Curettage and Cauterization
A kind of electrosurgery, this procedure uses heat to treat a skin lesion. The surgeon will remove the lesion on the skin (curettage) and then treat the skin with heat (cautery).
BEFORE THE SURGERY
As with any surgery, your dermatologist will talk you through the process of curettage and cautery, indicating why he recommends it for the treatment of your skin condition. He will also go over alternative options for treatment. Once you consent to the procedure, be sure to fully inform him regarding any medications you are taking as well as information about your medical history.
THE ACTUAL PROCEDURE
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. He will do so 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 he 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.
LESIONS WHICH ARE TREATABLE
Skin lesions that can be treated with curettage are generally softer than the skin around them, or they might be easily separated from the rest of the skin tissue as if 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 can be treated with curettage include viral warts, seborrheic keratoses, solar keratoses, skin tags, pyogenic granuloma, keratoacanthoma, in situ squamous cell carcinoma, and 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. 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.
CARING FOR THE WOUND
Your dermatologist will likely counsel you to leave the dressing on the wound for a full day and to resist the desire to stretch the skin. Also, do not do any strenuous
exercise for 24 hours because this will increase blood flow to the area and can affect the healing process. The wound may bleed after the surgery, in which case it is best to put consistent pressure on the wound with a towel for a full twenty minutes. Consult your dermatologist, doctor, or other medical professional if the bleeding continues after that point. In addition, it is important to keep the wounded area of skin dry for a period of 48 hours, after which you can wash and dry it carefully. Any signs such as reddening or becoming particularly painful may indicate other problems 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.