Curettage and Cautery

Curettage and cautery removes selected superficial skin lesions by scraping tissue and treating the base with heat or electrical energy.

Curettage and cautery, sometimes called scrape and burn, combines two actions. A clinician uses a curette, a small spoon-shaped instrument, to remove a lesion or abnormal superficial tissue. Cautery then uses heat or an electrosurgical unit to seal small blood vessels and treat the area left behind. Local anaesthetic numbs the skin before treatment, so you remain awake while the area is managed.

The method is chosen for selected lesions whose depth, appearance, and diagnosis make scraping appropriate. It may be used for conditions such as seborrheic keratosis, pyogenic granuloma, molluscum contagiosum, milia, and some other superficial growths. A clinician should first decide what the lesion is; a changing or uncertain lesion may need a different assessment or procedure.

The treated spot commonly forms a raw, crusted surface as it heals. Keep the dressing or wound covering in place as instructed, wash gently, and avoid picking the crust. A small amount of oozing can occur early; firm, uninterrupted pressure with clean gauze is usually the first step if the area bleeds. Follow the clinic’s advice about ointment, showering, swimming, exercise, and sun protection.

Healing depends on the lesion and its location. The area may feel tender or sting as the anaesthetic wears off, then gradually become less noticeable. Once the crust separates, the new skin can look pink, red, or darker than nearby skin before its colour settles. Contact the treating clinic if pain is increasing, redness is spreading, drainage develops, or bleeding does not settle with pressure.

Possible problems include bleeding, infection, prolonged tenderness, a visible change in skin colour, and a scar that is lighter, darker, raised, or depressed. The treated lesion can also remain partly present or return, particularly when its deeper portion is not removed. Risk varies with the body site, lesion type, skin characteristics, medicines, and wound care, so a clinician can give advice tailored to you.

Tell the clinician about blood-thinning medicines, a tendency to form thick scars, immune conditions, allergies, and previous reactions to local anaesthetic. Seek prompt medical advice for worsening warmth and swelling, pus, fever, severe pain, or bleeding that continues despite sustained pressure.

Curettage and cautery can remove the treated lesion in one visit when the diagnosis and depth are suitable. It does not prevent every new lesion, and some conditions can recur if tissue extends deeper or if the original trigger remains. The expected result therefore depends more on the specific diagnosis than on the procedure name alone.

Ask whether the removed tissue will be sent for laboratory assessment, whether the appearance should be checked again, and what change would warrant a return visit. For a lesion such as a [Seborrheic Keratosis](/conditions/seborrheic-keratosis/), the aim may be removal of a bothersome surface growth; for a [Pyogenic Granuloma](/conditions/pyogenic-granuloma/), the plan also considers bleeding and recurrence.

Treatment is performed on a defined area of skin after examination and consent. Local anaesthetic is used, and the clinician chooses the scraping and cautery settings according to the lesion and site. A wound dressing is often applied, with aftercare instructions for keeping the area clean and protected.

A dermatologist may consider this approach for a selected superficial lesion that is suitable for scraping, including some [Corns And Calluses](/conditions/corns-and-calluses/), [Dermatosis Papulosa Nigra](/conditions/dermatosis-papulosa-nigra/), [Milia](/conditions/milia/), and [Keratoacanthoma](/conditions/keratoacanthoma/) cases. The correct option depends on diagnosis, size, thickness, location, symptoms, and cosmetic priorities. It is not a universal treatment for every bump or growth.

A consultation is especially useful when a lesion is new, changing, repeatedly bleeding, painful, or difficult to identify. Your clinician may discuss observation, sampling, excision, or another method if scraping would not provide adequate treatment or diagnosis.

First, the clinician confirms the site and cleans the skin. Local anaesthetic is injected around the lesion, allowing time for numbness to develop. The visible tissue is then removed with the curette. Cautery is applied to the base and any small bleeding points. The clinician checks the wound, places a dressing, and explains how to care for it at home. A treatment involving several lesions may take longer than a single small spot.

Immediately afterwards, numbness and mild tenderness are common. During the early healing phase, protect the dressing and expect a crust or superficial wound. Over the following days, keep the site clean and avoid disturbing the surface. After the crust comes away, colour changes may remain while the skin remodels. The clinic can tell you when review is needed based on the treated lesion and wound appearance.

The main considerations are bleeding, infection, delayed healing, scarring, and a temporary or lasting colour change. Cautery can leave a deeper wound than scraping alone, especially when more energy is needed to control bleeding. Report symptoms that worsen rather than steadily settle, and follow the prescribed wound-care plan.

Depending on the diagnosis, alternatives may include observation, shave removal, surgical excision, topical treatment, or [Cryotherapy (Lesion Removal)](/treatments/surgical-dermatology/cryotherapy-lesion-removal/). The choice balances diagnostic certainty, depth, bleeding, healing time, recurrence, and the appearance of the final mark. An [Electrosurgical Unit](/technology/electrosurgical-unit/) may be used as part of cautery, but the equipment does not determine whether this treatment is right for a particular lesion.

Look for a dermatologist or appropriately trained skin clinician who can identify the lesion, explain why curettage and cautery fits it, and provide clear wound-care instructions. Before booking, ask who performs the procedure, how uncertain lesions are assessed, what follow-up is offered, and how concerns about scarring or pigmentation are handled.