Surgical Excision (Shave Excision of Skin Lesion)

Written by Natalie Phillips
Medically Reviewed by George Krucik, MD

What Is a Shave Excision?

Shave excision is a simple procedure done to remove growths such as lesions, tumors, and moles on the skin. The growth is removed with a sharp razor and soothed with antibiotic ointment to encourage healing. Sometimes an electrode is used to “feather” the edges and make the scar less noticeable.

Shave excision is usually performed with local anesthesia, which prevents the patient from feeling pain.

Once removed, the growth is sent to a laboratory for analysis to determine whether the growth is malignant (cancerous).

What Are the Reasons for a Shave Excision?

If you have a skin growth, your doctor may recommend a shave excision. Shave excision is a simple, less-expensive procedure than a full-thickness skin excision.

Full-thickness skin excision is a more invasive procedure that requires sutures (stitches) after the procedure. Shave excision does not require stitches. The scar that is produced after a shave excision is generally less noticeable than the scar made from a full-thickness skin excision.

How Is a Shave Excision Performed?

Shave excision is usually done with local anesthesia. This ensures the patient feels no pain during the procedure.

Generally, during a shave excision your doctor will:

  • Inject the immediate area under the growth with a numbing medicine or anesthetic. The injected anesthetic helps with the procedure because the anesthetic causes the growth to rise upward, making it easier to remove.
  • Cut the growth off with a sharp razor by making multiple horizontal cuts. You may feel a pushing sensation as the cuts are made, but you should not feel pain.
  • Perform some electrosurgical feathering. This is done by using a small dermal loop electrode to “feather” (smooth) the edges of the wound. Feathering helps remove any cells from the growth that have been left behind. It also minimizes scarring by blending the edges of the wound in with the surrounding skin.
  • Apply a chemical such as aluminum chloride hexahydrate to the skin to stop bleeding.
  • Clean the surgical site and apply a soothing, antibiotic ointment to encourage faster healing.
  • Cover the wound with a sterile bandage to prevent the wound from rubbing on clothing or getting infected.

Your doctor will ask you to keep the wound dry for 24 hours and will l tell you when you can remove your bandage. You may be given a topical antibiotic ointment to rub on your wound site twice a day.

What Happens After a Shave Excision?

You may have discomfort or a burning sensation where the growth was removed. You can take over-the-counter painkillers such as acetaminophen or ibuprofen every four hours for the first few days after the procedure.

You can expect some scarring. The scar will be red for a few weeks, but it will gradually get lighter. Try to be patient. Healing can be a slow process.

You may be able to lighten the appearance of your scar by applying:

  • topical silicone gel or silicone gel sheets
  • vitamin A cream
  • petroleum-based ointments

These are readily available at your local drug store.

You should cover the surgical site with a bandage when you are in bright sunlight. Sunburn can permanently darken the wound, making your scar more noticeable.

Call your doctor if scarring seems excessive (hard, raised, or dome-shaped).

What Complications Are Associated with a Shave Excision?

Infection is rare. Call your doctor if you notice signs of an infection. These may include:

  • pus coming from the wound site
  • extreme tenderness
  • swelling or increasing redness

Some bleeding may occur. If this happens, press on the wound firmly with a sterile bandage or dressing for 20 to 30 minutes. If the wound bleeds for more than 30 minutes, get medical attention.

Sometimes tumors or growths come back after shave excision. Call your doctor if you suspect your growth is coming back.

What Do Test Results Mean?

Your doctor will contact you with the laboratory results. The growth may be determined to be benign (noncancerous). Benign growths include:

  • angiofibroma (a small, reddish brown lesion)
  • skin tag (a stalk-like, protruding lesion)
  • dermatofibroma (small, hard lesions that usually occur on the lower body)

If the test results show that the growth is malignant (cancerous), you will need to go to your doctor for a follow-up. Your doctor may send you to a skin cancer specialist.

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