Curettage and Cauterization

A kind of electrosurgery, this procedure uses heat to treat skin lesions, in which the surgeon will remove the lesion on the skin (curettage) and then treat the skin with heat (cautery). It’s minimally invasive and can be typically be done in a scheduled office visit.

As with any surgery, after diagnosing your skin condition, your dermatologist will talk you through the process of curettage and cautery, indicating why they recommend it for the treatment of your specific condition. They will also go over any alternative treatment options and address any questions on concerns regarding the actual procedure.
 
In preparation for the procedure, be sure to fully inform the provider of any medications you are taking, as well as information about relevant medical history.
 
Typically, a separate appointment is required to allow for the proper preparations and amount of time needed for this procedure, so our office staff can help you get this scheduled.
  • To conduct the procedure, your dermatologist will treat the affected area with a local anesthetic to prevent you from feeling pain during the surgery. As a result, the tissue will feel completely numb so that the doctor can freely work to remove the lesion.
  • The removal will be done by using a curette (a surgical tool that can be compared to a spoon with sharpened edges) to scrape it off of the skin.
  • After removing the lesion, he will cauterize the area using an electrosurgical unit to stop the bleeding and cleanse the area, killing dangerous and unhealthy cells that may have remained.
  • Often, the surgeon will go through the process of curettage and cautery two times to make certain that the lesion is fully removed.
  • Finally, the wound will be covered and dressed and they will tell you what you can do to help the healing process. 
  • It may continue to be tender for a few hours after the local anesthesia wears off. Meanwhile, the skin lesion that was removed will be sent off for analyses.
Skin lesions that can be treated with curettage are generally softer than the skin around them or might be easily separated from the rest of the skin tissue by a natural line of cleavage.
 
This excludes skin lesions that are not easily separated or defined, but have blurred edges, which have to be treated in other ways.
 
Lesions that often can be treated with curettage include:
  • Viral warts
  • Seborrheic keratoses
  • Solar keratoses
  • Skin tags
  • Pyogenic granuloma
  • Keratoacanthoma
  • In situ squamous cell carcinoma
  • Basal cell carcinomas.
If you have basal cell carcinomas that are recurring or large, curettage is likely not going to be recommended by your dermatologist.
Because this procedure involves cutting off a part of the skin, there will be a scar.
 
However, your dermatologist knows what methods to use and how to advise you as you care for the wound so that you can minimize the amount of scarring that occurs.
 
Scars from this procedure are usually round, reddish, and raised early on, but over a few months become flat and less noticeable.
 
They are roughly the same size as the lesion of skin removed. Scarring can look different for those individuals whose bodies have a difficult time healing.
 
Again, your provider can answer any questions or concerns, as well as educate you on how to minimize scarring from this procedure.

Your dermatologist will likely counsel you on the following wound care instructions:

  • Leave the dressing on the wound for a full day and to resist the desire to stretch the skin.
  • Keep the wounded area dry for a period of 48 hours, after which you can wash and dry carefully.
  • No strenuous exercise for 24 hours because this will increase blood flow to the area and can affect the healing process.
  • Although some bleeding is common, if the wound continues to bleed, put consistent pressure on the area with a towel for a full 20 minutes. Consult your dermatologist, doctor, or other medical professional if the bleeding continues after that point.
  • If the wound begins to get red, hot, or particularly painful, this may indicate signs of infection and should be observed by a doctor.
  • Be aware that there will naturally be some red to the wound as the scar tissue forms, but this will fade over the course of a few months. The wound itself should heal within two to three weeks.

For more complete information on general wound care, click here.