17. Comparison of Mole Removal Approaches: Beauty Salons, Traditional Dermatologists, and Traditional Plastic Surgeons
美容院的脫墨痣方式
在美容院進行脫墨痣，通常由美容師或治療師負責。他們並無醫學專業資格，往往是透過同行傳授或自學而來，甚至依靠網上影片（其中不少示範並不正確），或憑個人經驗與直覺操作。部分美容師可能曾在醫院或診所工作，因為經常目睹醫生進行相關手術，便自行開業嘗試為顧客脫墨痣。
其常見方法是利用激光或電灼，對痣的表面進行燒灼，觀察痣是否消退；若未完全消失，便在數週後再次加深燒灼。這種方式的問題在於，墨痣的根部往往深入真皮層，尤其是生長多年（超過 5–10 年）的痣，根部更深。僅靠表層燒灼難以徹底清除，反覆操作（由於皮膚被反覆破壞）則容易造成深層疤痕，並增加感染或組織損傷的風險。
傳統皮膚科醫生的脫墨痣方式
皮膚科醫生具備專業醫學訓練，對消毒、感染控制及診斷能力遠高於美容師。然而，在臨床實踐中，由於傳統皮膚科屬於內科培訓，較少手術訓練，部分皮膚科醫生對於墨痣的處理仍偏向快速、以激光或電灼為主。他們通常會燒灼表層，若未清除乾淨，再進行一至兩次追加治療。此方法對於淺層痣較有效，但對於根部深厚的墨痣（例如有些墨痣雖然看上去不大，但生長年期已經超過 5–10 年的痣），仍難以徹底清除，反覆操作（由於皮膚被反覆破壞）亦可能留下難看的疤痕。
值得注意的是，傳統皮膚科醫生雖然較少選擇切割手術，但在必要時仍會進行病理檢查，以確保痣屬於良性，避免忽略惡性病變的風險。
傳統整形外科醫生的脫墨痣方式
傳統整形外科醫生屬外科專科，習慣以手術刀進行切除。他們對激光治療相對手術而言較少經驗，因此在臨床上更傾向建議病人以手術方式處理墨痣，對於較細小的墨痣亦然。手術切除的優點是能徹底移除痣，包括深層根部，並可送病理檢驗，確保安全。然而，手術費用通常較高，且會留下線狀或複雜疤痕。
在臨床上，部分傳統整形外科醫生即使面對細小、淺層的墨痣（激光已足以清除），仍會建議以手術切除。有時甚至會提出較複雜的方案，如皮瓣移植或皮膚移植，處理原本可簡單切除的良性墨痣。這種「過度治療」可能導致疤痕比單純切除更明顯，對患者的美觀造成不必要的影響。
專業總結
美容院：缺乏專業訓練，方法簡單但風險高，難以徹底清除深層痣，容易造成疤痕或併發症。
傳統皮膚科醫生：具備醫學背景，消毒及診斷較可靠，但若僅依靠激光或電灼，對深層痣仍有局限。
傳統整形外科醫生：能透過手術徹底切除痣並進行病理檢驗，但費用高，疤痕較明顯，部分情況可能有過度治療的傾向。
在選擇上，病人應該選擇聽取多位醫生及不同專科的意見才作最後決定，因為面上/身體的墨痣一旦被破壞，已經會有疤痕的風險，雖然良性的墨痣通常都不會因為錯誤的治療而導致有生命危險，但是好多時候因為選擇錯誤的治療而導致的疤痕是不能逆轉的。雖然舊有教材強調避免「四處尋醫」(即doctor shopping)，但在現代醫療環境下，合理的多重意見比較是患者教育與自主權的重要體現。作為受過教育的患者，聆聽不同醫生的專業意見，並在充分理解後作出知情選擇，才是真正符合現代醫學倫理的行為。
Mole Removal in Beauty Salons
Mole removal performed in beauty salons is typically carried out by beauticians or therapists who lack formal medical qualifications. Their skills are often acquired informally—through peer instruction, self-learning, or online videos, many of which demonstrate incorrect techniques. Some beauticians may have previously worked in hospitals or clinics and, after observing physicians perform mole removal procedures, attempt to replicate these methods independently in their own practice.
The common approach involves the use of laser or electrocautery to superficially burn the mole. If the mole persists, the procedure is repeated after several weeks with deeper cauterization. The limitation of this method lies in the fact that many moles extend into the deeper dermis, particularly those that have been present for more than 5–10 years. Superficial burning alone is insufficient for complete removal, and repeated destructive procedures (ie CO2 laser or cauterisation) often result in scarring, infection, or tissue damage.
Mole Removal by Traditional Dermatologists
Dermatologists possess formal medical training, with expertise in sterilization, infection control, and diagnostic accuracy far exceeding that of beauticians. However, traditional dermatology training is largely medical rather than surgical, and many dermatologists prefer quick, non-invasive methods such as laser or electrocautery. Typically, they cauterize the mole’s surface and, if incomplete, repeat the procedure several times. This approach is effective for superficial moles but inadequate for deeper lesions. (Please note: Some moles may appear small on the surface, but their roots can extend very deep into the dermis, particularly those that have been present for more than 5–10 years) Repeated cauterization will thus leave conspicuous scars.
While traditional dermatologists may prefer non-invasive laser treatments, they are more likely to conduct histopathological examination when necessary, ensuring that malignant lesions are not overlooked.
Mole Removal by Traditional Plastic Surgeons
Traditional plastic surgeons, trained in surgical disciplines, are accustomed to excision with a scalpel. Compared to surgery, they generally have less experience with non-invasive laser treatments and therefore tend to recommend surgical removal even for small moles. The advantage of surgical excision is complete removal of the mole, including its deep root, with the added benefit of histopathological confirmation. However, surgery is more costly and often leaves unsightly scars.
Some traditional plastic surgeons may recommend surgical excision for small, superficial moles that could otherwise be effectively treated with laser. In certain cases, they may even propose complex procedures such as skin grafts or flap reconstruction for benign moles that could be managed with simple excision. Such “over-treatment” can result in scars that are more pronounced than those from straightforward removal, unnecessarily compromising cosmetic outcomes.
Summary
Beauty Salons: Lack professional training; methods are simple but high-risk, often ineffective for deep moles, and prone to scarring or complications.
Traditional Dermatologists: Medically trained with reliable sterilization and diagnostic practices, but reliance on laser/electrocautery limits effectiveness for deep-rooted moles.
Traditional Plastic Surgeons: Capable of complete excision with pathological confirmation, but higher cost, more visible scarring, and occasional tendency toward overtreatment.
Conclusion
Patients should seek opinions from multiple physicians across different specialties before making a final decision. Once a mole is treated, scarring risk is inevitable, and while benign moles rarely pose life-threatening danger, scars from inappropriate treatment are irreversible. Although older medical texts discouraged “doctor shopping,” in modern healthcare, obtaining multiple professional opinions is an essential aspect of patient education and autonomy. An informed patient listens to diverse medical perspectives and makes a decision based on comprehensive understanding—this reflects the true spirit of contemporary medical ethics.