Surgical Dermatology

Benign Skin Lesion Removal Singapore

Dr. Liew Hui Min

accredited consultant dermatologist

Benign skin lesion removal is a procedure that involves the extraction of non-cancerous growths from the skin. This procedure eliminates abnormal skin formations such as moles, cysts, lipomas, skin tags, and warts, which may cause discomfort, irritation, or cosmetic concerns. This procedure is performed using various techniques depending on the type, size, and location of the lesion, with the goal of removing the growth while minimising scarring and tissue damage.

Indications Benefits Techniques Preparation Procedure Recovery Risks FAQ

Indications for Benign Skin Lesion Removal

Patients may require benign skin lesion removal based on several clinical and personal factors.

Physical Discomfort: Lesions can catch on clothing or jewellery, causing pain or irritation during daily activities. They may also become inflamed or develop recurring infections.
Diagnostic Confirmation: Some benign-appearing lesions require removal for pathological examination to rule out malignancy. This examination provides a definitive diagnosis when visual assessment is insufficient.
Functional Interference: Lesions in certain locations can impair the normal function of body parts. Growths near the eyelids may affect vision, while those on the palms or soles can make walking or gripping objects difficult.
Recurrent Infection: Certain lesions, such as epidermal cysts, may become repeatedly infected, necessitating removal. These recurring infections can cause pain and potential scarring if left untreated.
Rapid Growth or Change: Benign lesions that suddenly change in size, shape, or colour may require removal for examination. Such changes occasionally indicate transformation to precancerous or cancerous conditions.
Bleeding or Ulceration: Lesions that frequently bleed or develop open sores benefit from removal. These symptoms can indicate underlying issues requiring treatment.

Benefits of Benign Skin Lesion Removal

Benign skin lesion removal offers several advantages for patients who undergo the procedure.

Pain Relief

Removal eliminates discomfort caused by lesions in friction-prone areas. Patients experience relief from symptoms like itching, tenderness, or pain associated with the growth.
Infection Prevention

Excising lesions prone to infection reduces future health complications. This particularly applies to cysts that can rupture and cause inflammation of surrounding tissues.
Definitive Diagnosis

Removal allows for histopathological examination to confirm the benign nature of the lesion. This examination provides certainty about the type of growth and rules out malignancy.
Cosmesis

Improve appearance by removing unsightly and unwanted benign skin lesions such as seborrhoeic keratoses.
Functional Improvement

Eliminating lesions that interfere with movement or sensory function restores normal body mechanics. Patients regain full range of motion and function in the affected area such as lipoma.

Removal Techniques

Shave Excision

This technique involves using a surgical blade to slice off raised lesions at or slightly below skin level. The procedure is quick and suitable for elevated lesions such as skin tags, seborrhoeic keratoses, and some moles. The wound typically heals without stitches, leaving minimal scarring but may not remove cells deep within the dermis.

Curettage and Electrodesiccation

This two-step process first removes the lesion with a curette (a spoon-shaped instrument), then seals the wound base using electric current. This technique works well for superficial lesions like seborrhoeic keratoses, warts, and some basal cell carcinomas. It provides effective removal of the visible lesion and destroys remaining abnormal cells.

Punch Excision

This is a specialised circular instrument removes a cylindrical core of tissue containing the entire or partial portion of the lesion. This method works well for small to medium-sized lesions that extend deeper into the skin, like certain moles or dermatofibromas. The resulting wound typically requires 1-2 stitches and provides a complete tissue sample for pathological examination.

Excision

Excision of skin refers to the surgical removal of skin tissue, often a lesion or tumor, along with a margin of surrounding healthy tissue under local anaesthesia. This procedure is used for both diagnostic purposes (biopsy) and therapeutic treatment, especially the size of the growth is moderate or large in size (usually more than 6mm in diameter). This procedure involves a precise incision, removal of the lesion, and closure of the wound, often with sutures.

Cryotherapy

This technique uses extreme cold, typically liquid nitrogen, to freeze and destroy lesion tissue. It effectively treats warts, actinic keratoses, and some seborrhoeic keratoses without cutting the skin. The procedure causes the lesion to blister and eventually fall off as the skin heals, though it may require multiple treatments for complete removal.

Laser

CO₂ laser is often the preferred choice for removing small skin lesions such as moles, skin tags, or seborrhoeic keratoses. It targets the affected area precisely, minimizing damage to the surrounding healthy skin. Compared to other treatment options, it tends to be less painful and offers a faster recovery.

Preparing for the Procedure

Medical Assessment: A thorough evaluation determines the appropriate removal method and identifies potential complications. This includes reviewing medical history, current medications, and allergies, and examining the characteristics of the lesion. Patients with bleeding disorders, immune suppression, or extensive lesions may require additional preparation.

Medication Review: Certain medications affecting blood clotting require temporary discontinuation before the procedure. Anticoagulants such as warfarin, antiplatelet medications like aspirin, and some supplements may need to be stopped 2-7 days before the procedure.

Pre-procedure Skincare: The treatment area should remain clean and free from creams, lotions, or makeup on the day of the procedure. Patients should avoid applying topical medications to the area on the day of the procedure of the appointment unless specifically instructed otherwise. This ensures the skin surface is properly prepared for the procedure and reduces contamination risk.

Step-by-Step Procedure

Anaesthesia Administration

Topical or local anaesthesia may be administered depending on the size and location of the lesions. Topical anaesthesia will be applied at least 30-45 mins before the procedure. This should be applied in clinics if the area to be treated is large. Local anaesthesia is administered soon before the procedure, and it takes effect in less than 1 minute.

Lesion Removal

The lesion is removed using the selected technique based on lesion type and location. For excisions, precise incisions follow planned margins, while shave procedures use horizontal blade movements at the appropriate depth. The technique focuses on complete removal while preserving surrounding healthy tissue and minimising scarring.

Haemostasis

Bleeding is controlled using pressure, electrocautery, or chemical agents depending on the extent and location. Small blood vessels may be sealed using electrocautery, while larger ones may require medical-grade adhesives or suture ligation.

Specimen Handling

The removed tissue is properly labelled and prepared for pathological examination if required. The specimen is placed in a container with preservative solution, labelled with patient identification and lesion location.

Wound Closure

Depending on the removal technique, the wound may be closed with sutures, surgical tape, or left to heal naturally. Suture selection depends on wound depth, tension, and location, with layered closure for deeper wounds.

Dressing Application

A sterile dressing is used to shield the wound and absorb any initial drainage during the healing phase. The choice of dressing depends on factors such as wound size, location, and anticipated fluid output. Applying the right dressing promotes an ideal healing environment, helps prevent infection, and guards against external contaminants. However, certain treated areas may not require a dressing—especially if they are moist and covered, which could foster microbial growth.

Post-Procedure Care and Recovery

Wound Care

The surgical site should remain covered with the original dressing for 24-48 hours as advised by the dermatologist. After this period, patients should gently clean during shower, pat dry with a clean towel, and apply a fresh dressing with or without topical antibiotic when recommended.
Activity Restrictions and Pain Management

Patients should avoid strenuous activities and excessive movement of the treated area for 1-2 weeks depending on the size and location of the excision. Heavy lifting, vigorous exercise, and swimming should be avoided. Most discomfort can be managed with over-the-counter pain medication such as paracetamol. Patients should avoid aspirin and other NSAIDs if advised, as these may increase bleeding risk.
Follow-up Care

Patients typically return for suture removal 5-14 days after the procedure, with additional follow-up visits scheduled to monitor healing if necessary.

Potential Risks and Complications

Benign skin lesion removal is generally safe but carries some risks. Infection may present as redness, warmth, swelling, or discharge. Scarring varies based on healing factors and the technique used. Some patients may develop keloid scars, especially in high-tension areas. Bleeding complications are uncommon but possible in patients on blood thinners. Wound reopening can occur with excessive tension. Nerve damage, though rare, may cause numbness or pain. Incomplete removal may occur, particularly with encapsulated lesions, sometimes requiring additional procedures. Some patients may experience allergic reactions to anaesthetics or dressing materials.

Frequently Asked Questions

Will I have a scar after lesion removal?

Some degree of scarring occurs with most removal techniques, though its appearance varies. The scar typically fades over 6-12 months and can be minimised with proper wound care and sun protection.

Can the lesion grow back after removal?

Complete removal of benign lesions usually prevents recurrence. However, certain lesions like seborrhoeic keratoses, warts, or cysts may recur even after proper removal. Incompletely removed lesions have higher recurrence rates, particularly if the base or capsule remains intact.

How many lesions can be removed in one session?

The number of lesions that can be safely removed in one session depends on their size, location, and the removal technique. Multiple small lesions in the same area can often be removed during one appointment. However, extensive removals may be staged across multiple sessions to minimise complications and optimise healing.

Dr Liew Hui Min

Dually Accredited Dermatologist In Singapore and the UK

Dr. Liew Hui Min is an accredited consultant dermatologist from the Ministry of Health and the General Medical Council UK.

Her clinical interest includes:

Paediatric Dermatology,
Women’s Dermatology,
General Adult Dermatology.

Having trained in major London Hospitals, Dr Liew returned to Singapore in 2014 as a Consultant at KK Women’s and Children’s Hospital (KKH) where she specialised in paediatric, women, obstetric and vulva dermatology. Currently, Dr Liew practices at The Skin Drs. clinic located at Gleneagles Hospital.

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