Minor Surgical Procedures

Skin lesion assessment, mole and skin lesion removal procedures at the Skin Clinic are carried out by Dr Marta Jackowiak.

Dr Marta is a GP with a special interest in dermatology, particularly skin lesion assessment and removal.

Dr Marta also works as an NHS Dermatology Specialty Doctor with the outpatients Dermatology team at the Royal Shrewsbury Hospital.

Our services

• Skin lesion assessment and full body skin checks for patients concerned about a new or changing lesion or those who have previously had a skin cancer
• Removal of skin lumps, cysts, moles and skin tags (lesions can be removed for cosmetic reasons or if causing bothersome symptoms, eg pain, catching or bleeding)
• Cryotherapy (freezing with liquid nitrogen) of suitable lesions, eg skin tags, warts and verrucas
• Surgical removal of an ingrown toenail
• Split or stretched earlobe repair
• Treatment for axillary hyperhidrosis (excessive sweating in the armpits) using Botulinum toxin injection (“Botox”)
• Treatment of keloid scars by steroid injection or cryotherapy

The types of procedures carried out include

• curettage (scraping off) & cautery (burning)
• shave excisions (slicing off)
• cryotherapy (freezing off)
• full excision (cutting off) of lesions

Lesions can either be completely removed, or a small sample taken (biopsy) and sent for analysis at the laboratory (histology) to make an accurate diagnosis and to provide reassurance or plan further treatment.

Histology is not normally necessary unless a lesion seems concerning or there is a doubt about the diagnosis. There is an additional fee for a private histology sample.

After a consultation, if a lesion is deemed suspicious, Dr Marta can recommend to your GP that an NHS referral be made for further evaluation and treatment.

Most minor surgery is usually a quick procedure and we can offer treatment within your initial appointment.

Before your procedure

Please let us know in advance if:

• you are taking any blood thinning medication (such as warfarin, clopidogrel, aspirin, rivaroxaban or apixaban). It is not normally necessary to stop these medication before a procedure, but we will advise you if it is required for specific circumstances
• you have had any allergic reactions to local anesthetics
• you suffer from needle phobia
• you are pregnant
• you have a pacemaker or another implantable electronic device

About the procedure

• please ensure you have something to eat and drink before attending (you are more likely to feel faint if you attend on an empty stomach)
• a local anaesthetic will be used to numb the area to be operated on
• it helps to wear loose fitting clothing. We will only need to expose the affected area that is being treated
• if your surgery involves stitches, you will be asked to return for the removal of the stitches within 7-14 days
• after your procedure, you will be given detailed wound care advice
• skin procedures leave scars; these will be permanent but may fade over time
• problems after skin surgery can include bleeding, infection and scarring which will be discussed with you when you consent to the surgery
• if your skin surgery involves your head or neck, we may advise you not to drive after the procedure (this is in case you are feeling unwell, faint or have any swelling around your eyes)
• sports and exercise : you should not swim, play sports (including golf), or exercise whilst the stitches are in place. Depending on the size and site of the surgery you may be asked to refrain from activities that will stretch that area for some time (3-4 weeks) after the stitches have been removed. Dr Marta will provide individual advice tailored for you

Potential risks and complications

The risk of complications is low. Problems that may occur include:

• bleeding: the risk is higher in the first 24 hours and we advise that patients should rest and avoid any strenuous activities
• anaesthetic complications: adrenaline in the local anaesthetic can rarely cause a feeling of rapid heartbeat (palpitations). We can exclude the adrenaline if this has happened to you before. Allergy to the local anaesthetic is extremely rare
• wound breakdown: this is a very uncommon occurrence that may happen once the stitches have been removed in an area under tension or if the would has become infected
• scarring and the change to skin pigmentation: it is important to know that any procedure can leave a permanent scar. The appearance of the scar tends to improve over time
• recurrence risk: some lesions, such as moles or cysts can grow back after removal. There is no real way to predict whether or not this will happen. For the visible moles, such as those on the face, the shave excision method is preferable as or tends to have excellent cosmetic results with minimal scarring

Holidays and special events

If you are travelling abroad, going on holiday or attending a special event within three weeks of surgery please plan your procedure at an alternative time.

This is because of the risk of post-surgical complications, and your dressing and stitches will need to be removed.

There may also be bruising/swelling and therefore you may not feel your best for a special event.