A shave excision is a small operation to remove minor benign (harmless) lumps from the skin, and the treatment is performed in the clinic under local anaesthetic.
While shave excision may be used to treat some non-melanoma skin cancers, such as superficial basal cell carcinomas (where the diagnosis is clear, and it is deemed appropriate by the dermatologist), the treatment is not suitable for all skin cancers, since it is not possible to confirm that the cancer is fully removed without performing a full-thickness excision, which also removes some surrounding healthy tissue.
A shave excision may also be performed if a patient wishes to have a non-cancerous mole, or any other benign growth removed. In the latter instance, it is sometimes considered a ‘cosmetic,’ or ‘elective’ treatment, since there is no clinical need to remove the mole, and choosing to do so is typically about the patient’s aesthetic concerns.
Sometimes after a shave excision, the dermatologist may need to send on the removed skin to a specialist laboratory for analysis, which is called histopathology.
What is the Benefit of a Shave Excision?
Shave excisions are quick to perform, and the small wound they leave behind heals more quickly than the wound resulting from a full-thickness excision necessary to remove either a larger growth, or a more dangerous skin cancer.
Since shave excisions are less invasive, they may require less intensive follow-up treatment, as there are no sutures or stitches.
A shave excision is less expensive than an excision treatment, however it will not be offered unless it is medically suitable for a patient – meaning you can only choose to undergo a shave excision if the dermatologist says it is appropriate for you.
In ‘cosmetic’ treatment, shave excision would take away the mole or benign growth, in most cases leaving very little scarring.
What is the Process of a Shave Excision?
The process is similar to a biopsy, which you may already have undergone as a test to diagnose melanoma, basal cell carcinoma or squamous cell carcinoma, but when you are undergoing shave excision on a growth, the diagnosis is already known - or the dermatologist feels it is appropriate to remove the entire lesion without undergoing a biopsy first.
Before a shave excision, your skin will be numbed with a local anaesthetic. You are awake during the procedure, and the dermatologist will check to ensure you do not feel anything. The anaesthetic also typically causes the skin to rise, so it is easier to perform the shave excision.
Once the skin is numb, the area to be treated is disinfected, and then a sterile surgical knife is used to make a horizontal cut, which subsequently removes the growth, leaving behind a flat surface. You might feel some pressure as this happens, but you won’t feel any pain.
When the dermatologist has finished the shave excision, they may apply a chemical that stops bleeding - such as aluminium chloride hexahydrate or use electric cautery. Finally, the wound will be dressed with the appropriate dressings to keep it clean and dry; and to prevent it from rubbing against clothing.
It is essential that you adhere to the instructions of the dermatologist to ensure proper healing – even if you feel well, you must follow this guidance to the letter. There are also some over-the-counter medications that need to be avoided following a shave excision, as to take them could increase the risk of complications. You will be given all the information you need at the time of your appointment.
If samples have been sent off for laboratory analysis, once the results of the histopathology have been received and checked by the dermatologist, you may need to have a follow-up appointment, to inform you of the outcome and let you know the next steps.
What are the Risks and Complications of a Shave Excision?
As with all surgical intervention, there is a small risk of complications, and the risks will be explained by the dermatologist, who is the best trained and qualified person to avoid these events.
As the anaesthetic wears off, the site of a shave excision and the skin surrounding it may be sore, and your dermatologist will let you know which over-the-counter pain medications you can take, should you need to. Most people find the soreness to be minimal, and more of an inconvenience.
Some people bleed more than others, and bleeding can occur after shave excision. If this happens, you can apply pressure using a sterile bandage or dressing to stop the bleeding. The risk of bleeding may also be increased by taking certain over-the-counter medications or supplements, so it is essential that you heed the advice of your dermatologist in the weeks prior to, and after excision surgery.
A shave excision can leave minor scarring, however it is significantly less visible than the scarring from a full-thickness excision, and depending on your age, the location of the shave excision, and how your skin usually scars, it may be more or less visible. Most scars are reddish to start and take a little time to fully heal and blend in with the surrounding skin in a few weeks.
Occasionally, a growth may recur after a shave excision. If you suspect it is returning, you can contact the clinic for advice.
Depending on the location of the site of the shave excision, and/or the patient’s mobility, it might be more difficult to keep a healing wound clean and dry – this may elevate the risk of complications. Your dermatologist can advise if this is likely to be the case with your treatment.
While the infection is quite rare after a shave excision, it is not impossible. If you experience;
It is important to contact the clinic if you are experiencing any of these complications or unexpected pain or discomfort, whether they present immediately in the days following treatment, or weeks on from the shave excision.
In the extremely rare event that you need care urgently and cannot contact the clinic, you should contact your GP or call 111 for advice.
What is the Recovery Time and Outcome?
Shave excisions typically take about 5-7 days to heal, but depending on the individual, complete healing can take up to 2 weeks. Most people heal quite quickly if they are in generally good health and haven’t had any complications.
The follow-up care instructions provided by the clinic will let you know how long you’ll need to recover before you resume normal activities, or when you can resume taking certain over-the-counter medications. If there are any special considerations, your dermatologist will advise you, and if you have any questions during your recovery, you can email our team, who will endeavour to reply as quickly as possible.
Unless the dermatologist has specified that you will need a follow-up appointment, wound healing is quite straightforward, and you shouldn’t need subsequent appointments. If you have undergone shave excision for superficial basal cell carcinoma, you will still need to have your regular skin checks or mole mapping in accordance with the treatment plan agreed with your dermatologist.