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Skin lesion removal

Published by Bupa's health information team, August 2008.

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

Skin lesions can be removed from your skin using chemical and surgical procedures.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your doctor's advice.

About skin lesions
Preparing for your operation
About the operation
What to expect afterwards
Recovering from skin lesion removal
What are the risks?
Questions and answers
Related topics
Further information
Sources

About skin lesions

Lesions on the skin are lumps or bumps such as moles, cysts, warts or skin tags. Most skin lesions don't cause serious problems, but you may want to have them removed for practical or cosmetic reasons.

How is a skin lesion removed?

If you have a minor skin lesion, such as a wart, it may be frozen off with liquid nitrogen gas (extreme cold) or treated with chemicals that are painted on, such as salicylic acid.

Some skin lesions, such as actinic keratosis, can be treated with photodynamic therapy. A chemical that is activated by light is applied to your lesion and then light is shone on to it. This activates the chemical to destroy the lesion.

For more precise removal or for larger lesions, surgical removal is usually recommended.

Surgery is also advised if you have a skin lesion that shows any sign of turning cancerous, for example, a mole that has changed shape or colour.

Your doctor will send the removed tissue to a laboratory for testing to determine the type of cells and if these are benign (not cancerous) or cancerous.

Preparing for your operation

Your doctor will explain how to prepare for your operation. For example if you smoke you will be asked to stop, as smoking increases your risk of getting a wound infection and slows your recovery.

It's important to discuss the operation with your doctor so that you know what to expect. For example, a margin of skin around the lesion may have to be removed as well as the lesion itself. This will leave a bigger wound than you may expect from the lesion's size.

Skin lesions can be removed at a doctor's surgery or at a hospital. The operation is usually done under local anaesthesia. This completely blocks feeling from the lesion area and you will stay awake during the operation. A sedative may be given with a local anaesthetic to help you relax.

Your doctor will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

About the operation

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.

Your doctor will apply a dressing to the wound if necessary, however some wounds heal better if 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. You should try to have a friend or relative 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. You may be given a date for a follow-up appointment.

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

Recovering from skin lesion removal

If you need them, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice.

Sedatives can temporarily affect your coordination and reasoning skills, so you should not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you are in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your doctor/surgeon's advice.

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. Don't apply make-up to the healing wound until it has fully healed. This is usually about two weeks after surgery.

Most healing wounds simply need to be kept clean by daily washing with cool water. A new wound, or one that has just had the stitches removed, shouldn't be soaked in water. Your doctor will be able to give you more advice on bathing.

After having a skin lesion removed, there is a risk you may develop an infection. An infected wound can take longer to heal and may result in a more noticeable scar. Please contact your GP if you develop any of these symptoms:

increasing pain
the wound area looks red, inflamed or swollen
the wound starts to weep liquid, pus or blood
the wound starts to smell unpleasant

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.

The 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 are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or an infection. You may need antibiotics to treat an infection.

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

change in skin sensation - this can happen if surface nerves are damaged, it's usually temporary
unusual red or raised scars (keloids) - these can take years to improve
bleeding under the 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.