When should skin lesions be excised?

There are two types of skin lesions. On the one hand, some of the most common lesions are superficial, appearing on the epidermis, the so-called pigmented lesions. This includes the classic freckles or nevi. Many times it is the patient who requests a visit with the surgeon because he/she is concerned that the lesion has changed in size or color, other times it is the dermatologist who sends the patient to the general surgeon so that we can remove the skin lesion.

On the other hand, there are deep lesions, which are cysts and lipomas. Cysts can be fatty or sebaceous cysts, which appear very frequently in any part of the body and also in the scalp. Lipomas are lumps of adipose tissue or fatty tissue, very frequent and usually benign, and surgical removal is very simple.

When should we see a specialist to remove a lesion, or when should we suspect that the lesion is beginning to look abnormal?

In the case of nevi or freckles, a specialist should be consulted when they change shape, size or color. Many times this is detected by the patient himself by direct observation of the lesion or because of discomfort that he did not have before, and he goes to the doctor on his own initiative or, sometimes, it is the dermatologist who detects it and sends the specialists in surgery to do the removal.

What risk factors can aggravate some skin lesions?

Above all the sun, which is the great enemy of pigmented lesions in particular. The sun can worsen a lesion that already exists or cause a lesion that did not exist to appear. The main risk is that the lesion becomes malignant and transforms into melanoma, which is skin cancer. Fortunately it is not the most frequent but it is very serious and important when it appears. That is why prevention is very important and, when there is any kind of doubt about this type of lesions, to make a quick excision.

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What dermatologic surgery is applied in the case of each skin lesion?

The lesion is always excised with sufficient and wide margins because, one thing is the macroscopic margin that we see, and another thing is the microscopic margin, since these lesions are sent after surgery to the laboratory for a microscopic study. In this way it can be seen if there are any cells that may have contact with the margins, as in the case of basal cell carcinomas, squamous cell carcinomas and melanomas.

A resection or wide excision with margins must be performed, which is done under anesthesia and is an easy and quick procedure.

All this is done with minimal damage to the skin, although it will always depend on the size of the lesion, since the larger it is, the larger the scar will be. Generally, however, they are usually small lesions that are removed on an outpatient basis, without hospitalization, in an operation that lasts no more than 20 minutes.

What care should we follow after the removal of a skin lesion?

It is recommended to avoid direct exposure to the sun, especially during the first two to three months, which is the period in which the scar is developing, and thus avoid leaving more marks. In addition, the wound or scar should be kept clean and dry and, for the first few days, covered with a dressing. In fact, there are special dressings that protect the surrounding skin so that the aesthetic result is much better. The stitches are usually removed after seven or eight days, and they are usually painless surgeries. Rarely should the patient take any painkillers, such as paracetamol at most, as it is something that does not usually cause pain.