1. Diagnosis of a mole as being of the type that is statistically more likely to become malignant; such a mole would be the large, hairy ‘bathing trunk’ naevus.

2. The presence of changes suspected to be malignant.

3. The occurrence of functional changes within the mole. These may be irritation, trauma, or infection.

4. Cosmetic reasons. In this case removal is only successful if the result improves the appearance of the individual. The choice of surgical technique is therefore important.

There is absolutely no foundation for the widely-held misconception that surgical interference with a mole will cause it to become malignant. This may have arisen from the result of inadequate treatment of what in fact was already an early malignant melanoma, not a simple mole. All doubtful moles should be excised with an adequate margin and submitted for pathological examination. No moles should ever be simply destroyed by cauterization or similar treatment without adequate pathological examination. Removal for cosmetic or functional reasons does not necessarily have to be complete. Elliptical excision and suturing may be avoided and a very satisfactory cosmetic result obtained by a shave excision. This entails shaving the mole off flush with the skin surface, and stopping bleeding with light electro-desiccation.

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