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Skin lesion removalThis factsheet is for people who are considering having a skin lesion removed. Your care may differ from what is described here because it is adapted to meet your individual needs, so it's important to follow your doctor's advice. Lesions on the skin are lumps or bumps such as moles, cysts, warts or skin tags. Most are benign (non-cancerous). However if they are painful, unsightly or restrict movement, you may want to have them removed.
Why have a skin lesion removed?Most skin lesions do not cause serious problems, but you may want to remove them for practical or cosmetic reasons. Surgical removal of lesions is usually only considered if other treatments, such as medicines or creams are not an option. Your doctor will be able to discuss your options with you. Surgery is usually advised if a skin lesion shows any sign of turning cancerous, for example, a mole that has changed shape or colour. Samples of the removed tissue may be sent to a laboratory for examination under a microscope. This is called a biopsy. How is a skin lesion removed?Minor skin lesions, such as warts, may be frozen off with liquid nitrogen gas or treated with chemicals that are painted on such as salicylic acid. For more precise removal or for larger lesions, surgical removal is often preferred. Surgical procedures for skin lesion removal are usually quick and straightforward. The treatment may be available at a doctor's surgery or at a hospital. Hospital treatment is usually done as an out-patient or day case, which means that you can have the operation and go home the same day. What happens before surgery?Your doctor will discuss how to prepare for your operation. It is important to discuss the operation with your doctor so you know what to expect. For example, a margin of skin around the lesion may have to be removed as well as the lesion. This will leave a bigger wound than you may expect from the lesion's size. The operationThe operation is usually performed under a local anaesthetic. This means that the affected skin area will be completely numb but you are awake. Sedative drugs can be given with a local anaesthetic to help you feel relaxed during the procedure. The technique for removing the lesion depends on factors such as its size and location. Your doctor will advise which method is most appropriate for you. Some lesions can be shaved down to the level of the surrounding skin, either using a surgical blade or a laser (a high-energy beam of light) to destroy skin tissue. Skin tags may be simply snipped off with surgical scissors. Other lesions can be cut out entirely and the wound closed with stitches. The stitches are usually removed three to 14 days later. If dissolvable stitches are used, these disappear on their own in about seven to 10 days. Your doctor may apply a dressing to the wound, which will need to be left in place for up to 48 hours. This is not always necessary as some wounds heal better if left uncovered. What to expect afterwardsMost people can go home within an hour or two of the procedure. If you have had a sedative, you will need to arrange for a friend or relative to drive you home and stay with you for the next 24 hours. Sedatives can temporarily affect your co-ordination and reasoning skills, so you should not drive, drink alcohol, operate machinery or sign legal documents until your surgeon tells you that it is safe. This will be at least 24 hours after your procedure. If you are in doubt about driving, please contact your motor insurer so that you are aware of their recommendations. Recovering from skin lesion removalAs the local anaesthetic wears off, the operation site may feel sore. Painkillers will help, and should be taken as advised by your doctor. You should take it easy for the first few days and take special care not to bump or knock the healing wound. If you have had a lesion removed from your face, it may be helpful to use extra pillows in bed as this will help to reduce swelling and bruising. Do not apply make-up to the healing wound until you have had your stitches removed. Most healing wounds simply need to be kept clean by daily washing with cool water. A fresh wound, or one that has just had the stitches removed, should not be soaked in water. Your doctor or nurse will be able to give you more advice on bathing. After having a skin lesion removed, the wound will generally heal fairly quickly. This can be about two to three weeks if your lesion has been cut out, or one to two weeks if it has been shaved off. Your doctors and nurses will do everything that they can to prevent your wound from becoming infected during surgery, but it is important that you know how to tell if you are developing an infection after you go home. If a wound becomes infected, it may:
Contact your doctor if you have any of the above symptoms. Wound infections can be treated successfully if they are diagnosed early. What are the risks?Having a skin lesion removed is generally a very safe surgical procedure. 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. Side-effects are the unwanted but mostly temporary effects of a successful treatment. An example of a side-effect is the numbness caused by the local anaesthetic. There may also be some pain, swelling and bruising of the skin around the wound. The operation will usually leave a scar. How big and noticeable this will be, depends on how much skin has been removed. Please ask your doctor how much scarring to expect after your treatment. Most scars fade significantly over the first year. Complications are when problems occur during or after the operation. Most people are not affected. The main possible complications of any surgery include excessive bleeding during or soon after the operation, infection, and an unexpected reaction to the anaesthetic. These may require further treatment, such as returning to theatre to stop bleeding or antibiotics to treat an infection. An infected wound can take longer to heal and may result in a more noticeable scar. Complications of having a skin lesion removed include those listed below.
You should ask your doctor to explain how these risks apply to you. The exact risks will differ for every person and will depend on the nature of the lesion and the exact type of operation required. This is one of the reasons why we have not included statistics here. Further information
Sources
Related BUPA factsheetsPublished by BUPA's health information team, healthinfo@bupa.com, July 2006.
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