Skin lesion removal

Your health expert: Dr Anton Alexandroff, Consultant Dermatologist
Content editor review by Liz Woolf, Freelance Health Editor and Michelle Harrison, Lead Editor, Bupa Health Content Team, April 2021
Next review due April 2024

Skin lesion removal means removing a mole, wart, skin tag or other skin growth. Most skin growths (lesions) are harmless, but your doctor may recommend you have one removed if it’s causing significant problems or could be cancerous. You may want to have a lesion removed privately if it bothers you or you don’t like how it looks.

Types of skin lesion

Skin lesions are areas of skin that are growing abnormally or look different from the surrounding normal skin. Types of benign (non-cancerous) skin lesions include:

moles – small, dark-coloured growths on your skin, which mostly appear during childhood
dermatofibroma – firm, raised growths that can be brown, purple or red in colour and may develop after an insect bite or minor injury
actinic keratosis – rough, scaly patches of skin, which develop on areas exposed to the sun
seborrhoeic keratosis – grey, black or brown raised lesions that may appear on your body or scalp and are more common with age
keratoacanthoma – rapidly-growing lesions that have a solid, scaly core and normally develop in areas of skin exposed to the sun, usually your face
skin tags – very common, small flesh-coloured growths forming where skin creases or gets rubbed
pyogenic granuloma – small, bright red nodules that often develop after an injury, tend to bleed easily and are often removed
sebaceous cysts – round lumps that can become infected, ranging in size from a few millimetres to several centimetres
warts – small, rough lumps caused by infection with the human papilloma virus (HPV)

Actinic keratoses can change into a type of skin cancer known as squamous cell carcinoma, so your doctor will usually recommend removing them. Keratoacanthomas can look very similar to squamous cell carcinomas, so are usually removed to rule that out.

It’s important to see your GP if you notice any new changes to your skin, especially if it's a change in the size, shape or colour of a mole.

When should a skin lesion be removed?

Your GP will recommend removal if they think your skin lesion is or could become cancerous. Some benign (non-cancerous) skin lesions look very like skin cancer. The only way to tell for sure is to have the lesion removed and examined in a laboratory.

If your skin lesion has no signs of cancer, you don't need to have it removed. But if it’s causing you significant problems, for instance catching on clothing, you may prefer to have it taken off. You may also decide you want a skin lesion removed if you're unhappy with how it looks. But if this is the case, you'll usually need to pay to have it removed privately.

Many procedures are likely to leave a scar. Your doctors will do their best to keep the scar to a minimum, but they may be noticeable.

Your GP may be able to remove your skin lesion at your local surgery or prescribe a skin lesion removal cream or gel to use at home. For some types of skin lesion, especially those that may be cancerous, your GP will refer you to a dermatologist (a doctor specialising in identifying and treating skin conditions).

How are skin lesions removed?

Skin lesions can be cut out, frozen off, treated with special creams or destroyed using heat, laser or light therapy. The treatment you’re offered will depend on the type of skin lesion you have and where it is on your body. Your GP or dermatologist will let you know which method will work best for you.

Your doctor will talk through what will happen before, during and after your procedure, including any pain you might have. This is your chance to ask questions so you understand what will happen. You don’t have to go ahead if you decide you don’t want the procedure. Once you understand and agree, you’ll be asked to sign a consent form.

Techniques to remove a skin lesion include the following.

Complete excision (excision biopsy)

This is the standard way to remove a lesion where there is any possibility that it might be cancerous. It’s a type of skin biopsy – this means the whole skin lesion is cut out and removed. It’s usually done under local anaesthesia to block any pain. Your doctor uses a surgical blade to remove the whole lesion, as well as some normal skin around the edge.

Your doctor will close the wound using stitches and cover it with a dressing.

Partial removal (shave biopsy)

Used for skin tags and seborrhoeic keratoses, partial removal is a technique to ‘shave off’ lesions that stick out from your skin.

Your doctor cuts across the base of the lesion, so it’s level with your surrounding skin. You may also have cautery, which uses heat to seal your skin and stop it from bleeding.

Heat treatment (electrocautery)

Your doctor applies a heated coil to the base of the lesion to remove it. Electrocautery can be used to remove skin tags. You may also have it after other types of treatment to stop any bleeding.

Creams and gels

Your doctor may prescribe a skin lesion removal cream or gel containing medicines such as imiquimod, salicylic acid, 5-fluorouracil or diclofenac to get rid of a wart or actinic keratosis. You usually need to apply the cream or gel daily for several weeks.

Freezing (cryotherapy)

Freezing off lesions with liquid nitrogen can be used for actinic and seborrhoeic keratoses, warts and skin tags. Your doctor applies liquid nitrogen to the area for around 10 seconds, using either cotton wool or a spray. A blister forms after the treatment. It dries up to form a scab, which falls off one to two weeks later (sometimes longer).

Scooping away (curettage)

This method can be used for warts, pyogenic granuloma, actinic keratoses and seborrhoeic keratoses. Your doctor uses a curette ‘spoon’ to gently scoop away the lesion. This may be combined with electrocautery (heat treatment).

Laser therapy

Your doctor may recommend treatment with a laser if you have a wart, a dermatofibroma or an actinic keratosis patch on your lip.

Photodynamic therapy (PDT)

This technique uses light to activate a chemical applied to your lesion, which destroys it. Your doctor may recommend PDT if you have actinic keratosis.

Aftercare for skin lesion removal

You can usually go home as soon as you feel ready. Your doctor or nurse will give you some advice about caring for your wound. You may have a date for a follow-up appointment and to have any stitches taken out.

If you've had a local anaesthetic to remove your skin lesion, it may take an hour or two before the feeling comes back. Take care not to bump or knock the affected area, and don't have hot drinks if it’s numb anywhere near your mouth. Your wound may feel tender and sore after the anaesthetic has worn off.

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

Recovering from skin lesion removal

Healing time

If you've had minor surgery such as a skin biopsy or curettage, it can take a few weeks for your wound to heal. Your doctor or nurse will tell you when to have your stitches removed, but it's usually within 14 days.

It normally takes a couple of weeks, occasionally longer, for a lesion to scab and fall off after cryotherapy. Your skin may look completely normal after this, but if you have darker skin you may notice it looks lighter or darker. This normally improves with time.

After photodynamic therapy, it'll take a few days for a scab to form, and can take several weeks to heal. Because of the light-sensitising drug you’ve had, you must use sunscreen that’s at least SPF30 for 48 hours after your treatment.

Looking after your wound

Your doctor or nurse will give you specific advice relating to the type of procedure you've had. They may also ask you to:

avoid touching or scratching the affected area, particularly if you've had stitches
keep the wound dry for 48 hours or until dressings have been removed, then clean gently every day
avoid picking scabs that form or doing anything to accidentally dislodge them

If the area where your skin lesion was removed gets increasingly painful or becomes red and sore, contact the doctor who performed your procedure. You could have an infection in the wound, and may need antibiotics.

Side-effects of skin lesion removal

Side-effects are unwanted but mostly temporary effects you may have after treatment. Exact side-effects will depend on the type of treatment you've had, but it's common to have some pain, inflammation and swelling.

All surgical skin lesion removal procedures, including biopsy and curettage, leave you with a scar. How big and how noticeable this is depends on the type of procedure you’ve had and how much skin is removed. Ask your doctor what scarring to expect after your treatment. Your scar is likely to be red and raised at first, but most get smaller and fade significantly over several months.

Some types of creams and gels can cause a stinging or burning sensation when you apply them. Your skin can also become inflamed – you may have itching, burning, redness and pain. This is often an expected effect of these treatments and shows that your skin is responding. The inflammation will settle down once you have stopped the treatment.

Complications of skin lesion removal

Complications are when problems occur during or after the procedure. Complications of having a skin lesion removed include the following.

Infection can develop after many skin lesion removal procedures. The affected area may become increasingly painful, red or sore and you may have a discharge (pus). Contact your doctor if this happens because you may need antibiotics.
Changes in skin sensation (numbness or burning) can happen if nerves on the skin surface are damaged. It's usually only temporary but may last a few months.
Your skin may look lighter (hypopigmentation) or darker (hyperpigmentation). This can happen if you’ve had surgery, cryotherapy or photodynamic therapy. The affected area will be more prone to sunburn, and you'll need to use sunscreen to protect it.
Excessive bleeding may occur. It’s usual for the wound to bleed a little after surgery, but occasionally it can be more severe. If this happens, your doctor may apply firm pressure to the wound, inject a substance that stops bleeding into the wound or stitch any blood vessels.
Unusual red or raised scars (keloids) may develop. These can be unsightly and difficult to treat. For more information on this, see our FAQ: What are keloid scars? below.

Yes, skin tags, including those near your eyes, can be removed. Skin tags are small, flesh-coloured bumps on your skin. They often form in places where your skin creases or gets rubbed. For example, skin tags may form around your neck, armpits, groin and eyelids.

Skin tags don't usually cause problems, but may be particularly noticeable on your eyelids. If you want skin tags removed because you’re unhappy with how they look, you normally have to pay to have it done privately. Treatments include:

surgery – your doctor may cut skin tags off using surgical scissors
freezing with liquid nitrogen (cryotherapy) – your doctor may use forceps or a cotton wool tipped stick to apply the liquid nitrogen near your eyes
tying off at the base to cut off the blood supply

Larger skin tags may need local anaesthetic and cautery (heat) to stop any bleeding. Your doctor will be able to explain your options and help you to decide which method is best for you.

Most skin lesions such as moles, cysts, warts or skin tags are benign (non-cancerous ) and aren't harmful. But some skin lesions can turn out to be cancer. For this reason, any new mole or lump or an existing one that has changed, should be checked.

Skin cancer is usually painless. There are several types and they look different.

Basal cell carcinomas (also called rodent ulcers) may first appear as a flat red mark, shiny lump or scab that bleeds and doesn't heal.
Squamous cell carcinomas often appear as a small pink lump with hard, scaly or crusty skin.
Malignant melanoma is the most serious type of skin cancer. It usually starts as a new dark spot or mole or as changes to an existing mole (changing shape or colour or getting bigger).

If you notice any new mole, spot, lump or patch on your skin that doesn't heal after a number of weeks, see your GP. It's important to get it checked.

Keloid scars, also known as keloids, are abnormal scars that grow larger than the original wound. They become raised, lumpy and may be red or darker than surrounding skin.

We don’t know why some people develop keloid scars. But they seem to form when your body produces too much of a skin protein called collagen. They’re more common in people with dark skin, and tend to develop between the ages of 10 and 30. Keloid scars may be more likely if you’ve had one before or someone in your family has.

Keloid scars may feel painful, itchy, prickly, or burning. Unlike normal scars, they can develop after relatively minor skin damage, such as an insect bite, piercing, vaccination or acne spot. They can form anywhere, but are commonest on the shoulders, upper chest, neck and earlobes.

Keloids can be very difficult to treat. Surgery doesn’t usually help because they often grow back. Other treatment options include the following.

Monthly steroid injections into the scar for four to six months.
Steroids in a cream or tape that you apply to the scar. This can be more appropriate for children.
Silicone sheets, gels or sprays. You can buy these from a pharmacist without a prescription. After several months they can make the keloid thinner and paler.
Cryotherapy to freeze keloid scars and stop their growth. This can be used on its own or with other treatments.
Laser treatment, which may be combined with steroids.

With keloids, prevention is better than cure. If keloids run in your family, you may prefer to avoid piercings, tattoos and cosmetic surgery. If you have acne, ask your GP about having treatment to reduce scarring. If you need surgery, tell your surgeon so he or she can use steroids or silicone gel to try to reduce the risk of a keloid forming.

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