Cosmetic Removal of Blemishes

Skin tags, keratosis, dark spots, Red bumps, even irritated moles. The removal of benign skin lesions is one of the most common requests from patients in a dermatology clinic. Thankfully, dermatologists and dermatologic surgeons are skilled in the techniques for removing benign skin lesions, and these procedures can be accomplished with minimal discomfort and relatively little downtime.

What types of skin lesions are amenable to cosmetic removal?

• Moles

  The medical term for a mole is ‘nevus’. These lesions care composed of specialized pigmented melanocyte cells, referred to as nevus cells, in the skin. Nevi (pleural) can arise on the skin secondary to excess sun exposure, or sometimes appear at birth (known as a ‘congenital nevus’). While the appearance of a new or changing mole should be evaluated by a dermatologist for medical reasons, many individuals have moles that are benign but unsightly or frequently irritated on the skin.

• Seborrheic keratosis

  These rough warty grey-to-tan bumps on the skin are actually the most common benign epidermal tumors that occur in humans. They typically arise after age 40. Both genetic predisposition and sun exposure have been implicated in the causing these lesions.

• Skin tags

  these benign growths that stick up above the skin typically arise on the neck, in armpits and the groin and are often irritated by jewelry and/or clothing.

• Cysts

  A cyst is a pocket or closed sac that forms in the skin. Cysts can arise from a number of different causes, including acne, clogged pores or even trauma. While many cysts resolve on their own, others need to be removed surgically or by another dermatologic procedure.

• Lipomas

  These soft, mobile fatty growths arise under the skin. They are usually painless but appear as lumps. Sometimes, individuals can develop numerous lipomas, especially if there is a family history.

• Angiomas

  These lesions are composed of different vascular structures in the skin. Angiomas come in different forms. Cherry or capillary hemangiomas are small 1-2 mm red bumps that appear on the skin, typically on the trunk. A spider angioma presents as a small red bump (a dilated arteriole) with radiating blood vessels coming off of it. They are often seen in children but can also be seen with other systemic conditions such as liver disease.

• Sebaceous hyperplasia

  The dilated and enlarged glands typically appear on the face and yellowish bumps with a central pore. Often there is a genetic predilection for these bumps.

• Syringomas

  These are small benign sweat gland growths that often appear as whitish to flesh colored bumps, particularly on the eyelids

• Xanthomas

  These yellow plaques typically seen on the upper eyelids represent cholesterol deposits in the skin.

• Lentigos & Freckles

  These lesions appear as well-circumscribed flat brown, hyperpigmented lesions on the skin, typically in sun exposed areas such as the face, backs of the hands, forearms, shoulders and upper back. Lentigos and freckles represent benign increased pigment in the skin.

How is a skin lesion removed for cosmetic purposes?

A number of modalities are available for removing benign lesions from the skin for cosmetic purposes. The treatment selected depends on a number of factors, including the type of lesion, location, and others.

• Cryotherapy

  Application of extremely cold substance such as liquid nitrogen or solid carbon dioxide can be used to freeze and destroy epidermal lesions, such as warts and keratoses. The pigment producing cells in the skin are also extremely sensitive to cold. This method can therefore also be used to some dark spots.

• Intralesional injection

  Often a steroid solution can be delivered directly into a specific lesion, such as a cyst, causing it to shirk and ultimately be resorbed by the body. Mesotherapy employs a specific substance injected into fat to creating a localized reaction that ultimately destroys and breaks down fatty tissue.

• Electrosurgery

  Electric current can be applied to certain skin lesions, often with a tool known as an electrodessicator. The electric current destroy the lesion on the skin, causing them to fall off.

• Chemical destruction

  This method employs a concentrated chemical peel solution applied directly to specific skin lesions.

• Laser & Light based therapy

  Many laser and light therapies, such as Intense Pulsed Light (IPL) work by targeting specific colors (chromophores) in the skin. Therefore, skin lesions that are composed of, or have a high concentration of red blood vessels (angiomas, hemangiomas, port wine stains, broken blood vessels and facial redness) or lesions that are brown or hyperpigmented in color (sun spots, freckles, lentigos, hair, melasma, some moles and nevi) can be treated effectively with targeted laser therapy.

• Ablative Laser Resurfacing

  Certain lasers will target water in the skin. Because our skin cells are composed or large amounts of water, these laser will destroy the top layers of the skin, as well as any skin lesions present on the top layer.

• Surgical removal

  This approach involved the actual excision of a skin lesion. There are a number of surgical techniques applied in the removal of a benign skin lesion. This may involve a snip excision using sharp sterile surgical scissors; a shave excision where a lesions is shaved flush with the skin; or even an excision where the lesion is cut out with a scalpel and the skin is closed with sutures. The method chosen to remove a benign lesion involves a number of factors, include the type of lesion, location, and likelihood of obtaining the optimal esthetic outcome.

• Liposuction

  A cannula is place under the skin through a small incision and a subcutaneous lesion is removed with suction. Lipomas are very amenable to this form of therapy.

 
Regardless of what type of skin lesion you have, or the method of removal, it is essential that your skin be evaluated by a qualified board –certified dermatologist prior to undergoing any procedure. Many benign skin lesions can mimic skin cancers. Treatment of skin cancer is very different from the removal of benign lesions. If a skin cancer is not diagnosed and removed correctly, the results can be detrimental to your health.