​Careful Assessment and Plasma-Pen Removal of Suitable Benign Skin Lesions

Raised benign moles and skin tags can become irritating, catch on clothing or jewellery, interfere with shaving or simply cause cosmetic concern.

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At Jaime Correia Aesthetics, suitable benign raised moles and skin tags may be removed using controlled plasma technology. Every treatment begins with an assessment because not every lump, mole or pigmented mark is suitable for cosmetic removal.

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Jaime Correia is an Advanced Nurse Practitioner and Independent Prescriber with more than 20 years of NHS clinical experience and over 15 years in aesthetics. His priority is to determine whether cosmetic treatment is appropriate—or whether a lesion should instead be assessed by your GP or a dermatologist.

Changing, suspicious or uncertain lesions will not be treated with a plasma pen.

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What Is a Skin Tag?

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A skin tag, medically known as an acrochordon, is a small, soft piece of skin that projects from the surrounding surface.

Skin tags commonly develop in areas where skin rubs against skin, clothing or jewellery, including:

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• Neck

• Underarms

• Upper chest

• Beneath the breasts

• Groin

• Around the waistband

• Eyelid area

• Other natural skin folds

 

They can be flesh-coloured or slightly darker than the surrounding skin. Some have a narrow stalk, while others have a broader attachment.

Skin tags are usually harmless, but not every small raised lesion is necessarily a skin tag. Assessment is required before treatment.

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What Is a Benign Mole?

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A mole, medically known as a melanocytic naevus, is formed from a collection of pigment-producing cells.

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Moles can be:

• Flat or raised

• Skin-coloured, pink, tan or brown

• Smooth or textured

• Present from childhood or develop later

• Hair-bearing

• Small or relatively prominent

 

Most moles are harmless. However, appearance alone does not always establish that a lesion is benign.

Plasma treatment may be considered only for selected raised moles that have been appropriately assessed and show no concerning features. Flat pigmented moles, uncertain lesions and lesions requiring laboratory examination are not suitable for destructive plasma treatment.

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Why Assessment Must Come Before Removal

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Removing a skin lesion for cosmetic reasons should never begin with the assumption that it is harmless.

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During assessment, Jaime will consider:

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• How long the lesion has been present

• Whether it has changed

• Its colour, shape and border

• Whether it bleeds, crusts, itches or hurts

• Its size and location

• Whether it looks different from your other moles

• Previous skin-cancer history

• Family history

• Sun-exposure history

• Previous assessment or treatment

• Your medical history and medication

• Your healing and scarring history

• Your skin tone and pigmentation risk

 

If there is uncertainty about the diagnosis or suitability for cosmetic treatment, removal will not proceed.

You may be advised to obtain an assessment from your GP, dermatologist or another appropriately qualified skin-lesion specialist.

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When a Mole Must Be Medically Assessed

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Contact your GP rather than booking cosmetic removal if a mole or skin lesion:

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• Is new and continuing to grow

• Has changed in size, shape or colour

• Has become asymmetrical

• Has an irregular or poorly defined border

• Contains several colours

• Looks noticeably different from your other moles

• Bleeds without an obvious cause

• Repeatedly crusts or oozes

• Has become persistently itchy, painful or tender

• Forms a sore that does not heal

• Has changed in height or texture

• Has returned or changed after previous removal

 

These signs do not necessarily mean that a lesion is cancerous, but they require appropriate medical assessment.

The familiar ABCDE guide can help identify concerning changes:

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• A – Asymmetry: one half differs from the other

• B – Border: irregular, blurred, scalloped or uneven edges

• C – Colour: variation or development of new colours

• D – Diameter: a larger lesion may require particular attention, although melanomas can also be small

• E – Evolution: any change in appearance or symptoms

 

Evolution or change is particularly important. A lesion does not need to meet every ABCDE feature to require medical attention.

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Why Suspicious Moles Should Not Be Removed With a Plasma Pen

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Plasma treatment destroys or vaporises the targeted tissue. This can mean that there is no complete intact specimen available to send to a laboratory for histology.

Histology is the microscopic examination of removed tissue. It may be required when the nature of a mole or lesion is uncertain.

Where melanoma or another skin cancer is suspected, the usual diagnostic pathway involves appropriate specialist assessment and surgical removal so the tissue can be examined by a pathologist.

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For that reason:

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• Plasma treatment is not a diagnostic procedure.

• It must not be used on suspicious or uncertain moles.

• It is not a substitute for dermoscopy, biopsy or histology.

• It should not be selected simply because it appears quicker than surgical removal.

• A cosmetic outcome must never take priority over obtaining an accurate diagnosis.

 

How Does Plasma-Pen Removal Work?

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A professional plasma device creates a small, controlled thermal effect at the treatment point. This allows suitable superficial benign tissue to be reduced or removed without conventional surgical cutting.

Treatment is carefully limited to the assessed lesion. The technique and amount of treatment depend on:

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• Lesion type

• Lesion size

• Whether it is stalked or broad-based

• Treatment area

• Skin thickness

• Skin tone

• Healing history

• Proximity to delicate structures

 

Plasma treatment intentionally creates a controlled skin injury. A dry crust commonly forms afterwards as the area heals.

Although the procedure may avoid conventional excision and stitches, it should not be described as  painless or risk-free.

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Which Lesions May Be Suitable?

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Following assessment, plasma treatment may be considered for:

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• Typical skin tags

• Selected small, raised benign moles

• Some superficial, clearly benign raised lesions

• Lesions that repeatedly catch on clothing or jewellery

• Benign raised lesions causing cosmetic concern

 

Suitability cannot be confirmed from the name a patient gives the lesion. What appears to be a “skin tag” or “mole” may be another type of skin lesion requiring different management.

Treatment availability also depends on the lesion’s location, size, colour, depth and clinical appearance.

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Which Lesions Will JCA Not Treat?

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JCA will not use plasma treatment for:

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• Suspicious or changing moles

• Lesions without a reasonably clear benign diagnosis

• Possible melanoma or another skin cancer

• Irregularly pigmented lesions

• Lesions that require biopsy or histology

• Rapidly growing lesions

• Bleeding, crusting or non-healing lesions without diagnosis

• Infected or inflamed lesions

• Lesions situated where plasma treatment would be unsafe

• Lesions where surgery is likely to provide a more appropriate outcome

• Any lesion outside Jaime’s professional competence or insurance coverage

 

Referral is a safety decision, not a refusal of care.

 

Skin Tags Versus Moles

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Skin tags and moles are not the same.

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Skin tagsMoles

Usually soft and flesh-coloured. May be skin-coloured, pink, tan or brown

Often attached by a small stalk. Can be flat, raised or dome-shaped

Common in skin folds. Can occur almost anywhere

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Frequently associated with friction. Formed from pigment-producing cells

Usually straightforward to recognise. May require closer clinical assessment

Do not normally require histology when clearly typical. Some require surgical removal and histological examination

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If a lesion does not have the typical appearance of a skin tag, further assessment may be recommended.

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Why Do People Choose to Remove Benign Moles or Skin Tags?

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Patients may request removal because a lesion:

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• Catches on necklaces or clothing

• Is irritated by a collar or waistband

• Bleeds after shaving or friction

• Interferes with applying makeup

• Sits in a prominent facial or neck area

• Has become repeatedly inflamed through rubbing

• Causes self-consciousness

• Is inconvenient during grooming

 

Cosmetic concern is a valid reason to request a consultation, provided the lesion is benign and the expected benefit justifies the risk of scarring or pigmentation change.

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Your Consultation

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Your consultation is a clinical assessment rather than an automatic agreement to remove the lesion.

Jaime will:

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1. Discuss the lesion’s history.

2. Ask about change or new symptoms.

3. Review your medical history and medication.

4. Examine the treatment area.

5. Consider whether plasma treatment is appropriate.

6. Explain alternatives where relevant.

7. Discuss the likelihood of complete removal.

8. Explain healing, aftercare and possible complications.

9. Confirm the anticipated price.

10. Refer you for medical assessment where necessary.

 

Clinical photographs may be taken with your consent as part of your confidential treatment record.

In some cases, consultation and treatment may need to take place on separate days. Do not assume that every lesion submitted through an online photograph can be treated at the first appointment.

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Sending a Photograph Before Your Appointment

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A clear photograph may help with initial triage, particularly for patients travelling to the Manchester clinic. However, a photograph cannot provide a definitive diagnosis or replace an in-person examination.

If sending photographs, include:

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• A clear close-up in good lighting

• A wider image showing the location

• A ruler or another size reference where practical

• How long the lesion has been present

• Whether it has changed

• Whether it bleeds, crusts, itches or hurts

• Whether it has previously been assessed

 

Do not apply makeup or filters to the lesion before taking the photograph.

An invitation to attend following photographic triage does not guarantee that treatment will proceed.

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What Happens During Plasma Treatment?

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The lesion and surrounding skin are cleansed and prepared. A local comfort measure or topical anaesthetic may be considered where clinically appropriate.

The plasma device is then used carefully on the selected benign lesion. You may notice heat, stinging or a sharp sensation during treatment.

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The time required depends on:

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• Number of lesions

• Size of each lesion

• Treatment area

• Lesion attachment and depth

• Patient comfort

• Whether treatment needs to be staged

 

A small dry crust or scab commonly develops following treatment. This is part of the healing response and must be allowed to separate naturally.

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Can Several Skin Tags Be Treated Together?

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Multiple typical skin tags may sometimes be treated during one appointment.

The appropriate number depends on:

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• Their location

• Their size

• The total treatment area

• Your skin and healing history

• The amount of local inflammation created

• The time required

• Your tolerance

• The practicality of aftercare

 

Treating an excessive number at once may make aftercare and healing more difficult. A staged plan may therefore be recommended.

Each lesion still requires assessment; a group of lesions should not automatically be assumed to consist entirely of skin tags.

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Will One Session Be Enough?

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Many small skin tags can be removed during one treatment, but complete clearance cannot be guaranteed.

A further session may be required where:

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• A mole has a broad base

• A lesion is deeper than expected

• Conservative treatment was chosen to reduce scarring risk

• Residual tissue remains

• The lesion recurs

• Several lesions are being treated in stages

 

Trying to remove too much tissue in one session can increase the risk of a depressed scar, pigment change or delayed healing.

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What Will the Area Look Like Afterwards?

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Immediately after treatment, the area may appear:

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• Red

• Slightly swollen

• Tender

• Darker or charred-looking at the treatment point

• Dry or crusted

• More noticeable than before treatment

 

A small crust commonly forms and should fall away naturally as healing progresses.

Once the crust has separated, the new skin may initially appear pink, lighter or darker than the surrounding area. Colour usually evolves with healing, but persistent pigmentation change is possible.

The final appearance should not be judged immediately.

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Healing and Downtime

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Healing time varies according to:

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• Lesion size and depth

• Treatment location

• Number of lesions

• Skin tone

• General health

• Treatment intensity

• Aftercare

• Individual healing response

 

Areas exposed to friction, makeup, shaving or movement may require particular care.

The procedure should not be booked immediately before a wedding, holiday, swimming trip, photography session or another important event. The treated area may remain visibly crusted while it heals.

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Plasma-Treatment Aftercare

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You will receive personalised written aftercare.

General advice may include:

• Keep the area clean and dry as instructed

• Do not pick, scratch or remove the crust

• Avoid rubbing from clothing or jewellery

• Avoid makeup over the area until advised

• Do not shave directly over healing skin

• Avoid swimming, saunas and excessive heat temporarily

• Avoid unapproved antiseptics, acids or active skincare

• Protect the healed area from sun exposure

• Use the recommended sun protection once appropriate

• Contact the clinic if healing differs from what was explained

 

Picking the crust can increase the risk of infection, scarring and pigmentation change.

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Risks and Possible Complications

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Plasma removal involves controlled thermal injury to the skin. All procedures carry risks.

Possible effects and complications include:

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• Pain, stinging or tenderness

• Redness and swelling

• Bleeding

• Crusting and scabbing

• Infection

• Delayed healing

• Irritation or contact dermatitis

• A raised, hypertrophic or keloid scar

• A depressed or indented scar

• Persistent redness

• Post-inflammatory hyperpigmentation

• Hypopigmentation or loss of pigment

• A visible difference in skin texture

• Incomplete removal

• Recurrence

• Hair loss within a treated hair-bearing lesion

 

Every mole-removal method can leave a mark. Plasma treatment must never be advertised as scar-free.

Pigmentation changes can be more noticeable and persistent in some darker skin tones or in people with a previous history of post-inflammatory hyperpigmentation.

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Who May Not Be Suitable?

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Treatment may be inappropriate or require additional consideration if you:

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• Have a changing, suspicious or uncertain lesion

• Have active infection or inflammation in the area

• Have an open wound

• Have a history of keloid or problematic scarring

• Have previously developed significant pigmentation after injury

• Have poorly controlled diabetes

• Have impaired wound healing

• Are significantly immunosuppressed

• Have a bleeding disorder

• Take medication that affects bleeding or healing

• Have an implanted electrical medical device that may be relevant to the plasma equipment

• Have recently tanned or sustained sunburn

• Are unable to follow the required aftercare

• Expect completely unmarked skin afterwards

 

Elective treatment is generally postponed during pregnancy and breastfeeding.

Do not discontinue prescribed medication before treatment unless advised by the clinician responsible for prescribing it.

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Plasma Pen, Surgical Excision or Another Method?

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The most appropriate removal method depends on the lesion.

Plasma Treatment

May be suitable for selected superficial benign raised lesions where destructive treatment is clinically appropriate.

A benign lesion does not have to be removed. Monitoring may be the most appropriate choice where the cosmetic benefit is unlikely to justify the risk of a visible mark.

If histology is required, plasma treatment is not the correct removal method.

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