Reading Time: <1 minuteIn principle, the anesthetic used for mole removal is lidocaine hydrochloride, or xylocaine.　https://www.kegg.jp/medicus-bin/japic_med_product?id=00000332-003is used. We use xylocaine containing epinephrine, a vasoconstrictor. Epirenamine has the effect of constricting blood vessels during treatment to suppress bleeding and extending the effective time of xylocaine. Although medical school textbooks state that use on the tip of the nose and fingertips is contraindicated, there are currently no clinical problems. (It was thought that vasoconstriction could cause skin necrosis.) A 0.5% to 2.0% concentration is often used, but for mole removal, 0.5% is a sufficient concentration and there is no problem with use. We use xylocaine in our clinic, and as the name xylocaine hydrochloride lidocaine suggests, its pH is acidic 3.3 to 5.0. When injected into the body, especially into the dermis, the drug causes pain due to the difference in pH when it diffuses. For this reason, we mix an alkaline drug called Meylon to further lower the concentration and adjust the pH to about 7.3, which is as close to the body's pH as possible, and we make our own by adjusting the pH. In actual use, the pain during injection is much less than that of conventional xylocaine injections, reducing the burden on the patient. In addition, the needle used to inject is extremely thin, from 30G to 34G, which significantly reduces the pain. When removing multiple moles, an injection is required for each mole, so pain relief care for the patient during anesthesia is always necessary. Although the amount of anesthesia required for mole removal is small and easy, careful injection can relieve pain. At our clinic, we use extremely thin needles and a homemade xylocaine anesthetic with an adjusted pH level to remove moles.