2. Use the ¼-in. loop tip on the radiofrequency scalpel to carefully excise the mole to the dermis. For the initial passes, the CUT mode is used for the removal of the bulk of the mole. For the fine passes near the base, the device can be switched to the CUT/COAG mode to provide fine coagulation for hemostasis. The loop pencil is handled very lightly to avoid excessive depth of excision. Use a light brushing stroke to remove the mole layer by layer (Figure 9-3).

3. Loop-and-ball technique: The second stage involves the removal of a forehead lesion that is well demarcated at its base so a surgical marker is not used. The local block has been placed and is visible by the blanching of the skin around the base of the nevus. Again, use the ¼-in. loop tip on the radiofrequency scalpel to carefully shave the mole to the dermis. For the initial passes, the CUT mode is used for the removal of the bulk of the mole. Initially shave off 1 to 2 mm of depth at a time, then begin to make even thinner cuts as the base of the nevus is approached (Figure 9-4, A). (When only a small remnant of the nevus is left behind, the tip of the pencil is switched to the small ball-tip to lightly coagulate the remnants of the mole rim. After each layer is coagulated, firmly wipe the area with gauze, which removes the layer that was just coagulated. After repeating the procedure three to four times, the nevus will be fully eradicated, and only the surface of the dermis remains. Perform one final coagulation of the base of the lesion for hemostasis (Figure 9-4, B).