Curretage and electrocautery
Curettage and cautery is an effective treatment for small, superficial basal cell carcinomas and keratoacanthomas (a low-grade or slow-growing squamous cell carcinoma) with well-defined borders. It often is used on the trunk and other areas of the body where the scars caused by this treatment will not be objectionable.
Curretage is a procedure used to remove skin tissue by scraping or scooping using a small, spoon-shaped tool with very sharp edges. The area is first anaesthetised (numbed) with local anaesthetic and then layers of skin are scraped until the layer containing the cancer is removed. Once the lesion has been adequately removed, electrocautery (using a hyfrecator) will be used. This is often the most unpleasant part of the procedure for our patients as it involves burning of the skin with an electric current to control bleeding and to destroy any remaining cancerous tissue. Although there is no associated pain, the smell from the electrocautery can be disconcerting.When this procedure is being done to treat a skin malignancy such as a basal cell carcinoma, three cycles of curettage and electrocautery will be done sequentially to make sure that all the malignant cells have been removed. Done this way, you can rest assured that the clearance rate is 98%.
Recovery time is usually between three to four weeks, depending on the size and site of the area treated. Once the scab lifts, the skin below may look pink for some months and eventually normal skin colour should return although the scar may look paler than the surrounding skin. Very occasionally, it may appear darker. You should normally aim to keep the treated area covered until the crust or scab which forms has separated. The crust or scab will come away easily when the wound has healed. Do not be tempted to remove it too soon, as that will simply prolong the healing period. You will leave your procedure with written instructions on how to care for the curettage site both to prevent any secondary infection as well as to ensure the best cosmetic outcome. The scars from a curettage are usually flat and round and are of a similar size to that of the original skin lesion.
We will spend time discussing all the various treatment options to make sure that we are on the same page when it comes to expectations following your procedure. Curettage and electrocautery is a good choice for patients who cannot tolerate more involved surgical procedures. With a high cure rate in the treatment of carefully selected skin cancers, this treatment method is efficient and cost-effective.