Surgical Treatments

Curettage
Curettage is used to remove benign lesions such as warts and seborrheic keratoses. It is also used for treating basal and squamous cell carcinomas. A curet is an instrument with a circular, loop-shaped cutting edge and handle. In curettage, the physician uses the curet to scoop out the lesion using a firm, quick downward motion. Anesthesia is not always used, since anesthetizing the lesion can be more painful than removing the lesion.

Electrosurgery
Most physicians have small electrosurgical units in their offices. Electrosurgical units deliver high frequency alternating current through an electrode tip attached to a hand-held wand. The current destroys skin tissue. There are two methods of electrosurgery: electrodesiccation and eletrocoagulation.

Electrodesiccation destroys lesions through dehydration caused by bursts of electrical current. Electrodesiccation is usually used to treat benign, superficial lesions such as warts. This technique can also be used after curettage to destroy any remaining bits of lesion and control bleeding.

Electrocoagulation produces more severe, deeper destruction than electrodesiccation does. In electrocoagulation, the treatment needle "delivers an intensely hot current and literally 'boils' and coagulates the lesion." Electrocoagulation is used usually for large lesions that require extensive destruction.

Cryosurgery
Cryosurgery destroys tissue by freezing it. Cryosurgery is used to remove a range of lesions, including warts, seborrheic keratoses, actinic keratoses, and some skin cancers. Liquid nitrogen is the preferred agent because it is inexpensive, readily available, and non-combustible. Liquid nitrogen is delivered to the lesion via cotton tipped applicators or special cryosurgical units such as the Cry-Ac®

Mohs Surgery
Mohs surgery is a special type of skin cancer surgery in which areas of tissue are sequentially excised and then microscopically examined to define the extent of invasion and ensure that the malignancy has been completely removed. Mohs surgery is the most successful method of treating squamous and basal cell carcinomas.

Dermabrasion
Dermabrasion is used to treat acne scarring and, sometimes, widespread actinic keratoses on the face. In dermabrasion, the face is "sanded" with a rotating wire brush or diamond-covered disc.

Laser Surgery
Laser is an acronym for light amplification by stimulated emission or radiation. A laser is a device that concentrates high energies into an intense, narrow beam of electromagnetic radiation. Because laser beams are so narrow and so intense, they are very precise. This precision means laser surgery can destroy, for example, enlarged, visible superficial blood vessels without destroying surrounding tissue. Laser surgery is usually reserved for conditions that cannot be treated with conventional techniques.

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