Skin lesion removal

Published by Bupa's Health Information Team, October 2010.

This factsheet is for people who are having a skin lesion removed, or who would like information about it.

Skin lesions are lumps or bumps such as moles, cysts, warts or skin tags. They can be removed from the 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.

About skin lesion removal

Most skin lesions don't cause serious problems, but you may want to have them removed for practical or cosmetic reasons.

Your GP or dermatologist (doctor who specialises in skin conditions) will be able to advise you on what treatment will work for you.

Different methods of removal are used depending on what type of skin lesion you have. Some, such as benign (non-cancerous) warts, can be treated with non-surgical procedures. Larger skin lesions or ones that needs a precise removal may need to be surgically removed.

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 removed tissue will be sent to a laboratory to examine the type of cells and determine whether the lesion is benign or cancerous.

Preparing for skin lesion removal

Skin lesion removal is usually 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 whereabouts it is on your body, skin lesions 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, but you may still be able to feel some movement. 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, which you may be asked to do by signing a consent form.

It's important to discuss the procedure with your doctor so that you know what to expect. For example, if your doctor surgically removes your skin lesion, he or she may need to remove some skin around the lesion, leaving a bigger wound than you may expect.

What happens during skin lesion removal

The technique that your doctor uses to remove the lesion depends on factors such as its size and whereabouts on your body it is. Your doctor will advise which method is most appropriate for you.

• Some lesions can be shaved down to the level of your surrounding skin, either using a surgical blade or a laser (a high-energy beam of light) to destroy your skin tissue.
• Skin tags may be simply snipped off with surgical scissors.
• Other lesions, such as suspected skin cancer, can be cut out entirely and the wound closed with stitches.
• Warts may be frozen off with liquid nitrogen (this technique is called cryotherapy) or treated with creams such as those containing salicylic acid.
• Certain skin lesions can be treated with photodynamic therapy. A chemical is applied to your lesion and then light is shone on to it. This activates the chemical to destroy the lesion. This treatment may not always be available.

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

What to expect afterwards

You will 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, try to arrange for a friend or relative to stay with you for the first 24 hours.

Your doctor will give you some advice about caring for your healing wound before you go home.

Recovering from skin lesion removal

Your wound may take one to two weeks to heal depending on whereabouts on your body it is and your age and general health.

Dissolvable stitches will disappear on their own in seven to 10 days. Non-dissolvable stitches are removed a week after surgery.

Your doctor may advise you to:

• take over-the-counter painkillers such as paracetamol if you have any pain - always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice
• avoid stretching the affected area
• take special care not to bump or knock the healing wound
• keep the wound dry for 48 hours and clean it gently if the dressing becomes wet or dirty
• avoid applying make-up to your healing wound until it has fully healed

What are the risks?

Skin lesion removal is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects

These are the unwanted, but mostly temporary effects of a successful treatment. You may have some pain, swelling, and bruising of the skin around the wound.

A skin wound will usually leave a scar. How big and noticeable this is depends on how much of your skin is removed. Ask your doctor about how much scarring to expect after your treatment. Most scars fade significantly over the first year.

Complications

This is when problems occur during or after the operation. Most people aren't affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or an infection.

After having a skin lesion removed, there's a risk you may develop an infection. An infected wound can take longer to heal and may result in a more noticeable scar. Contact your GP if your wound:

• causes increased pain
• looks red, inflamed or swollen
• starts to weep liquid, pus or blood
• begins to smell unpleasant

If your wound becomes infected, your doctor may prescribe antibiotics to treat the infection.

Other complications of having a skin lesion removed are uncommon but can include:

• changes in your skin sensation - this can happen if surface nerves are damaged, it's usually temporary
• unusual red or raised scars (keloids) - these can be difficult to treat
• bleeding under your skin (haematoma) - this may need draining

The exact risks are specific to you and will differ for every person, so we have not included statistics here. Ask your doctor to explain how these risks apply to you.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.