Mole, Cyst, Lipoma and Skin Tag Removal

Removal procedures can help to:

• Improve comfort if lesions are irritated or painful
• Reduce rubbing, catching or inflammation
• Improve cosmetic appearance
• Remove lumps or growths that are increasing in size
• Provide reassurance through clinical assessment and pathology testing
• Treat recurrent or infected cysts

Where appropriate, procedures are performed with care to minimise scarring while achieving effective removal.

Minor skin lesion removal may be suitable for adults who:

• Have bothersome or uncomfortable skin lesions
• Are concerned about the appearance of a mole, cyst, lipoma or skin tag
• Have lesions that repeatedly become inflamed or irritated
• Have been advised to have a lesion assessed or removed
• Are in generally good health for a minor surgical procedure

A consultation with a specialist will determine whether removal is appropriate

In most cases these can be done under a local anaesthetic. If there are no concerns about its nature, they can be either shaved off, or excised. Some skin lesions can also be treated by freezing the skin – termed cryotherapy. All options are discussed with the patient beforehand

Skin tags are a bit easier and can be removed by cutting, freezing (cryotherapy) or burning off (electrotherapy). This should be done in a controlled sterile setting to minimise the risk of infection, and they do bleed so the clinic needs to be able to manage this.

Moles are usually excised with a scalpel. Occasionally they are shaved off, but to ensure completion of the removal, especially if there are any suspicious features, the whole depth of the skin needs to be removed in one piece. Moles should be sent to the lab for pathology to ensure there are no suspicious cells. At Kingsbridge we send all moles for pathology.

If there is going to be significant discomfort the doctor or surgeon should usually administer local anaesthetic to numb the area. There will be mild discomfort as the anaesthetic is being injected but it is usually not significant. The anaesthetic takes effect within a couple of minutes. For very small skin tags, they can sometimes be frozen off without anaesthetic. Local anaesthetic cream can be applied in advance of the procedure. We don’t like causing pain and make every effort to minimise it.

Most of these procedures are very quick. A mole can be removed and the skin sutured within 5 to 10 minutes. Administration of anaesthetic and skin preparation adds some time. If several lesions are being removed it will take a bit longer. A skin tag can be removed in a matter of seconds, but again, it is key that this is done in a controlled sterile setting (don’t try this at home).

Usually there is no issue with driving, unless for example the lesion was near the eye and vision was temporarily affected by swelling or watering. Hand surgery can also affect driving, but the vast majority of these lesions are small enough not to cause a problem. If in doubt bring a friend or relative or take a taxi.

There is usually a dressing for the first 3 to 7 days and, depending upon the operation site, sutures may need to be removed. On the face these are often removed between 5 to 7 days, but are left a bit longer on other body areas. Again these should be removed by someone skilled and experience. Doing it incorrectly can leave bits of stitch in the skin, or risk reopening the wound. After about a week most wounds do not need dressed, but should be kept clean. Paraffin ointment often helps at this time. Depending on your surgeon, the wound may be dressed with ointment alone or sometimes skin glue.

All surgery which cuts through the full depth of skin will leave a scar. Skin tag excision shouldn’t leave much noticeable scarring but mole excision usually will. The quality of the scar can vary depending on genetics. To optimise the scar we perform precise stitching, remove stitches at the appropriate time, and encourage scar management in the form of moisturising and massage. Scars can take up to 2 years to mature to their final appearance. If a scar does become thicker or remain red for a long time then there are treatments such as steroid injections or laser colour reduction. These are thankfully rarely necessary.

Recovery is generally straightforward following minor skin surgery.

Patients may experience:

• Mild soreness or tenderness
• Minor swelling or bruising
• Temporary redness around the treatment area

Most patients can return to normal daily activities within 24–48 hours, although strenuous exercise, swimming and heavy lifting may need to be avoided for up to 1–2 weeks depending on the treatment area.

If stitches are required, these may either dissolve naturally or be removed at a follow-up appointment.

Initial healing usually occurs within 1–2 weeks, although scar maturation can continue for several months.

Patients are advised to keep the area clean, follow aftercare instructions carefully and protect healing scars from sun exposure to support the best cosmetic outcome.