As a technique related to electrosurgery, curettage and cautery utilises heat to treat skin lesions. The surgeon/dermatologist first removes the lesion (curettage) prior to treating the wound area with heat (cautery). The procedure is commonly used to remove seborrhoeic warts, repair areas affected by solar keratosis (sun damage) and sometimes as a treatment for skin cancer. Stitches aren’t required and scarring is minimal once the wound has fully repaired itself.

Your dermatologist will provide a thorough understanding of the procedure prior to surgery. There are alternative options, so he or she will indicate why curettage and cautery is recommended for your skin condition. You will need to inform your dermatologist if you take medications, suffer from allergies or have other pre-existing medical conditions.

Curettage and Cautery procedure

As a minor surgery, curettage and cautery is undertaken in a clinical or hospital environment such as Pymble Dermatology – designed and appointed specifically for sterile operating procedures. The affected area is first treated with a local anaesthetic to block pain and numb the lesion area. A curette surgical tool with a sharp spoon-shaped end is then used to remove the lesion. After this, the wound area is cauterised with an electrosurgical unit. This additional step kills any remaining unhealthy cells, cleanses the site, seals the wound and inhibits bleeding.

Once the operation is complete, the wound is dressed and the removed skin lesion sent for laboratory analysis if necessary. The wound site will feel tender for several hours, especially once the anaesthesia wears off, although pain killers can be prescribed to assist with comfortable recovery. As most lesions are relatively shallow, the treated area will probably resemble a graze that naturally heals during the next couple of weeks. As with any graze, a scab will form then drop off after some time, revealing healthy skin that usually turns close to natural skin colour when fully restored.

What can curettage and cautery treat?

Curettage and cautery is usually performed when lesions are soft compared to surrounding skin, or if the lesion has formed with a natural line of cleavage separating it from surrounding tissue. Skin lesions that are ill-defined, have blurred edges, or are not easily detached are treated with alternative surgical methods. Lesions that are successfully treated by curettage and cautery include:

  • viral warts
  • solar keratosis
  • seborrheic keratosis
  • skin tags
  • pyogenic granuloma
  • in situ squamous cell carcinoma
  • basal cell carcinoma

The above lesions can’t always be treated by curettage and cautery. Their individual form and stage of development will assist your dermatologist in making the right judgement, with optimum outcomes always the top priority.

Curettage and Cautery wound care

The dressing should stay on during the first day of recovery. During this time, it’s best to relax and resist the temptation to stretch the skin. Avoid exercise during the first 24 hours of recovery as it will increase blood flow, potentially affecting the healing process. If there is bleeding from the wound site, apply pressure with a clean, soft towel for twenty minutes, resisting the urge to peep. If bleeding continues unabated, contact your dermatologist or other medical professional or emergency department if it is after office hours for advice and instructions.

The wound area should remain dry for the first 24-48 hours of recovery to assist with healing. After this time, remove the dressing and softly wash and dry the area. The wound should fully heal within two to three weeks with only a flat, round scar remaining which will slowly fade to closely match surrounding skin. Curettage and cautery isn’t dangerous, but skin cancer can be, so choosing Pymble Dermatology should be a straight-forward decision. The procedure remains a valuable asset to medical science, assisting dermatologists in curing disease, promoting good skin health and providing patients with greater self-esteem and quality of life.