When is curettage and cautery recommended for keratoacanthoma?

A keratoacanthoma is a rapidly enlarging, firm skin growth that can have a central keratin plug. It can resemble squamous cell carcinoma, so a clinician may need to examine it closely and sometimes take a tissue sample. Curettage removes the growth by scraping, and cautery treats the base and helps limit bleeding. This approach is not automatically suitable for every lesion: size, depth, site, growth pattern, immune status and the need for complete assessment all influence the decision.

Book a dermatology appointment promptly rather than attempting to squeeze, shave or burn the growth. Note when it appeared, how quickly it changed, and whether it has bled or become tender. Bring a list of medicines that affect bleeding or healing. Before treatment, ask whether tissue will be examined, how the wound will be dressed, and whether another procedure would provide a more appropriate margin or laboratory diagnosis.

Seek urgent clinical review if the lump is growing quickly, repeatedly bleeding, painful, ulcerated or surrounded by increasing redness. A changing keratoacanthoma-like growth should not be delayed while waiting to see whether it settles. After treatment, contact the clinic for spreading redness, pus, fever, worsening pain or bleeding that does not settle with firm pressure.

Ask how confident the clinician is about the diagnosis, whether a biopsy or excision is preferable, and what will happen if the growth returns. Clarify wound care, expected healing, scar appearance and when the site should be checked again.