What are skin lesions?
A skin lesion is a growth or bump that looks different from the rest of your skin. Some examples include spots, moles, warts, skin tags and patches of psoriasis and skin cancers. It may be an isolated growth or part of a cluster or rash.
What are the various types of skin lesions?
Most skin lesions are harmless and are known as benign.
Some common benign lesions include:
Important note: If you are unsure about any new or changing skin lesion, contact your GP. Or you can see a skin doctor called a dermatologist. You can then be advised on whether treatment is required and what the options are.
You should pay most attention to anything that seems to be an odd-one-out. These are areas which may look different from the rest of your skin, or from other marks or lesions you have.
Some harmless lesions can sometimes look like skin cancer. If your GP is uncertain if your lesion is benign, they will refer you for a hospital appointment.
Why are non-cancerous skin lesions sometimes removed?
Non-cancerous skin lesions usually don’t need to be removed. They often clear up on their own or cause no problems. Sometimes they are itchy or uncomfortable or catch on clothing, so a procedure may be possible to address this.
Removing a lesion always leaves a scar, although how visible it is varies a lot. There are also some risks like developing an infection.
It is understandable that you may want a lesion removed because of its appearance but this is not usually offered by the NHS. Often, they must be removed privately.
Removal by the NHS may be considered in certain cases, such as if the lesion is:
- Repeatedly getting infected and needs treatment with antibiotics.
- Bleeding regularly while carrying out normal everyday activities.
- At risk of causing further complications later if left untreated.
- Catching on clothing or causing damage to the skin.
- Causing pain which requires ongoing medication.
- Restricting your ability to move normally.
- Causing significant psychological distress.
- Affecting your vision.
A GP may be able to remove some types of lesions, or they may refer you to a skin doctor (a dermatologist).
They may also prescribe a cream or gel for certain lesions. Pharmacists can also prescribe creams for some lesions like warts.
How are skin lesions removed?
There are several ways to remove skin lesions. The method used is likely to depend on the type of lesion, where it is and what the potential risks and benefits are.
Some common methods for skin lesion removal include the following.
Freezing (Cryotherapy)
This involves freezing the skin lesion usually using liquid nitrogen. It is most likely to be used on sun-damaged skin but it can be used for most benign lesions such as warts.
The procedure takes a few seconds and the skin may be red or blister afterwards. After a few days, a scab will form which can take a few weeks to fall off. Scarring is rare if performed carefully by experienced clinicians but a change in colour of the skin afterwards is common. For example, you may have a small paler patch of skin.
Heat (Cautery/Electrosurgery)
This is sometimes used to remove lesions like skin tags, or haemangiomas which are a cluster of blood vessels.
Shave excision or curettage (scooping out)
This is done using a small spoon-like device or circular scalpel or blade. Heat may be used afterwards to stop bleeding. It is suitable for certain lesions on the skin surface but isn’t suitable for deeper growths. It is a quick clinic treatment without stitches but heals like a graze or burn. It requires local anaesthetic, usually by injection.
Photodynamic therapy
This is usually used to treat sun-damaged skin that may become cancerous like solar keratoses. It involves applying a cream to the affected area. The cream then works when either a special light or natural daylight is shone on it.
Laser therapy
A laser can be used to destroy the top layer of skin so new skin can grow. It can be used for treating conditions like actinic keratosis or even small skin cancers.
Biopsies
If the doctor needs to make a diagnosis of a rash, or is unsure if a lesion is cancerous, you will need to have a biopsy. This involves removing some or all the abnormal skin and sending it for testing in a lab.
Biopsies can be done in several ways depending on what’s best for your type of lesion. Part of a lesion can be sampled using an incision or curette or shave biopsy (see above). Very small lesions may be removed using a punch biopsy which removes up to an 8mm diameter cylinder of skin.
You may have an excision biopsy which involves removing part of or all of the lesion and a small area around it called the margin. A local anaesthetic is injected into the skin to numb the area first. Stitches are usually used to close the wound and a dressing applied.
Your clinician will tell you when to expect the results of your biopsy and what may need to happen next.
Larger or more complex skin procedures
Some lesions require removal of larger or more crucial areas that may need more involved surgery such as Mohs micrographic surgery or wide excision . These may include repairs or reconstruction with skin grafts or flaps. You should seek additional information from your healthcare professional about these procedures.
How can I prepare for my procedure?
A member of the healthcare team looking after you will tell you what you need to do to prepare for your procedure.
You will typically have to tell them about any medication you are taking, particularly if you take blood ‘thinners’ like warfarin. They’ll also need to know about any other important medical conditions you may have, or implants like a pacemaker.
Usually, all your normal medications should be continued around the time of your procedure but some changes may be advised. Your healthcare team should give you personalised advise on this, which considers the balance of risks and benefits.
It is also a good idea to wear loose fitting clothing and remove all make-up and jewellery from near the area of the procedure.
If you smoke, try to stop altogether. However, even stopping for a few days or weeks before surgery reduces your chances of getting an infection. It’ll also reduce the chances of your wound taking a long time to heal, which may affect the final scar.
What aftercare is involved in skin lesion removal?
At your appointment you’ll be given instructions on how to look after your wound. For example, you may need to keep it dry initially, typically for 24-48 hours.
If you have stitches, you’ll be told if and when they’ll be removed. Many stiches are self-absorbing but if not, they are usually removed between 5-10 days afterwards.
Petroleum jelly or a paraffin ointment can be applied in some cases to help the wound heal, especially after shave biopsies and curettage. Silicone scar gel or scar massage may also be advised later.
Sunscreen or make-up can usually be applied as soon as the wound appears healed on the surface and after scabbing or stitches have gone.
It’s best to avoid alcohol for 24 hours afterwards. This is to reduce the risk of the wound bleeding or knocking the area.
You may also be advised not to go on holiday for two weeks afterwards, in case you develop a complication that needs attention. It’s a good idea to also check with your travel insurer before going away following a procedure.
You may not be safe to drive yourself home, or for a few days afterwards. This depends on the procedure and where it was on the body. Avoiding driving is particularly advised for procedures near or above the eyes where swelling or dressings can obstruct vision. Procedures on the hands, feet or legs can also affect your driving ability.
Bear in mind that any procedure anywhere on the body may cause some discomfort or distraction, particularly as the anaesthetic begins to wear off. This is usually within an hour or two after treatment.
If the operation was near your mouth you may need to have soft foods afterwards for up to a few days. It’s also best to avoid hot drinks, at least until the anaesthetic wears off.
You may feel sore afterwards. If the area is painful, pain killers like paracetamol or ibuprofen are usually enough, if they are safe for you. If the pain does not get better, or the area becomes red, swollen or produces pus then you may have an infection. Your doctor can prescribe antibiotics for this.
How long does it take to heal after skin lesion removal?
You may have some bruising afterwards for up to several weeks, particularly if you’ve had surgery to the face. Healing time varies a lot, depending on the procedure and personal differences but most occurs in the first four months. Small procedures often look healed after a few weeks.
Will I have a scar afterwards?
All skin surgery produces a scar but how noticeable this is varies.
Some people, particularly those with darker skin, may develop difficult raised scars called keloids. These can become bigger than the original lesion being treated. They can be very difficult to treat and may need further treatment with a steroid or a procedure like laser therapy.
Hypertrophic scars are much more common. These are raised but don’t spread beyond the original cuts. They tend to peak about six months after surgery but then go down on their own.
Scars can also spread or stretch, especially on areas of the body with larger moving muscles like the back and shoulders.
Younger people are much more susceptible to problem scars. Older or frailer people may heal very slowly, particularly on the lower legs.
Are there any risks or potential complications?
Skin lesion removal carries the following risks:
- Bleeding
- Scarring
- Infection. This occurs in around 1 in 10 to 20 patients having skin surgery.
- Nerve damage which may make the area feel different afterwards, or less often could affect movement.
- Numbness to the affected area or nearby.
- Failure to remove all the lesion, or it may grow back in the future and need another procedure.
- Slow wound healing especially after other complications such as diabetes or smoking.
- In some cases, general anaesthetic may be necessary and this has its own risks.
You may be more sensitive to the sun afterwards or the area may appear darker or lighter afterwards.
What costs and fees are involved in skin lesion removal?
The initial private consultation costs and the procedure costs will be detailed on your hospital’s website. If they’re not, you can call to ask about them.
If you’re self-funding, you can find out more in our guide on paying for private healthcare
Where can I get skin lesion removal near me?
Our website has a database you can search for hospitals and consultants you can see privately near you. Please note: This link takes you to an example search result. You will need to 'Edit the search' to enter your postcode to find results near you.
Medical review
Thanks for Dr Adam Bray , Consultant Dermatologist & Mohs Surgeon (Bristol, UK),President, British Society for Dermatological Surgery (BSDS) for his support and reviewing this article
