential issues are addressed promptly.

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