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Before CO₂ Removal — Is It a Mole or Skin Cancer?

Dr. Jib from 22 Square Clinic explains

Many people walk into 22 Square Clinic with a similar question:

“Doctor, can I remove this mole with laser today? It looks really annoying.”

But before picking up the laser handpiece, Dr. Jib — a dermatosurgeon at 22 Square Clinic — always checks one crucial thing:
 Is it truly a harmless mole, or could it be something more serious?

Because not every mole is safe to remove with a CO₂ laser.
 Some might actually be skin cancer or atypical moles, which could spread or worsen if treated incorrectly.
 That’s why, before performing any laser procedure, a careful examination is always the first step.

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Mole vs. Skin Cancer — What’s the Difference?

mole (nevus)

A mole (nevus) is formed when melanocytes (the pigment-producing cells) cluster together in the skin.
 Most moles are benign, meaning they’re harmless and often stable throughout life.
 They may appear flat or raised, lighter or darker with time, or even have tiny hairs — all of which can still be perfectly normal.

skin cancer

However, skin cancer is a different story.
 There are three major types we often encounter:

  • Melanoma

  • Basal Cell Carcinoma (BCC)

  • Squamous Cell Carcinoma (SCC)

Among these, melanoma is the most dangerous because it can look deceptively similar to a regular mole — but has the potential to spread to other organs if left untreated.

⚠️ Warning Signs — When a Mole Might Be Dangerous

Dermatologists around the world use a simple rule called the ABCDE criteria to identify suspicious moles:

Letter

Meaning

Signs of Concern

A – Asymmetry

Uneven halves

One side looks different from the other

B – Border

Irregular edges

Blurred, notched, or spreading border

C – Color

Uneven color

Multiple colors like brown, black, red, or gray in one mole

D – Diameter

Size

Larger than 6 mm

E – Evolving

Change

Growing rapidly, painful, itchy, or bleeding

If you notice any of these changes, it’s essential to have the mole checked by a dermatologist using a dermoscope — a specialized magnifying device — before deciding to remove it.

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Why You Should Not Remove a Mole Immediately with CO₂ Laser

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A CO₂ laser works by emitting focused light energy (wavelength 10,600 nm) that vaporizes skin tissue precisely and effectively.
 It’s an excellent tool for removing benign growths such as moles, warts, or sebaceous hyperplasia.
 However, there’s one critical limitation:

Laser destroys the entire tissue — leaving nothing behind for pathological examination.

If the lesion turns out to be skin cancer, we lose the opportunity to confirm the diagnosis and assess its severity.
 This can lead to delayed treatment and cancer progression beneath the surface.

That’s why Dr. Jib always emphasizes:

“Before treating anything, we must first know what we’re treating.”

How We Examine a Mole Before Removal

จองคิวเพื่อเข้ารับการตรวจ - คลิ๊ก

At 22 Square Clinic, every mole is evaluated using a dermoscope, a device that magnifies and illuminates skin structures invisible to the naked eye.
 Within just a few minutes, this allows Dr. Jib to analyze:

  • Pigment network and symmetry

  • Vascular patterns

  • Presence of dots, streaks, or atypical structures

If the pattern looks suspicious, laser removal will be postponed and one of these steps may be recommended:

  • Skin biopsy: to confirm whether it’s benign or malignant

  • Follow-up observation: to monitor any growth or change over 3–6 months

Only when the lesion is confirmed benign (e.g., mole, skin tag, sebaceous gland hyperplasia, or wart) will CO₂ laser removal be safely performed.

CO₂ Laser

Step-by-Step: CO₂ Laser Mole Removal

สอบถามรายละเอียด

Once confirmed safe, here’s how the procedure typically goes:

Most patients feel only mild heat or tingling.
 There’s no downtime, and you can return to work or normal activities immediately after.

1. Cleansing and antiseptic preparation

2. Topical anesthetic applied for 30–45 minutes

3. CO₂ laser energy adjusted based on mole depth

4. Laser vaporization performed precisely, layer by layer

5. Antibiotic ointment applied with post-care instructions

CO₂ Laser

Aftercare for Smooth Healing

Proper care ensures a beautiful, scar-free recovery. Dr. Jib recommends:

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If the mole was on the face, a follow-up visit after 1–2 weeks helps ensure optimal healing and assess whether any touch-up laser is needed.

Avoid water and sweat for 24 hours

Apply antibiotic ointment until the scab naturally falls off (5–7 days)

Never pick or scratch the scab

Use brightening or anti-pigment creams (e.g., vitamin C, kojic acid) after the wound closes

Apply sunscreen daily and avoid strong sunlight for 2 weeks

Common Questions from Patients

Q: Can moles come back after CO₂ laser removal?

A: Yes, especially if the mole’s root extends deep into the dermis. In such cases, a repeat session may be needed — usually with excellent cosmetic results.

Q: Should I get checked if I have many moles?

A: Absolutely. People with fair skin, a history of sun exposure, or family history of skin cancer should get a full-skin examination at least once a year.

Q: Can children have moles removed?

A: Yes, if the mole grows rapidly or gets irritated from friction. However, it should always be evaluated and treated by a dermatologist.
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Dr. Jib’s Key Message

“CO₂ laser is a fantastic tool — but it’s only safe when we’re certain the mole isn’t cancerous.
 Beauty should never come at the expense of safety.”

At 22 Square Clinic, every laser procedure is performed by board-certified dermatologists, using FDA-approved medical equipment and strict safety standards.
 We also provide follow-up care to ensure proper healing and long-term skin health.

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Quick Summary Before You Remove a Mole

  • Never remove a mole without proper evaluation

  • Always check with a dermoscope first

  • If suspicious, do a biopsy instead of laser

  • Protect your skin from sunlight after the procedure
  • Choose a clinic with qualified dermatologists for best and safest results

At 22 Square Clinic, we believe your beauty deserves a safe home.
 Because your beauty deserves a home.

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LINE: @22squareclinic
22 Square Clinic
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Professional advice. Personalized service.
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