Skin Lesion Removal

Skin lesions are abnormalities that can appear on any part of your body. These can be moles, birthmarks, warts, or even more serious issues such as skin cancer. If you’ve noticed an abnormal mark or growth on your skin, you might be looking into skin lesion removal. It’s important to understand what skin lesion removal is, who it’s suitable for, the benefits, different types, how it’s performed, the recovery process, and the potential risks.

Anca Breahna is a renowned Chester Consultant Plastic Surgeon with a special interest in skin lesion removal.

What Is Skin Lesion Removal?

Skin lesion removal is a medical procedure to eliminate unwanted or potentially harmful marks, growths, or abnormalities from your skin. It can be carried out for either medical or cosmetic reasons, and in some cases, both. These procedures might involve minor surgery, lasers, or cryotherapy, which employs freezing temperatures to remove the lesions.

You may need a skin lesion removal procedure if you have a suspicious or bothersome growth that requires testing or needs to be removed due to its size, location, or appearance.

Who Needs Skin Lesion Removal?

Determining the necessity for skin lesion removal involves many factors. Each person is unique, and skin lesions can vary greatly in terms of size, appearance, location, and potential health implications. To elaborate further, here are the factors that contribute to whether you might need skin lesion removal:

Suspicious Characteristics of the Lesion

Anca might use an approach called the ABCDE rule to help determine if a skin lesion may be cancerous:

• Asymmetry: Normal moles are usually symmetrical, which means you could draw a line through the middle and the two halves would look alike. Moles or lesions that are asymmetrical may indicate a problem and may need to be removed
• Border: The edges or borders of a normal mole are usually smooth and even. If the edges of a mole are ragged, notched, or blurred, it may be a sign of a malignant lesion, which would need removal
• Colour: Most benign moles are a single shade of brown. If a mole has a variety of colours, or if the colour changes, it’s a good idea to have it checked. Lesions with multiple shades of brown, tan, black, or even red, white or blue, can suggest a problem
• Diameter: Benign moles are usually smaller than the size of a pencil eraser (about 6mm in diameter). Lesions larger than this, especially if they’re growing, should be evaluated
• Evolving: Any changes in size, shape, colour, or elevation, or any new symptom such as bleeding, itching, or crusting, are potential signs of a problem. If you notice a mole or skin lesion changing in any way, it should be checked

Personal Medical History

People who have had skin cancer in the past are at an increased risk of developing new skin cancers. If you have a personal history of skin cancer, you may need to have skin lesions removed more frequently as a precautionary measure. Anca will guide you on this.

Family History

Genetics play a significant role in many diseases, including skin cancer. If you have a family history of skin cancer, especially melanoma, you may need to have suspicious skin lesions removed even if they’re not causing symptoms.

Sun Exposure

Prolonged exposure to the sun without adequate protection can increase your risk of skin cancer, especially if you have fair skin or a history of sunburns. If you’ve spent a lot of time in the sun or used tanning beds, you may need to have skin lesions removed more often.

Age

The risk of skin cancer increases with age. This is due to the cumulative effect of sun exposure over time, as well as the natural decrease in the skin’s ability to repair itself. Older individuals, especially those with a history of sun exposure, may need skin lesion removal to rule out cancer.

Immune Status

People with weakened immune systems, such as those with HIV/AIDS or those who’ve had an organ transplant, are at a higher risk of skin cancer. They may need to have skin lesions removed more frequently.

Aesthetic Considerations

While many skin lesion removals are done for medical reasons, some are done for purely cosmetic purposes. If you have a skin lesion that you find unsightly or that affects your appearance, you may choose to have it removed. This is common with benign moles, skin tags, or other non-cancerous growths that might not pose a health risk but affect the way you look.

Lesion Location and Discomfort

Lesions located in areas where they may rub against clothing or get caught on jewellery may need to be removed to prevent discomfort. In addition, lesions located on the face or other visible areas of the body may also need to be removed for aesthetic reasons.

Benefits of Skin Lesion Removal

One of the primary benefits of skin lesion removal is the potential to detect and treat skin cancer early. If a removed lesion is found to be cancerous, further treatment can be planned quickly, which can significantly improve your prognosis.

Skin lesion removal also offers relief from discomfort and irritation. Some skin growths may rub against clothing or get caught in jewellery, leading to constant discomfort or even pain. Removing these growths can eliminate this problem.

In addition to relieving discomfort, skin lesion removal can also improve your appearance. Although it’s not the primary reason for many lesion removals, it’s undeniable that many people feel more comfortable in their skin after the procedure.

Remember, the benefits of skin lesion removal vary from person to person and depend on individual circumstances and the nature of the lesion.

Types of Skin Lesion Removal Procedures

Skin lesion removal procedures are as varied as the skin lesions themselves. Anca will select the most appropriate method based on the type, size, and location of the lesion, as well your overall health. Here are more details about skin lesion removal procedures:

Surgical Procedures

Surgical removal procedures are often used for larger lesions or those suspected to be cancerous. They are typically performed under local anaesthesia to minimise patient discomfort.

• Excision: This is one of the most common methods of removing skin lesions, particularly if there is a suspicion of skin cancer. In an excision procedure:
  • The area around the lesion is first numbed with a local anaesthetic
  • The surgeon then uses a scalpel to cut out the entire lesion, along with a margin of healthy skin surrounding it. The size of the margin depends on the type and size of the lesion
  • Once the lesion is removed, the wound is usually closed with stitches
  • The removed tissue is then sent to a lab where it’s examined under a microscope to check for cancer cells
  • Depending on the lab results, further treatment may be necessary
• Shave Excision: This is often used for lesions that are raised above the skin, like moles or skin tags. The procedure for shave excision includes:
  • The area around the lesion is numbed with a local anaesthetic
  • Using a sharp, small blade, the doctor shaves off the lesion at or slightly below the skin surface
  • Depending on the size of the lesion, stitches may not be necessary as the wound is typically small
  • The removed lesion may also be sent to a lab for examination

Non-Surgical Procedures

Non-surgical procedures are generally less invasive than surgical ones. They are often used for smaller, superficial lesions, or for those that are not suspected to be cancerous.

• Cryotherapy: This method is often used for small, superficial lesions such as warts or actinic keratoses (pre-cancerous lesions). The process of cryotherapy involves:
  • A healthcare professional applies liquid nitrogen to the lesion using a spray device or a cotton-tipped applicator
  • The extreme cold causes the lesion to freeze, and it may turn white
  • As the skin thaws, it may blister and eventually scab over. The scab usually falls off 1 to 3 weeks later, revealing new skin underneath
  • In some cases, more than one cryotherapy session may be necessary to completely remove the lesion
• Laser Therapy: This procedure is often used for superficial lesions or those located in hard-to-reach places. Laser therapy involves:
  • Anca will first numb the area around the lesion with a local anaesthetic
  • They then direct a laser (a concentrated beam of light) at the lesion. The light from the laser destroys or removes the skin lesion
  • The recovery time can vary depending on the size and location of the treated lesion
  • Laser therapy has the advantage of precision, and it minimises bleeding since the laser seals blood vessels as it destroys the lesion
• Electrocautery: This method uses a special instrument to burn off the lesion. The process of electrocautery includes:
  • The doctor numbs the area around the lesion with a local anaesthetic
  • They then use an electrocautery device, which has an electric current running through it, to burn away the lesion. The heat from the device also helps to seal the wound, reducing bleeding
  • Electrocautery is often used for small lesions and may be combined with other procedures like curettage, where the lesion is scraped off with a curette (a small, scoop-shaped instrument) before being cauterised

Each of these skin lesion removal methods has its own set of advantages and disadvantages, and Anca will consider all these factors before recommending the best option for your condition. The goal is always to remove the lesion completely with the least amount of damage to the surrounding healthy tissue and to minimise the risk of scarring.

How is the Skin Lesion Removal Procedure Performed?

The specifics of a skin lesion removal procedure will depend on the nature of the lesion and the removal technique chosen.

Consultation and Evaluation

The first step in any skin lesion removal procedure is a consultation with Anca Breahna. This appointment serves many purposes:

• Assessment of the lesion: Anca will carefully examine the skin lesion. This can help her determine the type of lesion and its nature, whether it’s benign or potentially malignant. She might use a tool called a dermatoscope, which can magnify the lesion and provide a more detailed view
• Discussion about the procedure: Anca will explain the different removal options available and discuss the most suitable option for your condition. This discussion will consider various factors such as the type, size, and location of the lesion, as well as your overall health
• Medical history: During the consultation, it’s important to provide Anca with a detailed medical history. They need to know about any underlying health conditions you may have, any allergies, and any medications or supplements you are taking. This information can help her plan the procedure in a way that minimises any potential risks
• Answering questions: The consultation is also an opportunity for you to ask any questions you may have about the procedure. You may want to know about the benefits and potential risks, what the procedure involves, what the recovery will be like, and what kind of follow-up care will be needed

Preparation

Once you and Anca have agreed on the procedure, the next step is to prepare for it:

• Anaesthesia: The majority of skin lesion removal procedures are done under local anaesthesia. This means that you’ll be awake during the procedure, but the area around the lesion will be numbed so you won’t feel any pain. In some cases, if the lesion is very small, anaesthesia might not be necessary
• Cleaning the area: The skin around the lesion will be cleaned thoroughly to minimise the risk of infection

The Procedure

The actual procedure will depend on the method of removal chosen. However, regardless of the method, the main goal is to remove the entire lesion and, if necessary, some of the surrounding tissue:

• Surgical Excision: In this method, Anca uses a scalpel to cut the lesion out of the skin. They may also remove a small amount of normal skin around the lesion to make sure no abnormal cells are left behind
• Shave Excision: During a shave excision, Anca shaves off the lesion using a sharp instrument
• Cryotherapy: In a cryotherapy procedure, Anca applies liquid nitrogen to freeze and destroy the lesion
• Laser Therapy: With laser therapy, the surgeon uses a concentrated beam of light (laser) to destroy the lesion
• Electrocautery: In an electrocautery procedure, the surgeon uses a special instrument to burn off the lesion

In many cases, especially if the lesion is suspected to be cancerous, the removed tissue will be sent to a lab for further examination.

Recovery after Skin Lesion Removal

The recovery process following a skin lesion removal procedure can differ greatly depending on the size and location of the lesion, the type of removal procedure, and the individual’s overall health. However, there are general steps and guidelines that can help you understand what to expect.

Wound Care

After the procedure, taking proper care of the wound is of utmost importance:

• Dressing: Following the procedure, Anca will apply a dressing to the wound. It’s essential to keep this dressing clean and dry to promote healing and prevent infection. You’ll receive specific instructions on how and when to change the dressing
• Cleaning: You’ll be given instructions on how to clean the wound. Usually, this will involve gently washing the area with mild soap and water after a specified period of time
• Ointments: Anca may recommend or prescribe a topical antibiotic ointment to prevent infection. Apply this as instructed, after cleaning the area

Pain Management

Some discomfort or pain can be expected following a skin lesion removal. Here’s how it can be managed:

• Pain Medication: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage any discomfort following the procedure
• Cold Compress: Applying a cold compress to the area can also help reduce pain and swelling. Wrap the compress in a clean cloth to protect your skin and apply it for short periods of time

Follow-up Appointments

Follow-up appointments with Anca might be necessary for:

• Stitch Removal: If stitches were used, you’ll need to return to have them removed. This usually happens one to two weeks after the procedure, depending on the location of the stitches
• Monitoring: Anca will want to monitor your progress, check for signs of infection, and ensure the wound is healing properly
• Lab Results: If the lesion was sent to a lab for analysis, you’ll discuss the results at a follow-up appointment. If any further treatment is necessary, Anca will discuss this with you

Long-term Care

After the wound has healed, there may be additional steps you can take to care for the area and minimise scarring:

• Scar Care: Once the wound has fully healed, you may want to consider treatments to minimise scarring. Options can include over-the-counter or prescription creams, gels, or patches, as well as massage techniques
• Sun Protection: It’s important to protect the area from the sun, as sun exposure can darken the scar and slow the healing process. Use sunscreen and wear protective clothing when exposed to the sun

Risks of Skin Lesion Removal

While skin lesion removal procedures are generally considered safe, as with any medical procedure, there are potential risks and complications that patients need to be aware of. These may vary depending on the type of procedure, but they most often fall into the following categories:

Infection

Infection is a risk with any surgical procedure, including skin lesion removal. When the skin is broken, it becomes susceptible to bacteria which can lead to infection. Signs of an infection may include:

• Redness and swelling around the wound
• Increasing pain
• Discharge or pus from the wound
• Fever or feeling generally unwell

Scarring

Scarring is another common concern with skin lesion removal. The extent of scarring can vary greatly depending on the type and location of the lesion, the removal technique used, the skin type and healing ability.

• While some procedures like laser therapy or cryotherapy tend to leave minimal scarring, others like surgical excision can result in more noticeable scars
• It’s also important to note that even with the best techniques, some degree of scarring is often inevitable when the skin is cut or damaged
• Anca may be able to recommend treatments or techniques to minimise scarring, such as using silicone sheets or gel, or certain types of massage

Changes in Skin Sensation

In some cases, skin lesion removal can result in changes to skin sensation in the treated area.

• This may include numbness, tingling, or even a loss of sensation, particularly if the lesion is large or if it’s located near a nerve
• While these changes are often temporary, in some cases they can be permanent

Allergic Reaction to Anaesthesia

Although rare, some people can have an allergic reaction to the local anaesthetic used during the procedure.

• Symptoms may include rash, itching, or difficulty breathing
• If you have had a reaction to anaesthesia in the past, it’s important to let Anca know before the procedure

Medical References about Skin Lesion Removal

• Skin Lesions – Cleveland Clinic
• Dermatology – Excision of Skin Lesion – NHS
• Skin lesions: Types and When to See a Doctor – Medical News Today
• Skin Lesion Removal – MedlinePlus