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Fine Wire Diathermy (Electrosurgery)
Fine Wire Diathermy is a high-precision treatment used to cauterize distinct, small skin imperfections that are often too tiny for liquid nitrogen or surgery. It involves using an ultra-fine needle through which an electrical current is passed. This current generates heat at the exact tip of the needle, allowing us to instantly seal off broken capillaries or vaporize small skin tags. At Smooth Skin Dermatology Clinic, we use this technique when "pinpoint" accuracy is required, ensuring that the surrounding healthy skin remains untouched.
Key Points
- High Precision The needle is as fine as a hair, allowing us to treat spots mere millimetres in size.
- Immediate Results Broken vessels often disappear instantly upon contact.
- Sensation It feels like a sharp, hot "prick" or a mosquito bite.
- No Stitches The wounds are microscopic burns that heal with tiny scabs.
- Versatile It treats both vascular (red) and structural (lumps) problems.
What is Diathermy?
Also known as "electrocautery" or using a "Hyfrecator," the device uses high-frequency electricity. When the needle touches the skin (or enters a vessel), the resistance in the tissue creates heat. This heat essentially "welds" blood vessels shut or dehydrates a skin tag until it shrivels and falls off.
Who needs it?
It is the treatment for:
Telangiectasia: Those distinct, purple/red spider veins around the nose and cheeks.
Skin Tags (Acrochordons): Small, hanging fleshy stalks on the neck, armpits, or eyelids.
Spider Angiomas: A central red dot with "legs" radiating out.
Milia: Hard white cysts under the skin that need to be opened.
Sebaceous Hyperplasia: Overgrown oil glands (yellow bumps) on the forehead.
Comedones/whiteheads and blackheads
Contact Smooth Skin Dermatology Clinic to clear these minor but annoying imperfections.
Clinical features
The conditions treated by diathermy have distinct presentations. Telangiectasia (Spider Veins) present as fine, non-palpable, bright red or purple lines, most commonly located in the alar grooves (sides of the nose) or on the cheeks. They blanch (turn white) when pressed. Skin Tags (Acrochordons) present as soft, pedunculated (on a stalk) papules, usually flesh-coloured or hyperpigmented, found in high-friction areas like the neck and axillae. During treatment, the clinical endpoint is distinct: vascular lesions will "zip" shut and disappear instantly, often leaving a tiny blanching mark, while skin tags will turn white/grey and shrivel immediately as the water is vaporized from the tissue.
The Healing Process
Immediate: The treated area looks red and may have a tiny white or black dot (eschar) where the needle touched.
Day 1-2: Tiny "micro-crusts" (pinpoint scabs) form. They look like little specks of dirt.
Day 5-7: The crusts fall off naturally.
Result: The skin is smooth. There may be a faint pink mark that fades over a few weeks.
Impact and complications
Scabbing: You will have visible scabs for a week. Do not pick them, or you will cause a pit scar.
Pitting: If the current is too high, it can leave a tiny depression (atrophic scar) in the skin.
Recurrence: Broken capillaries can come back if the underlying cause (like Rosacea or sun damage) continues.
Frequently Asked Questions
Have questions about scheduling or what to expect? Here are answers to common inquiries to help you feel fully prepared.
Yes, it is sharper than laser. It feels like a quick, hot sting. For most people, it is bearable without numbing. However, if we are treating a sensitive area (like the nose or eyelids), we can apply a topical anaesthetic cream 30 minutes beforehand.
Yes. This is one of the main advantages of diathermy. Because we control the needle precisely, we can safely remove tags on the eyelid margin where liquid nitrogen would be too dangerous to the eye.