​​​​​​​​​​​​鍾經略醫生【皮膚科碩士 x 美容醫學碩士】課程研究​

​​​​地址 香港中環皇后大道中9號嘉軒廣場

電話 Tel 23630598（注 6）

Address: the Galleria, No. 9 Queen's Road Central, Hong Kong

（1）脫墨案例/價錢（2）脫墨影片（3）脫墨須知​ （４）各種切除術的比較 （５）面部不同部位的縫合技術

 1. Everything about mole removal   2. Case studies & Surgical fees of diff moles   3. Mole removal video 

Highlight: Rationale for Surgical Excision Over Laser Treatment in a Clinically Benign Mole

Clinical Description of the mole:

A skin-coloured to light-coloured raised nevus is observed beneath the medial aspect of the left eyebrow. The lesion is oriented predominantly along a horizontal axis. It measures approximately 0.9 cm at its greatest diameter and 0.5 cm at its smallest. The elevation from the surrounding skin surface is approximately 5 mm. Notably, terminal hair growth is present within the lesion.

Likely Diagnosis: Intradermal (Dermal) Nevus

Key Features:
Raised above skin surface
Light or skin-coloured appearance
Terminal hair growth present
Smooth surface
Well-defined borders

These characteristics match the profile of an intradermal nevus, where nevus cells are located deep within the dermis, beneath the epidermis. Because the pigment cells are buried under semi-transparent skin layers, the mole often appears lighter or even flesh-toned. Hair growth is common because the lesion may involve or lie near hair follicles.

Clinical Insight

Intradermal nevi are benign and often stable over time. Their depth makes them less pigmented and more likely to be hair-bearing. If removal is considered, techniques like elliptical excision or CO₂ laser may be used, depending on location and cosmetic goals.

Rationale for Surgical Excision:

The reason we chose to excise the mole rather than remove it with a laser is not because it is malignant or because we are uncertain about its nature. The decision was based on the depth of the mole’s root, which extends deep into the skin. Laser treatment would likely require multiple sessions and could result in an unsightly scar. Additionally, for a better aesthetic outcome, we wanted to remove the hairs growing from the mole. Surgical excision allows for permanent removal of both the mole and the associated hair follicles, whereas laser treatment may not effectively eliminate the hairs.

討論重點：為什麼我們選擇手術切除這粒良性的墨痣，而不使用激光呢？

臨床描述：

在左側眉毛內側下方可見一顆隆起的皮膚色至淺色痣。病灶呈水平軸向分佈，最大直徑約為 0.9 公分，最小直徑約為 0.5 公分。病灶自皮膚表面隆起約 0.5 公分。表面可見終末毛髮生長，病灶邊界清晰，外觀穩定。

診斷理由：真皮痣（Dermal Nevus）

此病灶位於左側眉毛下方，呈皮膚色至淺色隆起，邊界清晰，表面可見毛髮生長，且病灶穩定。根據皮膚科臨床判斷，具備以下特徵，符合真皮痣的診斷標準：

✅ 病灶隆起且穩定：真皮痣通常呈半球狀或圓頂狀隆起，生長緩慢，外觀穩定。
✅ 色澤與皮膚相近：顏色多為膚色、淡褐色或粉色，與表皮痣相比，色素沉著較少。
✅ 毛髮生長：病灶表面可見終末毛髮，為真皮痣常見特徵之一。
✅ 病灶根部深入真皮層：根據醫師判斷，病灶位於皮層下方深處，若以激光處理，可能造成較大傷口，進一步支持其屬於真皮層病變。
✅ 邊界清晰，無惡性變化跡象：病灶邊緣清楚，無潰瘍、出血或不規則擴張，符合良性痣的表現。

綜合以上臨床特徵與醫學影像判斷，此病灶最可能為良性真皮痣，建議以手術方式完整切除，以減少復發及疤痕風險。

總結：為什麼我們選擇手術切除而不使用激光呢？

當我們選擇以手術切除這顆痣，而不是使用激光去除，並不是因為它具有惡性或我們對其性質感到不確定。事實上，這顆痣在臨床上看起來是良性的。

我們之所以選擇手術切除，是因為這顆痣的根部深入皮膚深層。若以激光處理，可能需要多次療程，且仍無法完全清除，反而容易留下明顯且不美觀的疤痕。此外，為了達到更理想的美學效果，我們也希望能一併去除痣上生長的毛髮。

手術切除能夠連同毛囊一併移除，達到永久去除毛髮的效果；而激光治療則可能無法有效清除這些毛髮，導致日後仍有毛髮再生的情況。

總結而言，手術切除不僅能確保痣被完整移除，也能降低疤痕風險，並提供更乾淨、自然的外觀效果。

備註：

有人會擔心手術後縫合時，可能會拉扯到眉毛或眼皮的皮膚，因而造成眉毛稍往下拉,或眼皮往上拉,會變成兩邊眼眉不對稱。

其實在手術當中皮膚科醫生可以製造足夠的undermining，以減低皮膚的表面張力，過度拉扯引致的變形及不對稱會因此動作而大大減少。狗耳的形成也可以此而避免。

Note:

Some people may worry that suturing after surgical excision of a mole could pull on the skin around the eyebrow or eyelid, potentially causing the eyebrow to droop slightly or the eyelid to lift—resulting in asymmetry between the two sides.

In fact, during the procedure, the aesthetic doctor performs adequate undermining to reduce surface tension on the skin. This technique significantly minimizes the risk of distortion and asymmetry caused by excessive traction. It also helps prevent the formation of "dog ears" at the edges.
 ​

切出的墨痣。Specimen

切出的墨痣。 Specimen

比較好的做法就是把它以手術方法割除。切除之後，傷口以超幼細線縫合。由於這種線線身極之幼細，所以針孔細到幾乎看不見，傷口癒合後，手術線將會被拆掉。

A better approach is to surgically remove the lesion. After excision, the wound is closed using ultra-fine sutures. Because these sutures are extremely thin, the needle marks are not easily visible 

位於左邊眉毛之下的巨大墨痣，有毛髮從其中長出來。墨痣的根部位於皮層下深處，如果以激光清除，傷口預期會相當大。傷口越大，疤痕形成的機會就會越大。而且，對於深層痣進行重複激光治療，可能造成顯著的組織損傷，並留下明顯且不美觀的疤痕。再者，激光脫墨並不能同時脫毛，而手術切除就連墨痣裏面的毛髮都會被一齊除去。

A large pigmented mole located beneath the left eyebrow exhibited hair growth from within. The root of the mole extended deep beneath the skin layers. If removed using laser treatment, the resulting wound would likely be quite extensive. The larger the wound, the greater the chance of scar formation. Moreover, repeated laser treatments on a deep mole may cause significant tissue damage and leave behind noticeable and unsightly scarring. Additionally, laser mole removal does not simultaneously remove hair, whereas surgical excision eliminates the entire mole along with the embedded hair follicles.

主診醫生：鍾經略醫生
皮膚科專業監督及指導機構 – 英國威爾斯大學/卡的夫大學臨床皮膚專科部門，倫頓大學皮膚科
皮膚科醫生常見的皮膚問題 - 手術切除墨痣

此墨痣的皮膚科醫學照片，版權所有，複製必究。