Curettage is a surgical procedure in which the dermatologist scrapes off a skin lesion using a sharp blade or spoon-like device called a curette to remove diseased tissue such as tumours or growths or to obtain a biopsy for diagnosis. Cautery is the method used to stop bleeding and seal the wound.
What does it involve?
The dermatologist injects local anaesthetic into the area surrounding the lesion to be treated, causing temporary tingling discomfort. This numbs the skin so no pain is felt during the procedure. You may feel a pushing sensation but it should not be painful. The skin lesion is then scraped off with a sharp ring blade (curette). The wound surface is then cauterised using a pencil-like metal instrument or needle to apply high-frequency electric current to the area. This prevents bleeding and removes any remaining unwanted tissue.
Treatable lesions
The following lesions can be treated with curette and cautery:
- Benign lesions such as warts, spider naevi, skin tags, seborrheic keratoses, and angiomas.
- Premalignant skin lesions called actinic keratoses.
- Cancerous skin conditions such as basal cell carcinoma and cutaneous squamous cell carcinoma.
Aftercare and healing
Following the procedure, your dermatologist will provide advice on wound care including pain management. The wound generally takes two to three weeks to heal. It may be red and raised initially, but the size and redness usually reduce over several months.
Curettage and cautery always leaves some degree of scarring as it is not possible to curette the skin without this occurring. Scars are generally round, flat, slightly depressed, white, and similar in size to the original lesion.
Some patients have an abnormal healing response which may cause scars to be larger or more raised than expected. This is referred to as keloid or hypertrophic scarring and is more likely to occur when lesions are removed from the upper back or chest, or if the patient has a family history of this type of scarring. These scars can be treated with various degrees of clinical response.