Popular Links
Request an appointment
Reserve your spot with our medical team in just minutes.
Curettage and Cautery ("Scrape and Burn")
Curettage and Cautery is a specialized surgical technique used to treat superficial skin lesions without the need for stitches. Unlike a formal excision (which cuts deep into the fat), this procedure removes lesions that sit on the surface of the skin. It involves "scooping" the lesion away with a sharp medical spoon (curette) and then sealing the base with a heat tool (cautery). At Smooth Skin Dermatology Clinic, we often choose this method for benign lumps or very shallow skin cancers because it is quick, efficient, and avoids the "train-track" scarring of sutures.
Key Points
- No Stitches The wound heals naturally like a deep graze.
- Tissue Saved Unlike freezing (where the tissue is destroyed), the scraped tissue is sent to pathology for confirmation.
- Stop Bleeding The "cautery" part uses heat to instantly stop bleeding.
- Scarring It leaves a round, flat white scar (similar to a chickenpox scar) rather than a line.
- Speed The procedure is completed in 15-20 minutes under local anaesthetic.
What is Curettage?
The doctor uses a "curette"—a ring-shaped instrument with a sharp edge. Because many skin lesions (like warts or basal cell carcinomas) are softer than healthy normal skin, the curette can selectively scrape out the abnormal tissue while sliding over the tough, healthy dermis underneath.
Who needs it?
It is the preferred treatment for:
Seborrheic Keratoses: The crusty, "stuck-on" brown warts of ageing.
Superficial BCC: Early-stage Basal Cell Carcinomas that haven't grown roots.
Pyogenic Granulomas: Rapidly bleeding red vascular bumps.
Hyperkeratotic actinic keratosis
Contact Smooth Skin Dermatology Clinic to see if this “stitch-free” option is right for you.
Clinical features
The clinical presentation involves a distinct difference between the "Pre-op" lesion and the "Post-op" wound. The target lesion, often a Seborrheic Keratosis, presents as a warty, well-defined, "stuck-on" papule that looks like it is sitting on top of the skin rather than growing into it. Immediately following the procedure, the patient presents with a shallow, saucer-shaped depression (ulcer) in the skin. The base of this wound is typically dry and may have a blackened or charred appearance due to the cauterisation (heat) used to stop the bleeding. Over the following weeks, this fills in with granulation tissue and forms a yellow-brown crust before healing into a flat, hypopigmented (pale) circular scar.
The Healing Process
Day 0: The wound is an open, dry graze. We cover it with an ointment and a dressing.
Day 1-7: A thick scab forms. It might look yellow or gooey—this is usually normal healing, not infection.
Week 2-3: The scab falls off naturally.
Month 3: The area is pink and smooth.
Month 12: The final scar is a pale, white, round mark.
Impact and complications
Scarring: While there are no stitch marks, there will be a scar. It is usually a round, white patch. It can sometimes be hypertrophic (raised/lumpy) on the chest or shoulders. Bleeding: Because there are no stitches holding it closed, the wound can ooze slightly if you knock it. Recurrence: As we are "scraping" rather than "cutting out," there is a slightly higher chance (approx. 5%) that the lesion could grow back compared to a formal excision.
Frequently Asked Questions
Have questions about scheduling or what to expect? Here are answers to common inquiries to help you feel fully prepared.
No. We inject local anaesthetic first, so you feel nothing during the scrape and burn. It may throb slightly for an hour afterwards.
It is "open healing." You can shower the next day. The main rule is to keep it greasy (with Vaseline or antibiotic ointment) so the scab doesn't crack, and let the scab fall off on its own. If you pick the scab, you will get a deeper scar.
Freezing is great for flat sun spots. But for thick, chunky warts, freezing often fails to get to the bottom. Curettage physically removes the bulk of the lump immediately. Also, freezing destroys the sample—curettage allows us to send the tissue to the lab to make sure it wasn't cancer.