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Skin Lesion Removal

There are many different types of skin lesions on the face, and it is generally those that appear with age which patients find most unpleasant. 

If the lesion is suspicious, a biopsy is required rather than removal, to exclude skin cancer. 

The general rule is that the smaller the lesion, the easier and less painful it is to remove, and the faster recovery. The type of removal depends on the type, size and location of the lesion. 

Types of removal include:

  • Cryotherapy
  • Dermabrasion
  • Radiofrequency ablation
  • Skin laser
  • Shave excision
  • Formal excision

Cryotherapy is a simple way of removing small scattered lumps and bumps. It works by freezing the skin cells so that they die, fall off, and are replaced by new skin cells. It is minimally painful, and recovery occurs over days. 

Dermabrasion is a more aggressive removal of lumps that extend a little deeper. Dermabrasion works by removing the skin cells and some of the structural layer, stimulating regrowth. It requires a focal injection of anaesthetic and will induce bleeding. The wound settles over 7-10 days.

Radiofrequency ablation is like dermabrasion but acts more as a skin eraser. A hand-held device removes the lesion layer by layer to allow healing without scarring. Local anaesthetic is required, there is minimal bleeding and the wound settles over 7-10 days. This works very well for pigmented age spots called Seborrheic Keratoses. 

Skin laser is a more costly approach to removing skin lesions and is indicated when the lesions extend over a larger area. Conditions like diffuse milia are best treated with skin laser. 

Shave excision is a minimally invasive office-based procedure to simply shave the top off a lesion so that it is not visible. It is best suited for minor polyps, and there is a risk of recurrence. 

Formal excision is an office-based procedure where the lump is completely removed and sent for pathological analysis. The wound is closed with stitches which are removed at around day 7, and wound healing continues for at least 3 months.

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