Definition & Overview

Lesion removal refers to any procedure that removes a skin lesion or any abnormal growth or mark on the skin, which can be either benign or malignant.

The procedure can be performed using several techniques including shave excision, cryotherapy, photodynamic therapy, and curettage, among others.

Who Should Undergo and Expected Results

The procedure is for patients with abnormal skin lesions, growths, tumors, or moles on the skin, including the following:

  • Angiofibroma, a small lesion that is reddish brown in colour
  • Skin tags, or lesions that protrude outwards and present in a stalk-like appearance
  • Dermatofibroma, or small hard lesions more commonly found on the lower body
  • Genital warts
  • Precancerous lesions
  • Cancerous or malignant lesions such as basal cell carcinoma, squamous cell carcinoma, and melanoma
  • Lesions associated with chronic skin irritations
  • Unsightly lesions and growths
    A successful lesion removal procedure effectively and completely removes any abnormal growth on the skin. In most cases, the lesion removed is sent to a laboratory and placed under closer analysis to determine malignancy. If the growth is found to be cancerous, the patient is referred to a skin cancer specialist. In this way, a lesion removal procedure plays a role in the diagnosis of skin cancer.

If a lesion is diagnosed as cancerous prior to excision, it is removed at the soonest possible time to keep the cancer from spreading to the surrounding skin.

How is the Procedure Performed?

The exact method on how a lesion is removed depends on the technique to be used. However, the preparatory steps are generally similar. The procedure begins with the doctor administering an anesthetic or a numbing medicine to the affected skin not just to prevent pain but also to cause the skin growth to rise upwards, making it easier to remove.

For a shave excision, the abnormal growth is removed by cutting it off horizontally with a sharp razor. Since anesthetics are used, the patient will not feel any pain but may feel some pressure and a pushing sensation during the procedure. An antibiotic ointment is then applied to the excision site to help promote faster healing and then covered with a sterile bandage for protection. Most surgeons follow the procedure up with electrosurgical feathering to improve the skin’s post-surgical appearance making sure that the edges of the wound blends in more smoothly with the skin surrounding it after the healing period.

Other possible techniques for the removal of skin lesions and growths include:

  • Excisional biopsy – Also known as a complete removal procedure, this technique is more appropriate for larger growths.

  • Cryotherapy or freezing – A technique that works best for warts, skin tags, and actinic keratosis, it involves freezing the lesions with liquid nitrogen to make them easier to remove. In fact, once the growth freezes, it can fall off on its own.

  • Photodynamic therapy – Simply known as light therapy, this technique is a skin cancer treatment and is used on malignant growths or those that have a high likelihood of becoming cancerous.

  • Curettage – This procedure involves scooping away the skin growth, usually a wart. It is often performed in combination with cryotherapy and heat treatment.
    Most of these techniques only take around 20 minutes. Patients may experience some pain, bruising, and swelling after the procedure but these typically subside without treatment after a few days.

Possible Risks and Complications

Lesion removal is associated with a number of potential risks and complications, which include:

  • Scarring – To help lighten scars caused by the procedure, patients may use topical silicone gel, petroleum-based ointments, or a vitamin A topical ointment.
  • Infection – Surgeons typically prescribe an antibiotic medication after the procedure to help prevent an infection.
  • Bleeding – To control post-surgical bleeding, surgeons typically apply aluminum chloride hexahydrate on the wound after the procedure.
  • Recurrence – Some tumors and lesions grow back even after the procedure.
  • Keloids formation – These are unusual raised scars that grow on the wound site.
  • Nerve damage – Although usually only temporary, it is possible for some nerves to get damaged or be affected by the procedure.
    Signs indicative of a possible complication include the following:

  • Increasing tenderness

  • Pus discharge from the wound
  • Swelling that seems to be getting worse
  • Burning sensation
  • Numbness
    The risk of experiencing complications due to a lesion removal procedure is higher among patients who:

  • Have a compromised immune system

  • Smoke frequently
  • Suffer from bleeding disorders
  • Have circulatory problems

References:

  • Yanofsky V., Patel R., Goldenberg G. (2012). “Genital Warts: A Comprehensive Review.” J Clin Aesthet Dermatol. 2012 Jun; 5(6):25-36. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390234/

  • Goldberg L., Segal R. (1996). “Surgical Pearl: A flexible scalpel for shave excision of skin lesions.” Journal of the American Academy of Dermatology.

  • http://www.jaad.org/article/S0190-9622(96)90612-X/abstract Pickett H. “Shave and Punch Biopsy for Skin Lesions.” Am Fam Physician. 2011 Nov. 1;84(9):995-1002. http://www.aafp.org/afp/2011/1101/p995.html

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