Benign & Malignant Skin Conditions

Evaluation and Surgical Treatment of Skin Lesions

Skin growths and lesions are extremely common. While many are benign and harmless, others may require removal to relieve symptoms, prevent infection, or treat skin cancer. Careful evaluation allows us to determine which lesions can be safely observed and which would benefit from surgical treatment. Your initial consultation will focus on a thorough assessment of your condition; to ensure adequate time and optimal care, any procedure is typically scheduled for a future appointment.

When surgery is recommended, the goal is complete removal with appropriate margins while minimizing discomfort and promoting optimal healing. Many procedures can be performed comfortably in the office, while others are best completed in the operating room depending on the lesion’s size, location, or complexity.

In general, lesions involving the face or hands are referred to other specialists to ensure the best functional and cosmetic outcomes.

Benign Skin Conditions

Lipomas

A lipoma is a soft, rubbery lump made up of fatty tissue that grows slowly under the skin. Lipomas are non-cancerous and usually painless, but some patients choose removal because of:

Discomfort or pressure
Enlargement over time
Interference with clothing or movement
Uncertainty about the diagnosis

Lipomas are often removed in the clinic under local anesthesia, though larger or deeper lipomas may require removal in the operating room.

Epidermal Inclusion Cysts

Epidermal inclusion cysts (sometimes called sebaceous cysts) are common, benign cysts that form when skin cells become trapped beneath the surface. They often appear as firm, round bumps and may slowly enlarge over time.

Infected or Inflamed Cysts

When a cyst becomes infected, it can cause redness, pain, swelling, and drainage. In these situations:

Antibiotics may be needed
Incision and drainage (I&D) may be required to treat the infection
Definitive excision is often delayed until inflammation resolves

Removing a cyst when it is actively infected increases the risk of recurrence and poor healing. Once the infection has settled, complete excision can usually be performed safely.

Skin Cancer

Skin cancer is the most common form of cancer in the United States. Early detection and appropriate surgical removal offer excellent outcomes for most patients.

Basal Cell Carcinoma

Basal cell carcinoma is the most common skin cancer. It typically grows slowly and rarely spreads, but it can cause significant local damage if left untreated. Surgical removal is often curative.

Squamous Cell Carcinoma

Squamous cell carcinoma is more aggressive than basal cell carcinoma and has a higher risk of spreading if not treated promptly. Early surgical excision provides the best chance for cure.

Melanoma

Melanoma is the most serious form of skin cancer. Treatment depends on the depth and features of the lesion and often includes wide local excision. In certain cases, additional procedures such as sentinel lymph node biopsy may be recommended.

Clinic vs. Operating Room Procedures

Many skin lesion removals can be performed in the clinic under local anesthesia, offering convenience and quick recovery. However, some lesions are better treated in the operating room, including:

Larger or deeper lesions
Lesions requiring wider excision
Cases where patient comfort or safety is improved with anesthesia

The appropriate setting is determined based on the lesion type, size, location, and individual patient factors.

Pathology and Follow-Up

All excised lesions are sent to pathology for formal evaluation. Results are reviewed with you, and follow-up care is tailored based on the diagnosis. For patients with skin cancer, surveillance and coordination with dermatology or oncology may be recommended.

When to Seek Evaluation

You should consider evaluation if you notice:

A new or growing skin lesion
Changes in size, color, or shape
Pain, bleeding, or recurrent infection
A lesion that does not heal

Early evaluation allows for simpler treatment and better outcomes.