Curettage & Cautery
Curettage is a surgical procedure in which the dermatologist or skin doctor scrapes off a skin lesion using a sharp blade or a spoon like device called a curette to remove diseased tissue such as tumors or growths or to obtain a biopsy that can be used for diagnosis. Cautery is the method that is used to stop the bleeding and seal the wound.
What does it involve?
The dermatologist will inject some local anaesthetic into the area surrounding the lesion to be treated (this causes a tingling discomfort which will last only a few moments). This will make the skin go numb so no pain should be felt during the procedure. You may feel a pushing sensation but this should not be painful. The skin lesion is then scraped off with a sharp ring blade (curette). The surface of the wound is then cauterized using a pencil-like metal instrument or needle to apply a high-frequency electric current to the area. This prevents bleeding and also removes any remaining unwanted tissue. The following lesions can be treated with currete and cautery:
- Benign lesions such as warts, spider nevi, 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
Following the procedure your dermatologist will give you advice on how to care for the wound including what pain killers to take.The wound generally takes two to three weeks to heal. It may be red and raised at first, but the size and redness usually reduce over several months.
Curettage and cautery of a skin lesion always leaves some degree of scarring as it is not possible to curette the skin without this happening. Scars are generally round, flat, slightly depressed, white and similar in size to the original lesion.
Some patients have an abnormal response to the skin healing which may cause scars to be larger or more raised than would usually be expected. This is referred to as keloid or hypertrophic scarring and it 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 degree of clinical response.
“The best way to find yourself is to lose yourself in the service of others” – Gandhi.