In short. A changing mole, a lesion that will not heal, or a rash with fever is assessed as disease before anything cosmetic is discussed. What to watch for.
Key points
- A diagnosis comes before a treatment plan, every time.
- Everything else on this site assumes that step has been taken, and a plan that skips it is a plan built on an assumption rather than on a finding.
Not every change in the skin is an aesthetic question, and the ones that are not take priority over everything else on this site. Recognising them is not a matter of expertise. It is a matter of knowing which behaviours belong with a doctor rather than with a course of treatment.
A mole that is changing
The finding that matters is change. A mole that is growing, altering in shape or colour, developing an irregular edge, or beginning to itch, bleed or crust is examined as a possible skin cancer before any cosmetic plan is discussed. Most such lesions are harmless, and the assessment is quick. The reason to have it done is that the serious ones are far easier to treat when they are small, and that judgement cannot be made from a photograph or in a mirror.
A spot that will not heal
A sore, crusted patch or small ulcer that has not settled over a few weeks is examined rather than treated, and so is one that bleeds with minor trauma or keeps crusting after it appears to be healing. This applies particularly to skin that has had years of sun exposure: the face, the ears, the scalp, the backs of the hands and the lower lip. Where a practitioner is asked to treat over such a lesion, the honest response is to have it examined first.
A rash with symptoms beyond the skin
A rash accompanied by fever, joint pain, mouth ulcers or a feeling of being generally unwell is a medical illness with a skin sign rather than a skin problem. A reaction that spreads rapidly, blisters, or involves the eyes or mouth needs urgent assessment. A rash appearing after a new medicine belongs with a doctor, and quickly if there is fever or swelling. These are not findings to manage with a skincare routine while waiting for an appointment.
What happens to the cosmetic plan
Where any of this is present, it is dealt with first. That is not a delay in treatment; it is the correct order, because an active skin disease changes what an aesthetic treatment is safe to do, and treating over an undiagnosed lesion changes its appearance and makes later assessment harder. Once the medical question is settled, the aesthetic one can be considered on a sound footing, and where nothing serious is found, the conversation begins where it left off.
The order is not negotiable
A diagnosis comes before a treatment plan, every time. Everything else on this site assumes that step has been taken, and a plan that skips it is a plan built on an assumption rather than on a finding.
Have these looked at promptly
- A mole that is changing, itching, bleeding or crusting, or a new dark lesion that is growing.
- A sore, ulcer or crusted patch that has not healed over a few weeks.
- A rash with fever, joint pain, mouth ulcers, blistering or involvement of the eyes.
Frequently asked questions
How long should a sore take to heal before it is checked?
A sore or spot that has not settled over a few weeks should be looked at, particularly on skin that is regularly exposed to the sun and particularly if it bleeds with minor trauma or crusts repeatedly. Most such lesions are not serious. The reason to have them examined is that the ones which are serious are far easier to treat when they are small, and that distinction cannot be made by looking in a mirror.
Can I have an aesthetic treatment over a mole?
Not over one that has not been examined. Treating over a lesion changes its appearance, which makes later assessment harder, and some treatments injure the skin around it. If a mole sits inside an area you want treated, the sensible order is to have it examined first and to plan around it. A practitioner who is willing to treat straight over an unexamined lesion has skipped a step.
What kind of rash needs urgent attention?
A rash with fever, joint pain, mouth ulcers or a feeling of being generally unwell is a medical illness rather than a skin complaint, and it needs prompt assessment. So does a rash that spreads rapidly, blisters, is painful rather than itchy, or involves the eyes, mouth or genitals. A rash that appears after starting a new medicine also belongs with a doctor, and urgently so if it comes with fever.
Risks & Limitations
- Every skin treatment carries risk, and no result can be promised.
- Pigment often returns after treatment, especially after sun exposure, because the cells that produce it remain in place.
- Skin that marks easily after injury can darken or lighten after a treatment, which is why a test spot is used to judge the risk.
- Results are judged over months rather than weeks, and maintenance is often needed to hold them.
When to Seek Care
- A mole that is changing in size, shape or colour, or one that bleeds, itches or crusts.
- A spot, sore or crusted patch that has not healed over a few weeks.
- A rash with fever, joint pain, mouth ulcers or blistering, or one that involves the eyes or mouth.
- A treated area that becomes increasingly painful, red, hot and swollen, which may be an infection.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
- National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
- Cochrane Library — systematic reviews
- Chinese Medical Association Plastic Surgery Branch — clinical guidance
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.