Skin lesion removal

e.g Skin tags, warts, verruca, seborrhoeic keratoses, cherry angiomas, haemangiomas

from £65

about skin lesions

What is a skin lesion?

A skin lesion is an area of skin that is distinctly different to the surrounding skin. They can be present from birth (primary, acquired) or show up later in life (secondary)

They can be Benign (non-cancerous) or

Suspicious and need further investigation as they could be, or become, malignant (cancerous)

Common benign skin lesions:

skin tags
warts & verrucae
seborrhoeic keratosis
cherry angioma / haemangioma
lentigo / age spots / liver spots / freckles
naevus (mole)
milia cysts
acne

How do you know they are benign?

To assess skin lesions, I use a specialist camera called a Dermatoscope which helps me to see the lesion on the skin and under the skin. You can read more about dermoscopy below.

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how do you remove lesions?

It depends on the lesion, but the two methods that I use are Cryotherapy (liquid nitrogen) and Verrutop (Nitrizinc)

Cryotherapy uses liquid nitrogen gas to freeze the lesion to -98 degrees within seconds. This allows me to create an intentional wound to the area we wish to remove, and, like any other wound, the body will remove the damaged tissue and replace it with healthy new tissue over the course of a skin cycle (4-12 weeks)

Cryotherapy treatment can be repeated after 4-6 weeks if required

Verrutop is a newer treatment specifically for warts and verrucae. These lesions are caused by the HPV virus and it is notoriously difficult to both remove the lesion AND kill the virus. There is a high rate of recurrence because the virus remains and reinfects. This treatment targets proteins and dries them out. Because skin cells are made up of protein, it dries the lesion out, but since the viral cells are also made up of protein, it targets both the lesion AND the virus at once.

Verrutop treatment is carried out fortnightly for a maximum of 6 treatments at which point we consider adding in cryotherapy.

what happens at my appointment?

When you book your appointment, I will send you a client questionnaire and some information about the service to read. I will check through this and we will start your appointment with a chat to gather your history including any skin conditions, previous history of skin lesions and history of sun exposure.

After this, I will check the lesion(s) with a magnifying glass and the Dermatoscope camera and if I am confident that the lesion(s) are benign and can be removed at the appointment, I will explain the method(s) I intend to use, ensure you fully understand and feel comfortable and ask you to sign a consent form.

Then we are on to treatment. I will explain and check in with you throughout the procedure to make sure you are comfortable. Once we are finished I will talk you through some easy to follow aftercare advice and you are done!

about dermoscopy

What is dermoscopy?

Dermoscopy uses light to remove reflection and allow us to see 'through' the skin or lesion to the superficial layers underneath.

In the picture to the side, you can see what a lesion looks like to our naked eye, and then what it looks like under Non-polarised light (left) and Polarised light (right).

With the dermatoscope we see much more detail, including blood vessels, keratin, and pigmentation. From the colours, shapes and structures we see, we can confidently tell if we see the known characteristics of specific benign lesions, or if we see specific characteristics which cause us concern.

I qualified as an Independent Dermoscopy Practitioner after a 6 month intensive course of online learning, real life case studies and exams. This means I can see and treat you even if you haven't already seen a GP or healthcare professional.

Risks & Side Effects

Common:

Redness & itching
Localised swelling
Blistering
Weeping / oozing / crusting

Rare:

Bleeding
Pins & Needles / Nerve pain (finger treatment)
Headache (head & neck treatment area)
Scarring / hypopigmentation
Damage to hair follicles / alopecia

Post-treatment complications:

Infection
Scarring
Sunburn to new skin
Recurrence / regrowth

I continually keep my skills up to date and follow best practice guidelines to ensure that any risk is minimised. Post-treatment complications can be minimised by following the aftercare instructions.

FAQ's

Does it hurt?

Both treatments can be uncomfortable but shouldn't hurt. Based on what previous clients have told me there may be slight stinging with Verrutop, but in most cases it is completely pain free. Cryotherapy feels like "pins and needles" when it is being frozen, and can throb when we stop and the area 'defrosts'.

Is there anyone who shouldn't be treated?

Cryotherapy:

Is suitable for most people, unless you have had a bad reaction to it in the past, or are intolerant to extreme cold. I also DO NOT treat "pre-cancerous" lesions (Actinic Keratosis / Bowens disease) as this is not the first line treatment for these.

Verrutop:

Is suitable for anyone from the age of 6 years old, and I am happy to treat children if I am satisfied that they can understand the treatment, can sit and have the treatment and can follow after care instructions.

Being immunosuppressed, diabetic or taking anticoagulants may mean you are not suitable for treatment with me and require specialist treatment instead.

How long until its gone?

This depends on so many factors including what the lesion is, where it is and how big it is. As a general rule, it will take a full skin cycle (where the dead skin comes off and new skin pushes up from the bottom) to see changes in any skin treatments. This cycle is around 28 days when we are young, but can be as long as 84 days when we get older.

For cryotherapy, I generally ask people to wait 4-6 weeks before deciding if they need a further treatment. Often the area will scab and heal, but will continue to improve as the skin layers push upwards.

Verrutop can see full clearance of a wart / verruca in 3 treatments, but equally, it can also take more.

How many treatments will I need?

Again, this can vary significantly with the type of lesion, age and other factors.

Small lesions (such as skin tags) often take a single treatment and are gone within 7-10 days.

Larger lesions, dry scaly lesions or lesions that are proud of the skin surface can take multiple treatments as they are removed layer by layer.

Verrutop treatment works differently, and you have the wart / verruca 'pared' at each visit - where we remove the top layer of hard dead skin - and treatment is applied in layers over the lesion. I generally use around 4-5 layers each time. For best results treatment should be carried out fortnightly.