Curette/ Shave Excision Treatment in Brighton
Curretage or shave excision is a procedure carried out by Dermatologists under a local anaesthetic. Dr DeGiovanni is sometimes able to perform these procedures on the same day as your initial consultation if your insurance company has authorised treatment. Once the area is numb the lesion is scraped away and the base is sealed with heat. Depending on the type of lesion this process may need to be repeated a few times. A dressing will be applied. The area will form a scab which will heal over a few weeks. It will leave a scar which, in most cases, can be concealed with make up.
What is curettage/ shave excision?
Curettage or shave excision is a way of removing superficial lesions (abnormalities in the upper part of the skin). Dr DeGiovanni will use a sharp hoop or blade to scrape the lesion off the skin. The procedure can be used to remove the whole lesion or a small sample of skin for biopsy purposes.
How is it done?
Dr DeGiovanni will clean the area with an antiseptic wash. Local anaesthetic will be injected around the area to be treated. The local anaesthetic takes effect within a few seconds and the area will become numb. The lesion is removed and the specimen put in a pot and sent to the laboratory to be analysed under the microscope. Bleeding is stopped by pressure and cauterisation, which is a method of sealing the tiny blood vessels with an instrument that emits heat. Occasionally, a special liquid will be used that chemically seals the vessels.
What to expect with this type of surgery?
The local anaesthetic will wear off in the next 1 or 2 hours. You may need to take a simple pain relief, e.g. paracetamol (as directed on the manufacturer’s packet), to cover the next 24-48 hours.
Although some weeping at the site is inevitable, this does not necessarily imply infection.
If the blood vessels were sealed with thermal cautery then the wound will initially look like a small burn. The dressing should be left on and kept dry for 3 days. After this time it can be removed. The treated area will form a scab. This should be left in place until it fades or falls off after 2 to 4 weeks. Vaseline or an antibiotic ointment should be applied daily once the dressing is removed. This helps to soften the scab so that it lifts with minimal scarring. The wound can be washed with water alone until it fully heals.
Over a period of 4 – 6 weeks the area will heal to produce a flat, pale mark.
Occasionally, and especially in those with dark skin, the mark may be darker or lighter rather than the regular skin tone. You will usually be able to return to work after your surgery. If your procedure was performed to obtain a diagnosis you may need further surgery.
Unfortunately scars are unavoidable with all surgical treatments. All damage to the skin creates a scar. In many cases the scar fades well and is frequently barely visible. The scar can be covered with make–up once it has healed. Scars following curette or shave excision tend to be white in colour and occasionally they are dipped in the skin. Rarely, a raised scar (called a keloid or hypertrophic scar) may form. Treatment may also disturb the colouration of the skin layers resulting in a scar that is either lighter (hypopigmented) or darker (hyperpigmented) than the natural tone of your skin. The risk of discolouration is higher in darker in skin tones.
How to care for your wound after curettage
If a dressing has been applied this should be left in place for 3 days. If the area is dry and healing, the dressing can be left off. If the wound is moist or is in an area where it may catch or rub on clothing, cover with a clean dressing until healed.
A greasy ointment (e.g. Vaseline) can be applied after removal of the dressing to prevent crusting. This softens the scab and helps it to lift with minimal scarring.
Pain after this type of surgery is unusual but paracetamol (e.g. Panadol) can be taken if the area is uncomfortable
The area should be kept dry for 3 days until the dressing can be removed. After bathing, never leave a wet dressing in place. If your dressing has become wet, wash your hands and change it for a plain plaster. A wet dressing increases your risk of infection.
Bleeding after surgery is minimal and usually controlled by a dressing if appropriate. The wound may however, ooze when the local anaesthetic wears off. If this occurs, take some clean tissues and apply pressure OVER the dressing for about ten minutes. Do not remove the dressing.
To reduce the chance of bleeding after the procedure, take it easy and avoid activities that can increase your blood pressure. Avoid alcohol for 24 hours.
Infection is not common after curettage/ shave excision. If you are concerned about how the wound is healing please contact the Outpatient nurses.
The signs of infection can be any of the following:
- Increasing pain at the site
- A pus-like discharge