GS05 Removing Benign Skin Lesions.Fm

Mr. Sanjay Singh MBBS, MS, FRACS, FRCS (UK) Consultant Surgeon 2 - 4 Charles Street MOGO NSW 2536 Tel: 02 4474 3774 www.mogodaysurgery.com.au Fax: 02 4474 3775

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Removing Benign Skin Lesions

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Expires end of December 2012 Issued December 2011 What are skin lesions? Are there any alternatives to surgery? Skin lesions are found on or just below the Surgery is the only reliable way to remove skin. Examples of skin lesions are skin lesions but you may simply leave them epidermoid cysts (also called epidermal alone. inclusion cysts or sebaceous cysts), lipomata (plural of lipoma), skin tags and What will happen if I decide not to have moles. These are usually not the operation? life-threatening but your surgeon can Epidermoid cysts can be left alone and often remove your skin lesion if you want. You cause no problems at all. Some may grow in may simply leave the skin lesion alone if size. Occasionally the contents of your surgeon is certain it is benign (not a epidermoid cysts leak out or they can cancer). become infected, needing antibiotics or It is your decision to go ahead with the surgery. operation or not. This document will give Lipomata tend to grow in size if they are left you information about the benefits and risks alone. As they get larger they appear more to help you make an informed decision. obvious and can interfere with clothing. If you have any questions that this Occasionally lipomata on the inside of the document does not answer, you should ask upper arm or thigh may rub during your surgeon or any member of the movement and cause irritation or pain. healthcare team. What does the operation involve? • What is an epidermoid cyst? The healthcare team will carry out a number An epidermoid cyst is a lump in the skin of checks to make sure you have the where a cyst fills with a waxy whitish operation you came in for. You can help by substance. It usually has a central pore confirming to your surgeon and the which opens onto the skin. healthcare team your name and the operation you are having. • What is a lipoma? Removing a skin lesion is usually performed A lipoma is simply a lump of fatty tissue in under local anaesthetic and usually takes the layer of fat underneath the skin. The skin between fifteen and twenty five minutes. over it is completely normal and is not Your surgeon will only begin the operation attached to the lipoma underneath. A lipoma when both of you are satisfied that the local can vary in size and some may grow to over anaesthetic is working. ten centimetres (four inches). There is often When removing an epidermoid cyst, your only one of them but some people have surgeon will try to remove it whole as this several at the same time. makes sure that none of the cyst wall is left behind and prevents it from returning. Your • What is a skin tag? surgeon will make an elliptical cut over the A skin tag is a small lump hanging from the cyst and will then cut out the cyst (see figure skin. 1). Your surgeon may be able to safely remove the cyst using a smaller cut. They • What is a mole? will close the cut with stitches. The cut usually heals to leave a small straight scar. A mole is a coloured lesion, which may be The stitches may be dissolvable. If not, they present at birth or develop later in life. Moles are usually left for five to seven days, but that change suddenly may be turning this will depend on your operation. malignant (cancerous) and your doctor may recommend that your mole is removed to make sure it does not change into a cancer.

Copyright © 2011 GS05 Page 1 of 3 Expires end of December 2012 Skin lesion Elliptical cut 1 Complications of anaesthesia Your anaesthetist will be able to discuss with you the possible complications of having an anaesthetic.

2 General complications of any operation • Pain, which happens with every operation. The local anaesthetic will start to Figure 1 wear off after a couple of hours. After this Epidermoid cyst and typical cut made to time you may feel some pain. You may need remove it simple painkillers such as paracetamol or To remove a lipoma, your surgeon will make ibuprofen. a straight cut in the skin directly over it. The • Bleeding during or after surgery. This is lipoma is freed up from the tissues around it usually little but may cause bruising or and removed. They will then close the cut temporary swelling under the skin. with stitches. • Infection of the surgical site (wound). A skin tag can simply be numbed with local This is unusual. To reduce the risk of anaesthetic and then removed. You will infection it is important to keep warm around the time of your operation. Let a member of often not need a stitch. When removing a mole, your surgeon will the healthcare team know if you feel cold. In cut all the way around it using an elliptical the week before your operation, you should not shave the area where a cut is likely to be cut. They will close the cut with stitches. The cut usually heals to leave a small straight made. Try to have a bath or shower either scar. the day before or on the day of your operation. After your operation, you should What should I do about my medication? let your surgeon know if you get a temperature, notice pus in your wound, or if You should let your doctor know about all your wound becomes red, sore or painful. the medication you are on and follow their An infection usually settles with antibiotics advice. This includes herbal remedies and but you may need another operation. medication to control diabetes and blood • Unsightly scarring of the skin. pressure. If you are on beta-blockers, you • Wound breakdown, if the skin fails to should continue to take them as normal. heal. This is usually treated with dressings You may need to stop taking warfarin or that allow the wound to heal without needing clopidogrel before your operation. more stitches.

What complications can happen? 3 Specific complications of this The healthcare team will try to make your operation operation as safe as possible. However, • A lipoma or an epidermoid cyst can complications can happen. Some of these come back, which may need a further can be serious. You should ask your doctor operation. if there is anything you do not understand. • A larger operation may be needed. If a Any numbers which relate to risk are from lesion was removed and was found to be a studies of people who have had this cancer, an operation will be needed to make operation. Your doctor may be able to tell sure it is completely removed. you if the risk of a complication is higher or lower for you.

Copyright © 2011 GS05 Page 2 of 3 Expires end of December 2012 How soon will I recover? Keep this information leaflet. Use it to help you if you need to talk to a • In hospital healthcare professional. After the operation you will be transferred to Acknowledgements the recovery area. After a short while you will be able to go home. A responsible adult Author: Mr Ayan Banerjea FRCS (Gen. Surg.) and Mr Simon Parsons DM FRCS (Gen. Surg.) should take you home in a car or taxi and Illustrations: Mr Simon Parsons DM FRCS (Gen. stay with you for at least 24 hours. You Surg.) should be near a telephone in case of an Australian Chief Editor: Associate Professor Steve emergency. Trumble MBBS, MD, FRACGP. If you are worried about anything, in hospital For more information about the SMS Editorial or at home, contact a member of the Review Board, go to www.smservices.net.au. healthcare team. They should be able to This document is intended for information reassure you or identify and treat any purposes only and should not replace advice that your relevant health professional would complications. give you. • Returning to normal activities You should not drive, operate machinery (this includes cooking) or do any potentially dangerous activities for at least 24 hours and not until you have fully recovered feeling, movement and co-ordination. If you had sedation, you should also not sign legal documents or drink alcohol for at least 24 hours. You should be able to return to work the following day unless your work will put a strain on the stitches. It is unusual for these procedures to restrict any daily activities you carry out.

• Lifestyle changes If you smoke, try to stop smoking now. Stopping smoking will improve your long-term health. Try to maintain a healthy weight. You have a higher chance of developing complications if you are overweight. Regular exercise should improve your long-term health. Before you start exercising, ask a member of the healthcare team or your GP for advice.

Summary Skin lesions are common and can be treated by surgery. Surgery is usually safe and effective. However, complications can happen. You need to know about them to help you make an informed decision about surgery. Knowing about them will also help to detect and treat any problems early.