Skin LesionAssessment & removal.

Which lesions can be considered?

You may also see skin tags called acrochordons, moles called melanocytic naevi, and sun or age spots called solar lentigines. The six groups above explain their differences.

Some marks need a different first step.

Cosmetic removal does not go ahead when a lesion is:

• new;
• changing;
• bleeding without a clear cause;
• irregular;
• persistently unhealed;
• suspicious;
• uncertain in identity.

A lesion that catches on clothing or jewellery, or rubs, can still be assessed. A lesion that has begun to hurt, bleed without a clear cause, grow or change on its own, or has not healed, needs GP or dermatology assessment first.

Cosmetic removal at odNOVA does not include laboratory examination of the tissue. If a lesion needs testing, GP or dermatology assessment comes first so that an appropriate biopsy can be arranged. Removing a mark cosmetically cannot confirm that it was harmless.

A mole, age spot or other pigmented mark that has become itchy, inflamed, sore or otherwise changed needs GP or dermatology assessment first, even if you think clothing or rubbing caused it.^[1]

A rough, scaly or crusty sun-damaged patch may be something different and needs medical assessment first.

If any of these features applies, arrange medical assessment before considering cosmetic removal.^[1]

Knowing when not to treat is part of the service.

A mark is not a diagnosis.

A message or photograph can help explain what is bothering you, but it cannot replace examination. If a mark is uncertain or concerning, I recommend GP or dermatology assessment first.

Do not try to cut, burn or chemically remove a mole, skin tag or uncertain lesion yourself. Home removal can cause bleeding, infection or scarring and may delay proper assessment.

The lesion and the person both matter.

It helps to know when you first noticed the lesion, whether it has changed and whether it catches, rubs or causes symptoms. Please tell me about your medicines, previous healing, unusual scars and any tendency to develop dark or light marks.

These details help me assess both the lesion and how your skin may heal after removal.

Removal is one possible outcome.

The assessment can lead to one of three sensible decisions:

1. the lesion appears suitable for cosmetic removal and you may consider treatment;
2. the lesion is left alone because the likely benefit does not justify the healing, pigment or scarring trade-off; or
3. you are advised to see your GP or a dermatologist before any cosmetic treatment is considered.

If treatment is an option, I explain the intended result, the limits, the risks, the likely healing process and the alternatives before you decide. You are under no obligation to proceed and may defer or decline treatment.

Planning removal and cost

The approach depends on the lesion, its location and how the area is likely to heal. Before you agree, I explain the proposed method, what it involves and what it may leave behind. Smaller lesions start from £100 and more complex lesions from £125; I confirm the cost of your plan before treatment. View lesion fees.

A useful consultation does not have to end with a procedure.

At the consultation, I assess the skin lesion and explain whether removal or further investigation is appropriate.

Removal does not mean invisible skin.

Removing a lesion leaves skin that needs to heal. The treated area may remain lighter or darker, and a scar can remain. It may be flat, raised or slightly indented; that depends on the procedure, location and how your skin heals.^[9] The likely improvement needs to be weighed against the mark treatment could leave. Some lesions need further treatment; read about persistence and recurrence.

Hair may remain or regrow after a mole is removed. Removing the visible lesion does not necessarily remove the hair follicle beneath it, so a smoother surface does not guarantee that the hair will disappear.^[12]

The area needs time to settle.

Surface healing and the final appearance are different stages. The lower legs can take longer to heal than other sites.^[15] Even after the surface has healed, redness or a change in colour may take months to settle. The size and depth of the treated area, its location and your health all affect recovery.

See the stages of healing · View the original before-and-after photographs

The treated spot may darken and form a small crust before the skin beneath it heals. Let the crust separate naturally. A darker appearance alone cannot tell you whether healing is normal; increasing pain, redness or discharge needs assessment.^[16]

Healing, skin tone and possible complications.

The relevant risks depend on the lesion, its location and the method considered. Before treatment, the discussion may include:

Your skin tone, the location of the lesion and any previous raised scars affect the assessment. The chest, shoulders and upper back are more prone to raised scarring.^[11] In some cases, a harmless lesion is better left alone if removal could leave a more noticeable scar.

Results and healing cannot be guaranteed. Before you decide, you should know the risks relevant to the exact method and how concerns about healing would be assessed.

Suitability is broader than the lesion itself.

Even when the lesion itself appears suitable, treatment may be unsuitable or need to be deferred where the skin condition, skin tone, medical history, medicines, healing or scarring risk, pregnancy or breastfeeding change the balance of benefit and risk.

Their importance depends on the procedure being considered and your individual health. Tell me about your health, medicines and previous scarring so the decision is based on the whole picture, not the appearance of the lesion alone.

Aftercare must match the procedure actually chosen.

Follow the written instructions for the exact procedure.

• Keep the area clean and dry.
• Let any scab separate naturally; do not pick, scratch or peel it.
• Avoid clothing, straps or jewellery that rub directly over the treated area while it heals. If the site needs a protective dressing, follow the dressing advice for your procedure.^[13]
• Avoid make-up over the area until healed.
• Keep the healing area covered or shaded from the sun. Once the surface has healed, use a broad-spectrum sunscreen of SPF 30 or higher. UV exposure can darken a healing mark.^[10]

Contact odNOVA if healing worries you or anything does not feel right. A review may be offered. Some problems need assessment by your GP, a dermatologist or NHS services. If a lesion persists, returns or changes, it should be reassessed before further treatment.

Some lesions need more than one treatment.

I reassess a persistent or returning lesion before suggesting further treatment. If it has changed, GP or dermatology assessment comes first. Removing one lesion does not prevent another from developing elsewhere.

Some heavy creams or ointments can contribute to milia, but skincare is not the only cause. If new milia keep appearing, the products used around the area are worth reviewing. Removing the existing bumps does not prevent new ones from developing.^[14]

Sometimes the best decision is to leave it alone.

If removal would leave a mark that bothers you more than the original lesion, leaving it alone can be a sensible choice. Another removal approach elsewhere may also be more suitable. If the lesion changes, arrange GP or dermatology assessment before cosmetic treatment.