Surgical Procedures

Why choose Dr Boone for removal of you skin cyst?

Dr Doron Boone specialises in the removal of skin cysts under local anaesthetic. He is very experienced at removing epidermoid and pilar cysts and has excised hundreds of them in the course of his career with excellent cosmetic results.

What would happen to my cyst if I decide not to have any treatment?

Sebaceous cysts are benign (non-cancerous) and the majority cause no harm or problems. Over time, they can increase in size and become more noticeable.

Sometimes these cysts may become inflamed either due to infection or rupture of the cyst lining. When this occurs, the cyst becomes painful, red and quite warm to touch. An infected cyst may discharge pale yellow, smelly material.

The main reason why some people want them removed is for cosmetic reasons, as they can look unsightly or become infected.

What is an Epidermoid cyst?

The lining of an epidermoid cyst is made from cells which are normally found on the skin surface. Epidermoid cysts can affect anyone but are most common in young and middle-aged adults. They can appear anywhere on the skin but develop most commonly on the face, neck, chest, and upper back.

Understandably, sebaceous (epidermoid) cysts on the face can be unsightly and on occasion disfiguring. These cysts also commonly appear on the neck and trunk where they are often much larger.

What is a Pilar Cyst?

The lining of a pilar cyst is made up of cells like those found in the roots of hairs.

Pilar cysts are most commonly found on the scalp and are often multiple. Pilar cysts usually appear firm, slightly mobile nodules, particularly when found under the skin of the scalp. Similar cysts may also be found on the genital skin. Pilar cysts can become red and sore if inflamed or infected and may discharge some foul-smelling pus. Those on the scalp can catch on the comb.

How are sebaceous cysts removed?

Surgical removal of these cysts is usually a simple procedure and can be performed under local anaesthetic. Generally, it is better to remove the cysts before they become too large or become infected because:

• Larger cysts require a larger incision.
• An infected cyst becomes adherent to surrounding tissues under the skin and so their removal becomes a little more difficult to perform, with a greater risk of recurrence.

The skin is closed with soluble stitches, which dissolve over time.

My cyst is red and inflamed – should I have it removed soon?

Surgery is best deferred until an infection has completely settled to reduce the risk of a wound infection and a more noticeable scar.

Where are Lipomas found?

Lipomas may occur in any part of the body and their size is very variable, from a centimetre to 10cm or more.

Are Lipomas common?

Lipomas are relatively common and can occur in people who are normal weight as well as people who are overweight.It is not uncommon to have multiple lipomas; some people have a genetic tendency to develop this type of lump.

What would happen if I left my lipoma?

Lipomas are slow growing and although they do not usually cause any symptoms, this type of lump may be unsightly or irritating. Lipomas on the forehead are frequently mistaken for cysts.

What is a Neurofibroma?

Neurofibromas feel similar to lipomas and are fatty lumps found alongside nerve sheathes and are often multiple. They are often more sensitive than lipomas and excision may be associated with some loss of sensation in the skin area affected.

How can Lipomas be treated?

Most lipomas can be easily removed under local anaesthetic with a small incision. The skin is closed with soluble stiches. When the wound heals, it will usually leave just a fine scar. We routinely send the fatty tissue removed for analysis under the microscope (Histology). Lipomas may be lobulated and tethered which increases the risk of recurrence.

What should I do if I am concerned my mole is malignant?

If you are concerned about malignancy, you should contact your GP who may arrange an urgent referral to the NHS pigmented lesion clinic for a detailed assessment. 

What are the different types of mole?

Flesh coloured raised moles –  ‘cellular naevus’

These benign (non-cancerous) moles are very common and can be removed by either shave excision or elliptical excision depending on their size and location.

Pigmented or Hairy Moles – Melanocytic Naevi

Pigmented moles may be flat, raised or hairy. A pigmented mole (melanocytic nevus’) is caused by overgrowth of the pigment cells (melanocytes) under the skin and are generally benign (harmless) in nature. The pigmented cells lie deep in the skin and the most effective way to remove these types of moles is by surgical excision under local anaesthetic. Moles are classified as Junctional, Dermal or Compound depending on which layer of the skin the cell nests are found.

Why do people remove moles

If your mole has no concerning features, then it should be safe to leave it and not undergo any surgical treatment. The most common reason we are asked to remove a mole is because of concern about its appearance or because it has become a nuisance, such as becoming irritated by clothing, comb or razor. 

What are the options for Mole Removal?

You may wish to remove your mole for aesthetic or practical reasons such as catching in clothing or interfering with shaving. If you choose to have the mole surgically excised. There are two options:

Shave excision

Elliptical excision

What does shave excision involve?

Treating a protruding mole is simple using a procedure called shave excision. The aim is to return the skin contour to its normal unblemished shape.

After numbing the skin with local anaesthetic using an ultra- fine needle, Dr Boone will carefully shave-off the projecting part of the mole to the level to the skin surface with a scalpel or by electrosurgery. He will then seal the skin surface using an electrosurgical hyfrecator device. The resulting wound is similar to a graze and heals to leave a flat pale mark, but sometimes the colour remains the same as the original mole. The scar will have the same footprint as the original mole.

Shave excision is best for skin coloured moles and in the vast majority of cases will heal to give an excellent cosmetic result. Laboratory analysis (histology) is generally required.

After a shave excision, up to 3% may regrow slightly and may require further surgery longer-term. Very rarely a raised scar may develop called a hypertrophic or a keloid scar, particularly in some very dark-skinned individuals. The risk of this occurring on the face is extremely low. On the trunk, neck or the shoulder, the risk of keloid formation is slightly greater. Dr Doron Boone is always happy to review patients if they have any concerns post-treatment.

What is an Elliptical Excision?

After numbing the skin with local anaesthetic using an ultra- fine needle, Dr Boone will make an elliptical cut in the skin to completely remove the mole. The full thickness of the skin is removed and the wound is finely sutured (stitched) back together. The specimen is sent to the laboratory for detailed microscopic examination (histology). The resulting scar is usually just a thin line, the scars foot print will be longer than the original mole and could be more noticeable. Dr Doron Boone will help advise you on the best treatment option to give you the best aesthetic outcome

What is anook a Minor Surgery Consultation

Can moles become malignant?

The good news is that most moles are not cancerous and can be treated in our clinic with simple surgical excision. Rarely, a malignant melanoma may arise within a mole and the more moles an individual has, the greater the risk.

What is a Malignant melanoma?

Malignant Melanoma

The following features may possibly suggest malignancy:

• Unusual uneven borders or asymmetric shape
• A mole that has bled or ulcerated
• Rapid growth or colour change
• Diameter larger than 6mm.
• Variation or change in pigmentation

If you are concerned about malignancy, you should contact your GP who may arrange an urgent referral to the NHS pigmented lesion clinic for a detailed assessment.

Why choose Dr Boone for your treatment?

Dr Doron Boone has removed countless seborrhoeic warts with excellent cosmetic results.

Who develops seborrhoeic keratoses?

Seborrhoeic keratoses affect 30% of the population over the age of 40 years and 75% of people over the age of 70. They may also be found in younger people. Some people will have only a few seborrhoeic keratoses, while others will have large numbers.

What are seborrhoeic keratoses?

Despite their name, seborrhoeic keratoses are nothing to do with sebaceous glands or viral warts and are not infectious and do not become malignant. Seborrhoeic keratoses (warts) are benign and are caused by a build-up of ordinary skin cells.

What do seborrhoeic keratoses look like?

Seborrhoeic keratoses have a rough surface, and range in colour from golden brown to mid brown to almost black. They are most common on the trunk but are also common on the head, face and neck. They can affect anyone, but on dark- skinned people they can also appear as multiple small dark brown or black bumps, especially on the face and the neck; in such a case this is called Dermatosis Papulosa Nigra.

Their size varies from less than 1 cm to several centimetres across. Many appear to be stuck onto the surface of the skin; however some may look like small pigmented skin tags.

What will happen if I do not remove seborrhoeic keratoses?

Small flat seborrhoeic keratoses can often become more raised and increase in size as the years go by. Once present, they usually stay, and new ones often appear over time. Seborrhoeic keratoses often cause worry by becoming inflamed or bleeding. If there is any doubt, a punch skin biopsy can be done to confirm the diagnosis. Individual seborrhoeic keratoses can be treated successfully as below. However, new seborrhoeic keratoses may continue to appear.

How can seborrhoeic keratoses be treated?

Although most seborrhoeic keratoses need no treatment as they are harmless and cause no symptoms; for those who wish to have some or all of their keratoses removed we offer a very effective treatment with electrosurgery and curettage under local anaesthetic at our clinic. We can treat single or multiple lesions in one session.

Sometimes after treatment, particularly with large keratoses, there can be a degree of pigment change of the skin of the area affected.

More about Skin Tags

Skin tags can vary greatly in size from a few millimetres to a few centimetres. They are often multiple and are often found wherever skin rubs against skin or clothing and the skin chafes.

Skin tags do not usually cause any symptoms unless they are particularly large. Occasionally, they can bleed or become sore and inflamed, if they catch in clothing or jewelry.

Understandably, many people do not like their appearance, especially when found on the face or neck.

Surgery to remove Skin Tags

Skin tags can be easily removed by electrosurgery under local anaesthetic using an ultrafine needle. Only the very largest require excision with stitches.

We do not recommend that you attempt to remove large skin tags yourself because they can bleed heavily.

We will usually remove up to ten small tags for a fixed cost. Fees for removal of additional tags will be heavily discounted if carried out at the same session.