Electrocautery & Curettage
Precise Surgical Removal of Skin Lesions
Electrocautery and curettage (also known as electrodesiccation and curettage or ED&C) is a proven dermatological surgical procedure used to remove various benign and malignant skin lesions. Dr. Jabu Nkehli expertly performs this minimally invasive treatment, which combines the use of electrical current to destroy tissue with a curette to scrape away the lesion. This technique offers precise removal with excellent cosmetic outcomes and minimal scarring.
What is Electrocautery & Curettage?
Electrocautery and curettage is a two-step surgical procedure performed in-office under local anesthesia. The procedure involves using a curette (a specialized spoon-shaped surgical instrument) to scrape away the lesion, then applying electrocautery (controlled electrical current) to destroy any remaining abnormal tissue and seal blood vessels. The process may be repeated 2-3 times in the same session to ensure complete lesion removal. This technique effectively removes the lesion while minimizing bleeding and reducing infection risk. The cauterization also helps control bleeding by coagulating small blood vessels. The procedure typically takes 15-30 minutes depending on lesion size and number. It's performed as an outpatient procedure with minimal downtime, allowing most patients to return to normal activities the same day.
Conditions Treated
Dr. Nkehli uses electrocautery and curettage to treat numerous dermatological conditions. BENIGN LESIONS: Seborrheic keratoses (age warts), dermatosis papulosa nigra, skin tags (acrochordons), milia, syringomas, sebaceous hyperplasia, cherry angiomas, and pyogenic granulomas. SKIN CANCERS: Basal cell carcinoma (low-risk, superficial types), squamous cell carcinoma in situ (Bowen's disease), actinic keratoses (precancerous lesions), and superficial squamous cell carcinomas (selected cases). OTHER CONDITIONS: Warts (resistant to other treatments), molluscum contagiosum, and certain benign growths. This technique is particularly effective for superficial skin cancers and provides cure rates of 90-95% for appropriate basal cell carcinomas. Dr. Nkehli will determine during consultation if your lesion is suitable for this treatment method.
The Procedure Step-by-Step
Understanding the process helps alleviate anxiety and prepare you for treatment. CONSULTATION: Lesion examination and diagnosis, discussion of treatment options and alternatives, explanation of procedure and expected outcomes, review of medical history and medications, and informed consent. PREPARATION: Treatment area cleansed and sterilized, local anesthetic injected to numb the area (lidocaine with epinephrine), waiting 5-10 minutes for complete numbing, and sterile draping of the area. STEP 1 - CURETTAGE: Using a curette, the lesion is scraped away with firm, controlled strokes, the curette removes soft, abnormal tissue down to healthy dermis, and the scraping action provides tactile feedback (abnormal tissue feels softer). STEP 2 - ELECTROCAUTERY: Electrical current applied via a needle-tip instrument, destroys any remaining abnormal cells, coagulates blood vessels to control bleeding, and sterilizes the base of the wound. REPEAT CYCLE: Process repeated 2-3 times to ensure complete removal, each cycle goes slightly deeper, and final cauterization creates a sealed wound base. POST-PROCEDURE: Antibiotic ointment applied, wound dressed with appropriate bandage, and post-operative instructions provided.
What to Expect During Treatment
With proper local anesthesia, the procedure is well-tolerated. ANESTHESIA: Local numbing injection (slight pinch and burning for few seconds), area becomes completely numb within minutes, and procedure is painless once anesthetized. DURING CURETTAGE: You'll hear scraping sound (normal), pressure sensation but no pain, and procedure typically takes 10-20 minutes. DURING CAUTERY: Smell of burning tissue (normal but can be unpleasant), sound of electrical buzzing, and still no pain due to anesthesia. AFTER PROCEDURE: Anesthesia wears off in 1-2 hours, mild soreness and tenderness expected, and manageable discomfort with over-the-counter pain relief. Dr. Nkehli works efficiently and carefully to minimize procedure time while ensuring complete lesion removal.
Recovery and Healing
Understanding the healing timeline sets realistic expectations. IMMEDIATE (Day 0-1): Wound site has dark, burnt appearance (eschar/scab), mild oozing of clear fluid or slight blood is normal, pain typically mild to moderate, and keep bandage in place for 24-48 hours. EARLY HEALING (Days 2-7): Change dressings daily, clean gently with mild soap and water, apply antibiotic ointment as directed, eschar begins to loosen, and some yellow drainage normal (not infection). MID-HEALING (Weeks 1-3): Eschar/scab falls off naturally (don't pick!), pink new skin underneath, wound continues to contract and fill in, and may be sensitive or itchy. LATE HEALING (Weeks 3-6): Wound fully epithelialized (skin closed over), area may be pink or red for weeks to months, gradual fading to normal skin color, and slight depression or white scar may form. COMPLETE HEALING: Full healing takes 6-12 weeks depending on location and size, final scar appearance continues improving for 6-12 months, and larger lesions take longer to heal completely. LOCATION MATTERS: Facial lesions heal faster (2-4 weeks), trunk and extremities slower (4-8 weeks), and lower legs slowest (8-12 weeks).
Wound Care Instructions
Proper aftercare is crucial for optimal healing and minimal scarring. DAILY WOUND CARE: Gently wash with mild soap and lukewarm water, pat dry (don't rub), apply thin layer of antibiotic ointment (e.g., Bactroban), and cover with clean, non-stick bandage. KEEP IT MOIST: Moist wound healing promotes faster healing and less scarring, antibiotic ointment maintains moisture, don't let wound dry out and scab excessively. DO NOT: Pick or remove scabs prematurely, apply hydrogen peroxide or alcohol (delays healing), submerge in bath, pool, or ocean until fully healed, or expose to direct sun without protection. WHEN TO STOP BANDAGING: Once wound is fully closed with new skin (no rawness), typically 2-4 weeks, and switch to sun protection. SUN PROTECTION: Essential once wound closed to prevent hyperpigmentation, use SPF 50+ for at least 6 months, and wear protective clothing when possible. SIGNS OF INFECTION (seek immediate care): Increasing redness, warmth, or swelling beyond wound edge, pus or foul-smelling drainage, fever, and pain worsening after first few days. Most wounds heal without complications with proper care.
Expected Results and Scarring
Cure rates and cosmetic outcomes are generally excellent. CANCER CURE RATES: Basal cell carcinoma 90-95% clearance, squamous cell carcinoma in situ 95-98% clearance, and actinic keratoses 85-90% clearance. RECURRENCE: If cancer recurs, typically within 1-2 years, follow-up skin checks essential, and recurrent lesions may require different treatment approach. SCARRING: All electrocautery procedures leave a scar, usually small, round, white or slightly depressed scar, less noticeable than surgical excision scar (no stitch marks), and final scar appearance best at 1 year post-treatment. COSMETIC OUTCOME FACTORS: Lesion size (larger = bigger scar), location (face heals better cosmetically), individual healing characteristics, and proper wound care compliance. HYPOPIGMENTATION: Treated area may be lighter than surrounding skin, more noticeable in darker skin tones, and may be permanent in some cases. Most patients find cosmetic results very acceptable, especially compared to leaving the lesion untreated.
Advantages of This Technique
Electrocautery and curettage offers several benefits over other treatment methods. COMPARED TO SURGICAL EXCISION: No sutures required (no stitch removal), quicker procedure time, less invasive, smaller wound size, and lower cost. COMPARED TO CRYOTHERAPY: More definitive removal, tissue available for pathology if needed, immediate complete removal in one session, and better for certain lesion types. GENERAL BENEFITS: Excellent cure rates for appropriate lesions, minimal bleeding during procedure, lower infection risk (cauterization sterilizes), performed in-office (no operating room needed), no general anesthesia required, cost-effective, and immediate return to most activities. LIMITATIONS: Not suitable for all skin cancers (high-risk areas, deep invasion), no tissue for pathology (lesion destroyed), and can leave more visible scarring than some other methods. Dr. Nkehli will discuss whether this technique or an alternative treatment is best for your specific lesion.
Who Is a Good Candidate?
Most patients with appropriate lesions are suitable candidates. IDEAL FOR: Patients with superficial basal cell carcinomas in low-risk areas, multiple seborrheic keratoses or benign lesions, those seeking quick, office-based removal, patients who want to avoid sutures, and generally healthy individuals. NOT SUITABLE FOR: Melanoma (requires excision with margins), high-risk skin cancers (face, areas around eyes, nose, ears), lesions with deep invasion or aggressive features, patients with pacemakers (caution needed), bleeding disorders or on blood thinners (relative contraindication), and keloid-prone individuals (may develop raised scars). SPECIAL CONSIDERATIONS: Darker skin types - higher risk of hypopigmentation, immunocompromised patients - altered healing, and pregnant women - generally safe but discussed case-by-case. Dr. Nkehli will thoroughly assess your lesion and medical history to determine if electrocautery and curettage is the optimal treatment choice.
Why Choose Dr. Jabu Nkehli?
As a specialist dermatologist, Dr. Nkehli brings extensive surgical dermatology training and experience to every procedure. She accurately diagnoses lesions and determines appropriate treatment methods, performs the procedure with meticulous technique to ensure complete removal while optimizing cosmetic outcomes. Dr. Nkehli understands the nuances of treating different skin types, particularly important for preventing pigmentation issues in darker skin tones. She uses proper depth and technique to minimize scarring and provides comprehensive pre and post-operative care. Her surgical expertise, combined with her dermatological knowledge, ensures you receive safe, effective treatment with the best possible results. You can trust Dr. Nkehli to provide honest assessment, expert technique, and compassionate care throughout your treatment journey.
Pricing and Consultation
Electrocautery and curettage pricing varies based on lesion characteristics. SINGLE SMALL LESION: R800-R1500. MULTIPLE LESIONS (same session): R1500-R3500 depending on number and complexity. SMALL SKIN CANCER: R2000-R3500 per lesion. LARGER OR MULTIPLE CANCERS: R3500-R6000 per session. BENIGN LESIONS (multiple): R1200-R2500 per session. Pricing includes local anesthesia, procedure, basic pathology (if sent), and initial follow-up visit. Insurance may cover treatment of skin cancers and certain medical conditions (verification required). Book your consultation with Dr. Nkehli for accurate diagnosis and biopsy if needed, determination of best treatment approach, personalized procedure plan, detailed pricing for your specific case, and discussion of expected outcomes and recovery. She'll examine your lesion, answer all your questions, and ensure you feel comfortable and informed before proceeding with treatment.