You may be having skin surgery to remove an abnormal patch or growth, or to take a sample from a rash so that it can be examined under the microscope, to aid diagnosis.
Prior to surgery you can eat and drink as normal.
Most operations take between 10 and 30 minutes and you will be free to go home as soon as the procedure is finished. However, it may be advisable not to drive yourself home, especially if your operation is on your hands or feet, or near your eyes. You should not have any make-up on if your face is going to be treated.
For virtually all types of operation you will be given a local anaesthetic; this is an injection into the skin next to the place that is to be treated; the injection will sting for a moment, but the painkilling effect is very rapid and after a few seconds the area will be completely numb and the rest of the operation will be painless.
Excision/ biopsy: A piece of skin is removed and sutures (stitches) are used to close the skin; these will usually have to be removed after a week or two; tell the doctor or nurse before the operation if you will have any difficulty arranging this, for instance because of a holiday. Occasionally the area will not be sutured, but will be left to heal on its own (secondary intention healing). You will be given careful instructions on how to manage the wound.
Shave excision/ curettage: In this procedure the surface of the skin is removed by either cutting a raised lesion or scraping off the lesion and the area may be treated with cautery to stop any bleeding; the area will scab over and heal within a few days.
Specimens sent for histology are usually reported in about 2 - 3 weeks but the report may take longer if special tests are required.
Unwanted complications of skin surgery can include:
Bleeding: If there is bleeding from the wound, simple pressure with a clean dressing for about 10 minutes is usually enough to stop it. If bleeding persists you should contact the Dermatology Department, your family doctor or practice nurse.
Bruising: Bruising may occur especially around the eyes; it will disappear over the next 7 to 10 days and will not leave any permanent mark.
Infection: If the wound becomes very red, painful or hot, weeps or oozes it may be infected. You should contact the Dermatology Department, your family doctor or practice nurse.
Scarring: Every effort will be made to ensure that your surgery causes as little scarring as possible and often the procedure will leave hardly any long-term mark on your skin. However, there is always a possibility of more noticeable scarring.
Certain areas of the body are more likely to develop scarring. In particular, operations on the upper chest or back, the shoulders and the upper arms may leave scars which can be broad and sometimes lumpy. If you have previously noticed lumps arising in scars (keloids), or if other members of your family have a tendency to this, you should be especially aware of this risk.
Skin surgery is very common in dermatology and all staff who perform it are experienced. If you were to be treated by a person who is in training you would be informed. As well as medical staff, some senior nurses also perform a range of skin surgery, for which they are fully trained.
Aftercare: You will usually have a dressing applied after your operation, although for some areas, such as the scalp, this is impractical. Usually it is advisable to keep the area dry for one or two days; after this the dressing is not essential, but if you wish to cover the area, for instance to keep it clean at work, a simple fabric plaster is usually sufficient. You will be informed if any special treatments or precautions are needed. Pain relief is not usually needed after an operation on the skin, but if required Paracetamol or Ibuprofen are the best drugs to take.
Avoidance of the following for a week after your surgery may improve the result; ASPIRIN, ALCOHOL, SMOKING, EXCESSIVE EXERCISE.
Other medications: Please tell the doctor or nurse about any other drugs you take, especially anticoagulants (blood thinning tablets) or steroids, such as prednisolone. It is not usually necessary to alter the dose.
Who to contact: Dermatology Department, Clifton Hospital, Lytham St Annes. Tel 01253 956238/957089 or 01253 957079 out of hours. You can also contact your own Family Doctor or the Practice Nurse for advice.
