Key messages
Medical lifestyle products, such as self-removal of pigment marks, are «in». However, the application is not free of risks, as the Medical history of a 31-year-old woman , which Dr. med Katja Schlömer Soares and her colleagues from the Skin Center Wuppertal describe.
The patient and her history
According to the authors, the patient presented 4 weeks after using a «mole removal pen» with the desire for laser therapy to correct the scars caused by self-treatment.She obtained the CE-marked pen from the Internet via a large trading platform for a price of about 30 euros and removed about 100 pigment marks on the entire body with it. The device would be, as the dermatologists further report, thin needles and an attachment for the removal of the pigment marks included. The patient followed the recommendations of the enclosed package leaflet and used the pen 10–30s depending on the size of the pigment mark. In the mostly painful treatment, there was «a burn of the skin with subsequent encrustation of the treated areas and scarring healing after about 5 to 10 days» After the crusts had fallen off, reddish ‘dots’ remained, which the patient found cosmetically very disturbing and now wanted to have laser medicine corrected».
According to Soares and her colleagues, the findings
According to Soares and her colleagues, the clinical examination revealed about 100 partly erythematous, partly white maculae along the entire integument.After the treatment, dermatoscopy showed partly whitish structureless areas in the sense of permanent scar tissue next to vascular structures of varying degrees of severity. The vessels were more pronounced on the legs than in upper body areas. In the course of the treated areas, multiple «light brownish maculae with pigment network in the sense of recurrent nevi (about 20)» could have been observed.
Discussion
In the presented case, according to the authors, «an uncontrolled and incomplete removal of pigment marks on the entire integument without prior medical diagnosis or indication» took place. The case shows that patients do not shy away from painful self-treatment with products «from questionable sources». And even obvious spelling or translation errors («mole removal»: «mole removal») in the product descriptions and the instructions for use did not stop some people from using it.
Products for such self-treatments are easily available via large online sales portals.These products also include the «mole removal pen» presented, the mechanism of action of which is presumably based on microablation by means of ionising gas; however, this is unclear due to a lack of manufacturer’s information. There are also affordable wrinkle reduction products such as microneedling pens and rollers with penetration depths of 2mm and more, «radio frequency» and «radio frequency devices», also «pico lasers» and other devices for applying energy to the skin.
Dangers are often not or only insufficiently pointed out in the user instructions. In addition to scars, the possible consequences of incomplete treatment of potentially malignant skin lesions should be considered; «The risk of not detecting malignant skin tumors, which in the worst case can lead to metastasis due to delayed diagnosis in the further course, should not be underestimated,» warn Soares and her colleagues.
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