Skin Lesion & Wart Removal

The term skin lesion is used to describe a part of the skin that is abnormal when compared to the rest of the ‘normal’ skin; this may be due to a growth on the skin or a change in the appearance such as pigmentation, redness, uneven texture etc.  They can be present from birth or acquired over a person’s lifetime, being referred to as primary skin lesions. Secondary skin lesions are caused by irritation or interfering with a primary skin lesion in a way that makes it worse, such as scratching, picking, causing bleeding and scabbing. Skin lesions can be small and localised or larger and more widespread, and they can be benign, precancerous, or cancerous in nature.

The term covers a broad range of skin growths and imperfections including acne, eczema, psoriasis, impetigo, cysts, cold sores, boils, warts etc.

Keratoses are a type of skin lesion; you may hear names like seborrheic keratosis, actinic keratosis, or solar keratosis. A seborrheic keratosis is a common skin growth seen as people get older, they are often brown, tanned, or black in colour, and called brown spots or age spots. Seborrheic keratoses and are benign, noncancerous. An actinic or solar keratosis is caused by sun damage and is a dry, scaly patch of skin, that may be itchy. They are usually benign, but can be precancerous so it is important to have them looked at by a medical professional with training in dermatology and skin cancers, especially if the lesion has altered in any way recently – started bleeding, got bigger, changed colour etc.

Cryosurgery, also called cryotherapy or cryoablation uses extreme cold to remove abnormal skin tissue through freezing with liquid nitrogen spray or via special cryotherapy devices where the cold is applied using a pen-like tip or probe that reaches temperatures below -100 degrees Celsius. Cryosurgery is regularly used in medicine to remove precancerous cells, skin cancers, warts, skin tags and other skin lesions.

By applying the extreme cold to the targeted lump or bump on the skin, we can selectively cause cell death within it, whilst preserving the surrounding skin to minimise scarring. The frozen lesion will blister within a few hours, eventually scabbing or crusting over, and your body will start to heal the area. The scab will eventually shed, allowing healthy skin to grown back beneath; this can take 1-4 weeks depending on the size of the lesion and the depth of treatment.

Minor surgical procedures refer to a number of dermatology procedures that are used to address the surgical removal of various diagnosed skin lesions, warts and other ‘lumps and bumps’. These are performed using local anaesthetic to numb the area but do involve the action of cutting or excising a piece of tissue. Examples of minor surgical procedures that we perform at Blemish Clinic include:

• using a scalpel – for cutting to excise a lesion and then sealing the wound with internal and external surgical sutures or stitches,
• using a curette for curettage – a looped or hooked instrument for scooping, scraping, or excising a wart or lesion,
• using cautery – heat used to seal off minor blood vessels as a lesion is removed.

To be successful, cryosurgery should be regularly performed every 1-2 weeks to prevent the wart from growing back and to kill it off.

With some warts and skin lesions, we may also recommend other minor surgical procedures like curettage, cautery, or excision using a scalpel, alongside a home care regime to effect complete removal.

Jan Birch, our dermatology specialist nurse has many years of experience in treating warts and verrucae and prides herself on complete resolution. She achieves this using her own protocols which vary depending on the individual case and can include cryotherapy and curettage, alongside a bespoke treatment protocol to follow at home. This is a partnership treatment, and you must be committed to undertake the home treatment consistently between clinic visits to achieve success.

During a consultation with either our dermatology specialist nurse, Jan Birch or consultant dermatologist, Dr Andrew Winter, your skin lesion or wart will be accessed to decide on the most appropriate treatment option. A full medical history will be taken to determine if there are any underlying health issues or medications which could be impacting on the formation of your skin lesions, or conflict with the proposed treatment, alongside any known allergies that you may have that we must avoid.

The removal of skin lesions and/or warts via minor surgical procedures and cryosurgery is suitable for men and women of all ethnicities and skin types.

If you have an active viral infection, such as a cold, or an active skin infection (bacterial or fungal) in the area to be treated, that is not related to the skin lesion, then these will need to be treated with prescribed medication before minor surgery can be performed.

Similarly, if you are currently pregnant or breast feeding, we will ask you to wait before removing the lesion and discuss ways to manage any symptoms whilst your infant is your priority.

If you have a problem with healing, such as keloid scar formation, you may not be suitable for some of the minor surgical options.

Your comfort is very important to us at Blemish Clinic and the removal of warts or skin lesions either via cryosurgery or minor surgical procedures can obviously be painful. We will inject the area before treatment with a local anaesthetic, lidocaine, to numb it and remove any discomfort.

You may experience some pain, soreness, and tenderness to the treated area afterwards, and advice will be given on aftercare options including over-the-counter pain medications and caring for the wound whilst it heals.

After 3-4 months of regular cryosurgery treatments, alongside a homecare regime, warts are effectively removed in over 70% of cases. If you have a particularly troublesome or unresponsive wart, we will consider other minor surgical techniques including curettage to resolve it to complete removal. You must also follow the home care treatment given to you by our specialist team.

When a skin lesion is removed, the area should heal completely, although there may be a small scar, depending on the type and depth of the lesion and the treatment performed. You will be advised on aftercare treatment, including scar prevention. Most scars fade with time.