Local anesthetic early pregnancy

[MSumner12]

Hi Dr. Rockoff,
Me again for the last time i hope.
My derm recommended removing mole on my areola
as it is new and dark, but also said he'd be shocked if
it was anything but benign.

I am 9 weeks pregnant, and going to try and wait maybe 2 more weeks so I am closer to 2nd trimester. He said he wouldn't wait more than a month.

Question is: what is the least risky way to remove this thing? I have been told so many different things re: epinephrine, lidocaine, etc. One person said no epi in pregnancy, yet my OB said it was fine, that the amount used was miniscule. Then the same OB's office lists it as safe AFTER first trimester. I know you mentioned saline, which is fine, but I usually get punch biopsy's done with stitch to get full depth, etc. I have no clue
if this is shallow or not. It looks to be right on surface, but I guess who knows.

Bottom line: what is the safest alternative here for both me and the fetus? I do not want to overreact, yet I certainly don't want to have any regrets either way! Thanks!

[Alan Rockoff, MD]

Yes, but you really don't need it.

Dr. Rockoff

[MSumner12]

Thank you-- is epinephrine also ok normally? You just mentioned lidocaine...

[Alan Rockoff, MD]

Most obstetricians I know have no problem with lidocaine during pregnancy.  Generally, I do shave biopsies using saline.  I'm sure any way your doctor recommends will be fine, both for you and the fetus.

Take care.

Dr. Rockoff