Skin Lesion

Overview

Most skin lesions are harmless, but a proportion are not, and the two are not always easy to tell apart by eye. Assessment establishes what a lesion is likely to be before any decision about removal, and where there is doubt, tissue is sent for pathological examination. Removal is planned so that the scar falls along a natural skin crease wherever the anatomy allows.

Common presentations

• Nevus removal — assessment of moles and their removal by excision or shave technique, depending on the lesion and the site. Any mole that is changing in size, shape, colour or symptom is removed for examination rather than treated cosmetically.
• Lumps and bumps — epidermoid and sebaceous cysts, lipomas and similar subcutaneous swellings, removed with their capsule to reduce the chance of recurrence.
• Wart — viral warts of the hands, feet and face, treated by excision or ablative methods according to type and site.
• Skin cancer — assessment of suspicious lesions, biopsy where indicated, and surgical excision with a planned margin, followed by direct closure, a local flap or a skin graft as the defect requires.

Consultation & planning

Assessment covers the appearance and history of the lesion, sun exposure and personal or family history of skin cancer, and examination of the surrounding skin. Where a lesion may be malignant, that is discussed before removal, along with what the pathology result may mean and what further treatment could follow. Anything removed is sent for pathological examination unless there is a clear reason not to.

Recovery

Most lesions are removed under local anaesthetic as a clinic procedure, taking twenty to sixty minutes. Sutures are removed at five to seven days on the face and ten to fourteen days elsewhere. Normal activity resumes immediately, though exercise and swimming are usually deferred for one to two weeks. Pathology results are usually available within a week and are explained at review.

Risks & considerations

Every removal leaves a scar, and on the trunk and shoulders scars tend to widen or thicken more than on the face. Other risks include bleeding, infection, altered sensation around the site, incomplete removal requiring a second procedure, and recurrence — particularly for cysts removed incompletely and for warts. Where a skin cancer is confirmed, the margin of clearance reported by the pathologist determines whether further surgery is needed.

This page provides general information only and does not constitute medical advice. Suitability, benefits, limitations and risks of any procedure can only be determined at a medical consultation.