The majority of facial lesions are caused by sun exposure and with this in mind it is important, at the time of the consultation, to check the face and scalp thoroughly as, if there is one, there may be others.
After any treatment it is also a good idea to reduce sun exposure to a minimum plus use broad brimmed hats and a good sun block cream to reduce the risk of any other lesions arising.
Lesions of the face fall into 2 broad categories: Benign (harmless) and Malignant (worrying). Lesions such as moles and lipomas fall into the benign category while basal or squamous cell carcinomas and malignant melanomas fall into the malignant one. It is thus important to make sure what type of lesion you have before it is treated and I am happy to do this – if there is any doubt then I will get a second opinion from a dermatologist.
Some small, benign lesions can be frozen or burnt off but the larger or more worrying lesions invariably need surgical removal, particularly if they are in cosmetically sensitive areas such as the mid-face, nose or ears.
Due to the more aggressive nature of malignant lumps, they need a little extra skin removed with them while benign ones do not. It is also important to check the neck for lymph nodes to make sure that the “malignant cells” have not spread – this needs to be treated but is thankfully rare.
Any lump/lesion removed from the face produces a wound that needs to be orientated correctly as the closure or the wound needs to produce a scar that lies in the natural lines of the face thus camouflaging it as much as possible. Occasionally a skin graft or even a flap of skin with its own blood supply can be used depending on the size and position on the face of the area to be repaired.
Dissolvable stitches will be inserted to pull the skin edges together while non-dissolvable stitches, or sometimes skin glue, can be used to hold the edges together. These are removed after 5-7 days.
• Chloramphenicol ointment is provided to keep the stitch area moist and infection free. If the area becomes hot and sore, contact a health care professional as the area may be infected. This may need antibiotic treatment.
• Bleeding is an unusual occurrence but if it does not respond to direct pressure contact me. The same applies to a blood clot formation.
• Any surgical procedure will produce a scar. Usually this is neat and well concealed but occasionally there can be thickening producing a hypertrophic scar or even a keloid. These can be very difficult to treat but may respond to local steroid treatment or possibly re-excision.