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Lesion Removal

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Experienced dermatologist is undergoing anti-aging ultrasound procedure at wellness center. Man is lying. His eyes are closed with pleasure

Lesion Removal

Skin lesions are lumps or bumps on your skin, such as moles, cysts, warts or skin tags. They can be removed from your skin using chemical and surgical procedures. You will meet the doctor carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs. Most skin lesions don’t cause serious problems, but you may want to have them removed for practical or cosmetic reasons. If you wish to have a skin lesion removed for cosmetic reasons, this will not be covered by the NHS, but you can have the treatment done at a private clinic. There are different methods to remove skin lesions – the type of procedure you have will depend on the type of skin lesion you have. If you have benign (non-cancerous) warts for example, you can be treated with non-surgical procedures. Larger skin lesions or ones that needs a precise removal may need to be surgically removed. Your GP or dermatologist (a doctor who specialises in identifying and treating skin conditions) will advise you on what treatment will work best for you. Your doctor may advise you to have surgery if you have a skin lesion that shows any sign of turning cancerous, for example, a mole that has changed shape or colour. The lesion that is removed will be sent to a laboratory for testing to determine the type of cells and if these are benign or cancerous.
Frequently Asked Questions
  • Preparation
  • The Procedure
  • Aftercare
  • Recovery
  • Risks
  • FAQ’s
Preparation

Your doctor will explain how to prepare for your procedure.

Skin lesion removal is routinely done as an outpatient procedure. This means you have the procedure and go home the same day.

Depending on the size of the lesion and where it is on your body, a skin lesion can be removed at your doctor’s surgery or at a hospital. Skin lesion removal is usually done under local anaesthesia. This blocks pain from the area and you will stay awake during the procedure.

Your doctor will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead. For procedures that require a local anaesthetic, you will usually be asked to sign a consent form.

The Procedure

factors such as its size and where it is on your body. Your doctor will advise you which method is most appropriate for you. Techniques to remove a skin lesion include the following.

  • Some lesions can be shaved down to the level of your surrounding skin. Your doctor will use either a surgical blade or a laser (a high-energy beam of light) to destroy the lesion.
  • Your doctor can snip skin tags off with surgical scissors.
  • Lesions, such as suspected skin cancer, are cut out entirely and your doctor will close the wound with stitches (these may be dissolvable) or skin glue.
  • Some skin lesions may be frozen off with liquid nitrogen (cryotherapy) or treated with creams such as those that contain imiquimod or salicylic acid.
  • Some skin lesions can be treated with photodynamic therapy. A chemical will be applied to your lesion and your doctor will then shine a light on it, which will activate the chemical and destroy the lesion.

Your doctor will apply a dressing to the wound, if necessary, but some wounds heal better if they are left uncovered.

Aftercare

After a local anaesthetic it may take several hours before the feeling comes back to the affected area. Take special care not to bump or knock the area.

You will usually be able to go home when you feel ready. If you have had a sedative, you will need to arrange for someone to drive you home. If you have had a larger procedure, such as a skin graft or an operation on your head and neck, try to have a friend or relative stay with you for the first 24 hours after your procedure.

Your doctor or nurse will give you some advice about caring for your healing wound before you go home. You may be given a date for a follow-up appointment.

Your doctor or nurse will remove any non-dissolvable stitches after your procedure. Usually, this is after about seven days if the stitches are on your face, and 10 to 14 days if they are on the rest of your body. The length of time any dissolvable stitches will take to disappear depends on what type you have. However, for most skin lesion removal procedures, they should usually disappear in about 10 to 14 days.

Recovery

Your wound may take two to three weeks to heal depending on where it is on your body and your individual circumstances.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Your doctor may advise you to:

  • avoid stretching the affected area, particularly until you have any stitches removed
  • keep the wound dry for 48 hours and then clean it gently
  • not apply make-up until your wound has fully healed
Risks

As with every procedure, there are some risks associated with skin lesion removal. We haven’t included the chance of these happening as they are specific to you and differ for every person. Ask your doctor to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Side-effects of skin lesion removal include:

  • pain
  • swelling
  • bruising

All surgical skin lesion removal procedures leave you with a scar. How big and how noticeable this will be depends on the type of procedure you have and how much of your skin is removed. Ask your doctor about how much scarring to expect after your treatment. Most scars fade significantly over several months.

Complications

Complications are when problems occur during or after the procedure. The possible complications of any procedure include an unexpected reaction to the anaesthetic or excessive bleeding.

Complications of having a skin lesion removed include:

  • infection – you may need to take antibiotics to treat this.
  • changes in your skin sensation, such as numbness, or a burning sensation – this can happen if surface nerves are damaged but it’s usually temporary.
  • unusual red or raised scars (keloids) – these can be difficult to treat.
  • excessive bleeding – it’s usual for the wound to bleed a little after surgery, but occasionally it can be more severe.
FAQ’s

I have found a new lump on my skin, what should I do?

Answer

Most skin lesions, such as moles, cysts, warts or skin tags, aren’t harmful. However, if you have a new mole or lump, or if an existing one has changed, see your GP to have it checked.

Explanation

There are many different types of skin lesion, which include those listed below. Most aren’t harmful.

  • Moles are small, dark areas of skin that you may be born with but mostly develop when you’re a child or in your early adult life.
  • Keratoses are brown or pink scaly bits of skin that can appear anywhere on your body. There are several different types of keratoses, some are related to sun exposure and have a small risk of developing into skin cancer.
  • Warts are small, rough lesions that are caused by infection with the human papilloma virus (HPV).
  • Skin tags are small, flesh-coloured bumps on your skin. They often form where your skin creases or gets rubbed (for example, on your neck).

Some skin lesions can be cancerous. Skin cancer is often painless and there are several types that can look different. Basal cell carcinomas often appear as a small, red, waxy or shiny lump. Squamous cell carcinomas often appear as a small pink lump with hard or scaly or crusty skin.

Malignant melanoma is a form of skin cancer that usually starts as a dark spot or mole on your skin. If a melanoma spreads to other parts of your body, you can develop other symptoms such as swollen lymph nodes (glands throughout your body that are part of your immune system).

Symptoms that may indicate skin cancer include any mole, spot, lump or patch that:

  • doesn’t heal after four weeks
  • gets bigger, changes shape or colour
  • has an irregular edge
  • is patchy in colour or multi-shaded
  • bleeds or is crusty

These symptoms aren’t always caused by skin cancer, but if you have them, see your GP.

I have skin tags on my eyelids: what is the best treatment?

Answer

Skin tags can be surgically removed or frozen off with liquid nitrogen. Both treatments are suitable for skin tags near your eyes.

Explanation

Skin tags, also called acrochordons, cutaneous papillomas and fibroepithelial polyps, are small, flesh coloured bumps on your skin. They often form in places where your skin creases or where it gets rubbed (for example, your neck, armpits and groin). Skin tags are more common in obese people and are occasionally associated with other conditions such as diabetes. Pregnant women are also more prone to getting skin tags.

Skin tags don’t usually cause problems, but you may choose to have them removed for cosmetic or practical reasons (for example, if they catch on your clothing).

Treatments include:

  • surgery – your doctor may cut skin tags off using surgical scissors
  • freezing with liquid nitrogen (cryotherapy) – this is usually applied as a spray but if the skin tag is near your eyes, your doctor may use forceps or a cotton wool tipped stick to apply the liquid nitrogen
  • ligation – your doctor may tie a suture around the neck of the skin tag and it will eventually drop off

Your doctor will be able to explain your options and help you to decide which method is best for you.

What are keloid scars?

Answer

Keloid scars, also known as keloids, are scars that have over-grown the original wound and become raised, lumpy and often, red.

Explanation

Keloid scars form inside scar tissue. They happen when the collagen your body uses to repair your wound overgrows so that it looks like an exaggerated scar. This can happen soon after an injury or several months afterwards. Doctors are unsure why this happens.

Sometimes keloid scars can be painful, itchy or cause a burning feeling. Some people never get them, while others get a keloid scar after an insect bite or minor injury. Keloid scars can form on any part of your body, but are most common around your shoulders, head and neck. Without any treatment, keloid scars will usually flatten and become less noticeable within a few years. Treatment for keloid scars usually involves having steroid injections or applying a tape that contains steroids.

Other treatments include:

  • liquid nitrogen (cryotherapy) to freeze keloid scars, which can help to stop their growth
  • laser treatment to lessen the redness, although this won’t shrink the scar
  • silicone gel sheeting – although there aren’t enough high-quality studies to show that this is an effective treatment
  • surgery – however, doctors mostly avoid it in case the scar gets bigger
  • a medicine called fluorouracil, available as a cream, which stops normal cells from working properly

You may be able to reduce your risk of developing keloid scars by doing the following.

  • Prevent your wound from becoming infected – an infected wound can take longer to heal and may result in a more noticeable scar. To help stop it becoming infected, keep your wound clean and keep it covered (if your doctor advises you to).
  • Wear a pressure garment – added pressure may stop keloid scars from forming and is recommended if you have a major operation that will involve a large cut in your skin.

If you have any questions about keloid scars, ask your doctor for advice.

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