Curettage

Curettage uses a curette - a small instrument with a spoon-shaped or ring-shaped cutting edge - to scrape a lesion away from the surface of the skin.

It works because certain lesions sit in or just below the outer layer of skin and are softer than the tissue around them. The curette separates them cleanly at that natural plane, leaving normal skin behind.

Performed under local anaesthetic, usually in a single short appointment.

What it suits

Seborrhoeic warts (seborrhoeic keratoses) - the classic indication; these are superficial by nature and lift away well
Solar keratoses, once assessed
Viral warts
Some raised benign skin lesions
Molluscum contagiosum

It is often combined with light cautery or electrosurgery to seal the base and control bleeding.

The point in its favour

Unlike laser, cryotherapy and radiofrequency, curettage produces tissue that can be sent to pathology. The curetted material is fragmented rather than intact, so it does not allow assessment of margins the way an excision does, but it does allow the lesion to be identified.

That makes curettage a middle option: less invasive than excision, without the total loss of diagnostic information that destructive methods involve.

Where a lesion may be a melanoma, it is still excised whole rather than curetted, because margin assessment matters. See skin cancers.

Curettage against the alternatives

Method	Tissue for pathology	Usual mark left
Curettage	Yes - fragmented	Flat patch, often pale
Excision	Yes - whole, with margins	Permanent line scar
Cryotherapy	No	Flat patch, often permanently pale
Electrosurgery	No	Flat patch
Laser	No	Flat patch

What to expect

Local anaesthetic is injected - a brief sting, then numbness. The lesion is scraped away, the base is sealed if needed, and a dressing is applied. Most lesions take only a few minutes; several can be treated in one appointment.

Afterwards there is a shallow raw area which scabs over within a few days and heals over one to three weeks, leaving a flat pink patch that fades over months.

Aftercare

Keep the site clean and dry; follow the dressing instructions
Do not pick the scab - let it separate on its own
Avoid swimming and soaking until healed
Protect from sun while healing, then use sunscreen on the site
Contact us for increasing pain, spreading redness, swelling or discharge

What results are realistic

The treated lesion is gone, and for seborrhoeic keratoses the result is usually good - a flat patch where a raised lesion was.

A pale or slightly textured mark commonly remains, and on darker skin the pale mark can be permanent. Curettage does not prevent new lesions forming elsewhere, and a lesion occasionally recurs at the site if any deeper portion remained. Individual results vary.

Risks

A flat scar or textural change at the site
Hypo-pigmentation - a permanently paler patch, more noticeable on darker skin
Hyper-pigmentation
Bleeding
Infection
Delayed healing, particularly on the lower legs
Incomplete removal and recurrence at the site
Reaction to local anaesthetic
Loss of margin information compared with excision, where that matters

See risks and complications.

Cost and Medicare

Cost depends on the number, size and site of the lesions. As at September 2024 and including GST, a consultation with a Cosmetic Doctor is $150. Pathology, where sent, is charged separately by the laboratory.

Removal of a medically indicated lesion may attract a Medicare rebate; removal for cosmetic reasons does not. Me Clinic is not a no-gap provider.

Booking

Me Clinic, 4 Burke Road, Malvern East VIC 3145. Phone 1300 852 050 or (03) 9569 3511, or use the online consultation form.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.