Moles, Spots and Genital Warts

UROLOGY TREATMENTS

Moles, Spots and Genital Warts

Removal of moles, warts and spots on the male and female genitalia by laser and minor surgery

Moles, Spots and Genital Warts

Table of Contents

Definition

What are moles, warts and spots?

The popular spots that appear on the skin of the face or body in general in the form of moles and warts can also affect the skin of the male or female genitals, darkening them and altering their aesthetic appearance. Lately, this is one of the most frequent consultations at Andromedi, and not only from patients from Seville and the province, but from the rest of Spain who travel to our city looking for a specialist in this type of lesions in the intimate area.

Fortunately, there are new and effective techniques in aesthetic medicine that provide great results, while at the same time delivering high levels of safety.

It is important to know which are the characteristics that differentiate these cutaneous phenomena. Among them:

What are moles?

Moles, also called melanocytic nevi, are small, painless, hyperpigmented lesions that appear scattered on the skin of the face and back, although they may appear in any location on the body, including places as diverse as the soles of the feet, the palms of the hands, or on the skin of the external genitalia.

The characteristics of moles can vary greatly in size, shape, location, colour, and texture (some are somewhat raised on the skin and can be felt).

They rarely exceed 3 mm in diameter and are usually dark brown, given their melanocytic nature. They are more evident on lighter skins and some of them appear and disappear overtime on their own. In some cases, they migrate and change colour.

Moles can occur spontaneously on the skin of the penis and scrotum (in men) and the skin of the vagina (in women), making these areas less beautiful or physically attractive and making those who suffer from them uncomfortable.

Asymmetric shaped mole

Mole with poorly defined edges

Different colors in the same mole

Diameter greater than 6mm

Notable negative evolution over time

What are warts?

Papilloma infection process

Warts are benign skin lesions where there is a visible and palpable bump on the skin. They are completely painless and in some cases are the result of skin manifestations of the human papillomavirus (HPV).

They often appear during adolescence but can occur at any stage of life.

The most common locations of warts are on the palms of the hands, knuckles, armpit region, soles of the feet, and in the genital and anal areas. These lesions are undoubtedly much more uncomfortable than moles and generic skin spots because in many cases, warts are large enough to become entangled in clothing or irritated by constant friction and contact, such as during sex.

What are spots?

Spots are areas of hyperpigmented skin, usually brown (with shades ranging from light to dark brown or reddish spots).

Most skin patches are present from birth and do not cause any symptoms in adulthood. Some may change in size, colour, or location over time. Some others simply disappear spontaneously after a few years.

The back, chest and neck are the most frequent sites of appearance. However, it is also common for them to appear in genital regions (such as the mons pubis, labia majora, and perianal region in women, and near the penis or in the scrotum in men).

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Medical Evaluation

Why are moles, warts, and skin spots removed from the genitals?

In recent decades there has been a clear increase in cosmetic interventions aimed at removing moles, warts and blemishes from the body. Especially those of the genital areas, in both women and men.

The first reason for this increase has to do fundamentally with the aesthetic aspect of the genital region. Most patients detest how certain skin imperfections on their genitals ruin how they look and make them uncomfortable when having sex, especially oral sex (cunnilingus, fellatio, etc). Not to mention the fact that in some cases, warts and moles can be uncomfortable and cause pain if they are rubbed for a few minutes or with the rubbing of underwear.

The second reason is related to the medical aspect.

There is medical evidence to support the hypothesis that certain skin lesions (such as moles or warts) tend to become malignant over the years and produce major symptoms, putting the patient’s life in danger. Especially if the patient has certain risk factors such as age, genetic predisposition and the amount of UV radiation he or she may have received during his or her lifetime.

Techniques and treatments

Techniques for removing moles, warts and spots

In Urology and Andrology, the application of laser technology has proven to be very effective in multiple and diverse treatments. The new implantation in our centre in Seville of several devices generating Fractional CO2 Laser allows us to offer solutions to a wide range of pathologies and aesthetic problems in the genital area, both male and female:

Conventional techniques (traditional, some outdated) of resection and removal of moles, warts and spots on the genitals included any of these three methods:

Cut it

With tweezers, scissors or surgical scalpels. This involves removing even some of the skin below the skin lesion and some stitches.

Freeze

The mole, wart or spot with a little liquid nitrogen (placed with a swab or in spray form). The lesion will fall off on its own after a few days and the wound should be covered.

Burn

The mole, wart or spot with an instrument that has a small coil of wire at one end and is heated by an induced electrical current.

These techniques are currently in disuse largely because of the many side effects they caused to the patient, not to mention the fact that recovery was somewhat painful and there was a risk of infection if the surgical wound was not properly cared for.

There is another set of quite avant-garde techniques to permanently remove moles, warts and stains from the genital skin. These surgical techniques use laser “scalpels”, which offer great precision and safety in the operation.

· ND Laser: YAG (Neodymium - YAG) ·

The neodymium YAG (or better known as ND: YAG) laser is one of the newest and most precise types of lasers in the arsenal of our centre for urology, andrology and sexual medicine in Seville.

It combines precision in the emission of waves with exact wavelengths, appropriate to each type of skin and skin lesion to be eliminated or removed. Its applications range from tattoo removal to the disappearance of moles, warts and spots in places as diverse as the skin of the external genitals, in men and women.

The wavelengths used by the neodymium YAG type laser range from 1064nm to 532nm.

The procedure consists of applying laser light beams directly on the skin lesion, on the skin previously prepared with moisturizing and antiseptic lotions. The treatment is carried out between 1 and 4 sessions, separated by an approximate time of three weeks (to favour the repair and the recovery of the skin).

The procedure is performed in a medical office, without the need for hospitalization and by a qualified professional in dermatology or its equivalent.

After each laser treatment session, the skin becomes a little rougher and whitish scabs of flaky skin appear, which will fall off on their own as the days go by. These skin scabs are cleaned with a physiological solution and protected from infection with antiseptic ointments.

Remove warts and spots with laser. Before

Remove warts and spots with laser. Treatment

Remove warts and spots with laser. Results

The applications of the Nd: Yag laser range from the removal of tattoos to the disappearance of moles, warts and spots in places as diverse as the skin of the external genitalia, in men and women.

· Fractionated carbon dioxide laser ·

The fractionated carbon dioxide (or CO2) laser is a somewhat more conventional and older cosmetic procedure than the neodymium laser. Until a few decades ago it was the most widely used type of laser in aesthetic medicine due to its cost, however, it was somewhat more expensive than the current ones. Nowadays, fortunately for all of us, it is much more affordable.

The fractionated carbon dioxide laser uses a complex CO2 laser-type ion emission system to reach the layers of the skin with the most need and thus eliminate blemishes, moles, scars and promote cell renewal.

The procedure is usually the same as with the previous type of laser. The patient goes to the dermatologist for a pre-treatment evaluation, his medical history and skin lesions are reviewed (through a physical examination) and the most appropriate treatment for the case is indicated.

preparación pre cirugía

The skin in the area to be treated receives a previous preparation with moisturizing creams and lotions (which facilitates the work of the laser). The emission of laser waves is done according to the specific needs of the area and after a few days, the skin flakes and spots start gradually disappearing. The sessions are carried out with a minimum of three weeks between them, for skin repair. Usually, one to four sessions are necessary to notice results.

The care of the area of skin treated with laser includes:

What is the scientific basis of the laser? Why does it work?

The vast majority of unsightly skin lesions (moles, spots…) are characterized by areas of hyperpigmented skin, which means that there is a large accumulation of melanin in a small area of skin. Melanin is a natural brown pigment that is produced by the human body cells. Its purpose is to protect the cells in the deeper layers of the skin from dangerous ultraviolet radiation.

Applying laser rays on hyperpigmented skin destroys the cells that accumulate melanin (called melanocytes) in the epidermis, causing it to be released into the extracellular matrix and reabsorbed by the circulatory and lymphatic system. As a result, the skin is freed of excess melanin and looks whiter.

Which of the two lasers is better and why?

According to various investigations, the ND: YAG laser has better results than the CO2 laser due to several reasons.

Laser contraindications

There are some medical conditions that keep the patient from being a candidate for laser treatments almost automatically and they will be taken into account from the first consultations, to review the person’s medical history. Among the contraindications are:

Wart removal with shock waves

Shock waves are one of the most versatile health solutions we currently have in Medicine, although they are known primarily in urology for their use in the treatment of lithiasis (stones). They have been used by urologists and today they are the most common way to solve a lithiasis problem (lithotripsy). However, in other specialities such as Cardiology, it has been shown that low-intensity shock waves induce tissue revascularization, the generation of new blood vessels; and they have been used during the last decade in the treatment of chronic cardiac ischemia (patients with angina pectoris and recurrent myocardial infarctions.

The so-called Low-Intensity Shockwave Therapy (LISW) uses a very low energy (0.09 mJ/mm2), equivalent to 10% of the energy used by conventional urinary tract stone lithotripters.

Shock waves impotence treatment

During the last 3 years, a similar low-intensity technique has been used in different centres with the same energy density level for the treatment of Erectile Dysfunction. The system used was the Omnispec 1000, essentially an orthopaedic device modified with focused energy. The results with this device are very promising and were reported in different international congresses and published in the European Urology.

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Frequent questions

Can moles be removed with pharmacy medications or do home remedies work as I have read online?

There are countless home remedies available on the Internet for removing moles, ranging from astringent and lightening creams to vegetable poultices. However, virtually none of these treatments have been tested or supported by relevant medical studies to measure their effectiveness and safety.

Removing a mole (or a melanocytic nevus) involves completely destroying a large group of melanocytic cells that are clustered together and located under the skin. For this reason, a home or drug treatment is unlikely to eliminate it completely and forever.

What are the risks of trying to remove a wart by ripping it off?

There are certain popular techniques for wart removal. These range from cutting out the entire lesion with a razor blade (at home) to tying the base of the wart with a strand of hair until the wart falls off on its own.

These techniques can be potentially dangerous because removing a skin element such as a wart without medical supervision and proper antiseptic care can carry a high risk of infection.

In addition, warts are skin lesions of varying sizes that protrude from the skin. They are incredibly vascularized and can bleed profusely if they are cut. Their removal must be done in a hospital and by qualified personnel to prevent bleeding or infection.

Is recovery after laser removal of moles, warts or spots on the genitals painful or uncomfortable?

In the days following a laser mole, wart or blemish removal treatment, the patient should watch for a number of normal skin reactions. For example, there is a slight peeling of the skin above the skin lesion, itching, and signs of irritation.

These discomforts are usually well-tolerated and disappear completely on their own after a couple of weeks.

How can I tell if a mole (or a nevus) is malignant or benign? When should I see a dermatologist?
In almost 95 per cent of cases, moles (also called melanocytic nevi) are benign skin lesions, which means that they are completely safe, asymptomatic, and do not pose a risk of becoming malignant. However, in other cases, moles can become malignant and produce more serious and delicate problems. Evaluating whether a mole has become malignant or not is the job of the dermatologist. They will carefully examine the lesion, review the patient’s medical history, and obtain a small sample of tissue to take to a laboratory for biopsy. If the result is positive, a treatment plan is drawn up that is appropriate to the patient’s needs. However, a benign mole can become malignant and modify some of its characteristics such as:
  • Size (they get bigger).
  • Colour (they change to darker colours or degrade rapidly).
  • Texture (some grow so large that they become palpable).
  • Contour (some tend to become irregularly contoured and grow without an apparent pattern).
In other cases, moles may itch, hurt, ooze pus, or bleed. This is a clear indication of a neoplasia process.

 

Dr. Natalio Cruz

Author

Dr. Natalio Cruz


El Dr. Cruz, con 25 años de experiencia médica, ha sido hasta 2016 Jefe de la Unidad de Andrología en el Servicio de Urología del Hospital Virgen del Rocío de Sevilla, Coordinador Nacional de Andrología de la Asociación Española de Urología (AEU) y Secretario General de la ESSM, cargos que ha delgado para centrarse de lleno en el ilusionante proyecto de ofrecer una consulta médica privada de alto nivel en Sevilla.