Did you notice a lump, sore, or an area of skin that is not normal? Chances are that you’ve developed a skin lesion, which is an area of skin that is different from the surrounding skin. While it is mostly benign it can be cancerous as well. That’s why when you notice any changes in your skin, you need to see the dermatologist to get diagnosed or for its removal to prevent complications. Learn different excision lesion techniques a dermatologist uses to diagnose or remove the lesion on the skin in this article. If you notice changes in the appearance of your skin, you can consult the best dermatologist in East New York. Please contact Doral Health and Wellness Dermatology Center.

Why do skin lesions need to be excised?

Skin lesions need to be excised for the following reasons:

• To make a diagnosis.
• To improve the appearance.
• To relieve symptoms like irritation or discomfort.
• To remove an inflamed or infected cyst.
• To remove any of the following skin cancers or other growths:
  • Basal cell carcinoma
  • Melanoma
  • Squamous cell carcinoma
  • Benign growths
  • Warts
  • Skin tags
  • Moles
  • Seborrheic keratosis
  • Actinic keratosis
  • Bowen disease
  • Molluscum contagiosum
  • Other skin conditions

Types of excisional techniques

There are many types of excision techniques depending on the location, size, and type of lesion. Here are some of the common types of excision techniques:

1. Shave excision: This technique is used to remove skin lesions that are above the skin or on the upper layer of the skin. In this technique, your provider uses a small blade to remove the outermost layers of your skin as well as the lesion after making the area numb. You don’t need stitches in this procedure. At the end of the procedure, your provider applies medicine to the area to stop bleeding or treats the area with cautery to seal the blood vessels. Both options are painless.
2. Simple scissor excision: This technique is also used to remove skin lesions that rise above the skin or are on the upper layer of the skin. In this technique, your provider will grab the skin lesion with small forceps and lightly pull it up. Then, they use small, curved scissors to cut around and under the lesion. Sometimes, a curette is used to cut any remaining parts of the lesion. In rare cases, you need stitches. At the end of the procedure, the medicine is applied to the area to stop bleeding, or the area may be treated with cautery to close the blood vessels.
3. Skin excision – full thickness: This technique is used to remove a skin lesion in the deeper levels of the skin down to the fatty layer under the skin. In this technique, your provider removes a small amount of normal tissue that surrounds the lesion to ensure it is clear for any cancer cells due to its risk of skin cancer.

Generally, an area in the shape of an ellipse (like an American football) is removed and closed with stitches. The entire lesion gets removed, by going as deep as the fat tissue, if needed to get the whole area. A margin of around 3 to 4 millimeters (mm) or more surrounding the tumor is also removed to set clear margins. The area is closed with stitches, and a large area that is removed, a skin graft or flap of normal skin may be used to replace the skin that was removed.

4. Curettage and electrodesiccation: This technique use scraping or scooping to remove the skin lesion. In this technique, your provider uses a special surgical instrument called a curette, which has a scoop or ring shape on the end and can scrape away the lesion down to the deeper skin layer called the dermis. This is less invasive than excision and often used for actinic keratoses and superficial basal cell carcinomas.

After curettage, electrodesiccation is used, which uses a high-frequency electrical current to heat and desiccate/dry out lesion cells, causing them to die and slough off. It also helps to manage bleeding and destroy the remaining abnormal tissue which makes it an excellent choice for thin, superficial lesions.

5. Laser excision: This technique is used to remove very specific types of cells. In this technique, the doctor uses laser heat to burn the cells in the area being treated. There are several types of lasers, and each laser has specific uses. It is mostly used for excision of:

• Benign or pre-malignant skin lesions
• Warts
• Moles
• Sunspots
• Hair
• Small blood vessels in the skin
• Tattoos

6. Cryotherapy: This method is used to destroy cancerous or precancerous skin lesions like warts, actinic keratoses, seborrheic keratoses, and molluscum contagiosum. In this therapy, the doctor uses either a cotton swab dipped into liquid nitrogen, a spray canister containing liquid nitrogen, or a probe that has liquid nitrogen flowing through it. It takes less than a minute. The freezing may cause some discomfort however, your provider may apply numbing medicine to the area first. The freezing destroys the cells and lesions will peel away.
7. MOHS surgery: This surgery is used to treat or cure certain skin cancers. In this procedure, the surgeons remove thin horizontal layers of skin incrementally and immediately examine them under a microscope by another surgeon. Repeat the process of removing skin until no skin cancer is present. This approach allows maximum preservation of healthy tissue.

Recovery and healing

Recovery and healing are different for every patient, depending on their case. Usually, it takes 1 to 3 weeks for an excision wound to heal. To get a proper estimation of your recovery period you should consult a board-certified dermatologist in your area.

Depending on your skin lesion, a dermatologist recommends a technique to remove the lesion while preserving the surrounding skin. It relieves your symptoms, improves appearance, and lowers the risk of skin cancers.

If you need help with your skin lesions, visit our dermatology clinic in Brooklyn to get professional medical treatment. Call us to book your appointment now! At Doral Health and Wellness Dermatology Center, we have the best dermatologists who can help you take care of your skin. As dermatology experts in East New York, we are dedicated to providing the best services. You can visit us at 1797 Pitkin Avenue, Brooklyn, New York to schedule an appointment. You can also call us at 1-347-384-5690 or visit our website at https://www.bestbrooklyndermatologist.com.