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Surgical Excision (Shave Excision of Skin Lesion)

What is a shave excision?

A shave excision is a simple procedure that your doctor can use to remove growths, such as moles, lesions, and tumors, from your skin. The primary tool used in this procedure is a sharp razor. You doctor may use also use an electrode to feather the edges of the excision site to make the scar less noticeable.

Once they’ve removed the growth, your doctor may send it to a laboratory for analysis. This can help them learn whether it’s cancerous.

When is a shave excision performed?

If you have a skin growth that you want removed, or your doctor suspects a growth may be cancerous, they may recommend a shave excision. This simple procedure is less invasive and expensive to perform than a full-thickness skin excision. A full-thickness skin excision requires sutures, or stitches, while a shave excision doesn’t. As a result, a shave excision typically produces a less noticeable scar.

How is a shave excision performed?

A shave excision is usually performed using local anesthesia, which ensures that you feel no pain during the procedure.

To perform a shave excision, your doctor will likely follow these steps:

  1. They will inject the area under the growth with a numbing medicine or anesthetic. In addition to preventing pain, the anesthetic will cause the growth to rise upward, making it easier to remove.
  2. Then they will cut the growth off with a sharp razor using multiple horizontal cuts. You may feel a pushing sensation as the cuts are made, but you shouldn’t feel pain.
  3. They may perform some electrosurgical feathering using a small dermal loop electrode to shape the edges of the wound. Feathering helps remove cells from the growth that have been left behind and minimizes scarring by blending the edges of the wound with your surrounding skin.
  4. They may also apply a chemical such as aluminum chloride hexahydrate to your skin to stop bleeding.
  5. Then they will clean the surgical site and apply a soothing antibiotic ointment to encourage healing.
  6. Finally, they will cover the wound with a sterile bandage to stop it from rubbing on your clothes. This will also help lower your risk of infection.

What happens after a shave excision?

If your doctor suspects the growth may be cancerous, they will send it to a laboratory for testing. They will contact you with the test results when they’re available.

In the meantime, they’ll likely ask you to keep the excision site dry for 24 hours, and they’ll provide you with instructions about when to remove or change the bandage. While it’s healing, you should keep the site covered when you’re in bright sunlight, as a sunburn can permanently darken the wound, making the scar more noticeable.

You may feel some discomfort or a burning sensation where the growth was removed. You can take over-the-counter painkillers, such as acetaminophen or ibuprofen, to relieve discomfort. Your doctor may also advise you to apply an antibiotic ointment to the wound to promote healing.

The excision site may be red for a few weeks, but it will gradually get lighter. Try to be patient; the healing process can be slow. If you notice excessive scarring or signs of infection developing, call your doctor.

What do test results mean?

Your doctor may send the growth to a laboratory for analysis to determine whether it’s noncancerous, or benign. Benign growths include:

  • angiofibroma, which are small reddish-brown lesions
  • skin tags, which are stalk-like protruding lesions
  • dermatofibroma, which are small hard lesions that usually occur on the lower body

Alternately, your doctor may learn that the growth is cancerous, or malignant. In this case, they will recommend follow-up steps. For example, they may refer you to a skin cancer specialist for treatment.

What complications are associated with a shave excision?

Some bleeding may occur after a shave excision. If this happens, press on the wound firmly with a sterile bandage or dressing for 20 to 30 minutes. Contact your doctor if it bleeds for more than 30 minutes.

You can also expect some scarring to develop at the excision site. You may be able to lighten the appearance of your scar by applying:

  • topical silicone gel or silicone gel sheets
  • petroleum-based ointments
  • vitamin A cream or vitamin C cream

These products are available at many drug stores. If you notice a hard, raised, or dome-shaped scar developing, call your doctor.

Infection is rare but can occur. Call your doctor if you notice any of the following symptoms of infection:

  • extreme tenderness
  • swelling or increasing redness
  • pus coming from the wound site

Sometimes tumors or growths come back after a shave excision. Call your doctor if you suspect your growth is returning.

Content licensed from:

Written by: Natalie Phillips
Medically reviewed on: Aug 25, 2016: University of Illinois-Chicago, College of Medicine

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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