I have a mole under my arm that has been causing me some concern. 
I've had it all my life, and previously, it was very small, flat and
was not bothersome.  Recently, it has become vexing - it has gotten
larger, is detaching from my skin, is much darker than before, and it
occasionally itches quite ferociously.

Yes, I know this is bad.  Yes, I know it could be cancerous.  Please
don't urge me to see my doctor, that will be vastly unhelpful - my
appointment is Tuesday.

I'm certain my doctor will recommend immediate removal.  What I need
is for someone to describe the different procedures available for mole
removal.

The entire mole is still mostly flat, and the size of the tip of a
pencil eraser.  The area still attached to my skin is about half that
size.  Does this make a difference in procedures?  I am also very fair
complected, and bruise and scar quite easily.  Does this influence the
sort of procedure that might be used?  Which method affords the
fastest healing?  What methods of pain management are used during the
procedures?

Ideally, this will be answered by someone who has either had a mole
removed themselves or has a close friend or family member who has had
such a procedure and can draw from their experiences as well as their
research.  Not a requirement, of course, but it would be helpful.

I am too tired and too nervous to effectively research this subject
myself, but want to be well informed before I see my doctor.  Your
help is appreciated.

--missy

Dear Missy:

Your mole will probably be surgically excised. Typically this results
in a very small scar. Laser or cautery removal is another option,
which leaves less scaring but destroys the mole and it can not be
examined histologically to determine if it is malignant.

The procedure will be done at the doctor’s office after a local
injection of a numbing medicine such as lidocaine or marcaine. Some
doctors use a cold spray that freezes the top of the skin so that you
do not feel the needle of the numbing medicine.

Once it is numb he will use a scalpel to make the necessary incision
and cut out the mole.
After it is removed he’ll put a stitch or two in place to close the
incision and send the mole off for testing.

The procedure should only take a few minutes: after which you will
probably not need anything stronger than Tylenol for pain.

When I had mine removed I did not have to take anything at all.

If the mole is benign no further treatment is indicated.

If malignant you may need additional testing and treatment.

Take courage! Most moles are benign.

Read more about moles and treatment at:

http://www.xtramsn.co.nz/health/0,,8086-1188606,00.html
http://www.merck.com/pubs/mmanual/section10/chapter125/125b.htm
http://www.merck.com/pubs/mmanual_home/sec18/207.htm
http://web.ukonline.co.uk/ruth.livingstone/little/melanoma.htm

Search Terms: skin mole removal procedure
Search Engine: Google
Other Sources: Merck Manual On-Line

You are in my prayers,
Kinglouie-ga

Thanks, kinglouie.  This is precisely the sort of information I was
looking for - matter of fact, non-alarming, and from a source known
for solid medical information.  The "funny moles" page was a nice
touch, as it handles a somewhat scary subject in a humorous, soothing
fashion.  Thanks too, to Rebekah, for the additional links and
descriptions.

I feel much better prepared and less nervous.

(Pre note,  I actually starting typing this about 2 hours ago, but I
put so much effort into it, that by the time I went to post it, it was
locked.. yet another downfall of not yet being a researcher :(  I hope
it still helps, nonetheless!)

Hey Missy,
   You probably know I'm not a researcher, unfortunately, so I can
only comment.   I have had seven-eight moles removed in the past 10
years, so I am very familiar with the process. Initially, they'll ask
you questions about your skin history, history of cancer, etc... and
they may take a small sample of the mole (by punching a small piece
out, or cutting), or, if it's really bothering you, they'll just go
ahead and remove it. From what I've experienced there are three-four
known ways of removing them, burning, freezing/laser, and cutting.

   I don't know particularly when burning or freezing are used over
one another.  I think burning may be an older thing, and no longer
used anymore, because lately all of my moles have been frozen off. Of
course, that may have also had something to do with the fact that my
newer ones have been on the face, I've never had one "burned" off of
my face.  If the mole is flat however, neither of these procedures
works well.  Burning is pretty self explanatory, (I honestly think my
doctor used a cigarette lighter!) and "freezing" is where they use a
torch type thing (no bigger than a pen), with liquid nitrogen, I
believe.  Neither is painful at all.

Additionally, now, more and more dermatologists (I've had a few) are
using lasers, which feels just like what I say is "freezing" (it may
actually be the same thing).  You just feel a little buzz, with the
little pen-type instrument, and it's over from there.

   Cutting is used when the mole is flat.  A scapel type instrument is
used (usually the skin is numbed, of course, and I've even had them
use the laughing gas that you might get in a dentist's office on me). 
This is a little more painful, depending on the size (diameter) of the
mole.

    Honestly, the only pain comes if stitches are used (if it's a
large mole), or if it's in an uncomfortable place. Being that it's
under your arm, you may be in for an agitating couple of days, but I'm
guessing it's no worse than the nervousness (and itching) you're
feeling now.

    I've very fairly complected as well (which got us both into this
situation to begin with, I'm afraid), and also bruise and scar easily.
 That has never been mentioned by any doctor, (in fact, one even said
that being fair skinned made me a better candidate for the procedure),
and all three removal procedures that I've experienced have been used
equally.

   From the type of mole that you've described,  I believe it most
likely (especially due to the location), will be "frozen" off, and
they may have to cut a little for the part that's attached flat to the
skin (unless it just falls off after the freezing), however I'm
definitely not a dermatologist.

 That's it for the personal opinion/experience.. here's, in the Google
Answers tradition, some links that may be of assistance:

Here's a nice article in a FAQ format, that answers many of the
questions you just asked me, in a simple to read kind of way:
http://www.ienhance.com/DermatologyProcedures/moleremoval.html

Here's another similar FAQ type article:
http://www.drgitt.com/mole.htm

Here's another one, but this is more on the explaining the cancer side
of it,
http://www.cancersource.com/LearnAboutCancer/FAQs/index.cfm?DiseaseID=8

Finally, some "Lagniappe" (extra) as they say in my hometown of New
Orleans,  just to cheer you up!  This is a great page of funny jokes,
uplifting stories, and other links:
http://pub26.ezboard.com/fostomymessageboardfrm3

Don't sweat it, it's pretty painless & takes less than an hour!

Let me know how it goes, I really hope this helped out,

-Rebekah

One more procedure involves using liquid nitrogen to "freeze" the mole
dead and then it's "dead" and naturally falls off. It's much like the
process to remove warts which have gotten too large. My friend's
father had this procedure done.

Hi missy-ga,

As already discussed above, the freezing off is used in the UK.
I had a mole removed which was slightly thicker than a pencil head.

It is totally painless too, they spray the mole with an 'aerosol' type
device for about 30 seconds. After a few days, it just drops off. (I
think it 'was' a form of liquid nitrogen). Though possibly the
freezing off method is not used if they want to carry out inspection
in the lab, as the specimen only drops off a few days later and the
cells are changed by the freezing. So if it was investigative it would
'probably' be need to be removed surgically. I have had a bump removed
surgically for lab inspection, and that was quite painless as well, as
the scalpel is so sharp. The pain management for me was not really an
issue, the main issue was 'get it off me!'  and the main worry 'was
it?' or 'isn't it?' (malignant) The freezing off method has left no or
very little scaring. The scapel has left a faint scar as stitches were
used, but in fairness the surgical removal was about twice the size of
the non surgical. Freezing off heals relatively fast, the surgical is
quite slow and I had to go back to have the stitches removed, the area
also felt sensitive.
I did a lot of research at the time and geee.... it's scarey reading
some of the articles. I'd leave it to your doctor on Tuesday. I'm a
bit of a hypocondriac myself!
all the best lot-ga