doctor diagnosing melanoma on a female body before excision

Why Do Skin Lesions Have To Be Excised?

Skin lesions are excised, or surgically removed, primarily to treat skin cancer like basal cell carcinoma, squamous cell carcinoma, or melanoma. Excision involves cutting out the entire lesion along with a margin of healthy tissue around it. This ensures that all cancerous cells are removed, reducing the risk of the cancer spreading or returning.

Excision is also performed to remove suspicious moles, cysts, or benign tumours that may pose a risk or cause concern. The procedure aims to eliminate these abnormal or potentially harmful skin lesions.

Key Information

During the excision of a skin lesion, Dr. Tina will explain to you why the skin lesion needs to be excised and walk you through the procedure. You may be asked to sign a consent form indicating your understanding and agreement with the surgical intervention. Inform Dr. Tina about any medications you are taking, allergies, medical conditions, or if you have a pacemaker or implanted defibrillator. Additionally, disclose any over-the-counter supplements or herbal remedies that could affect bleeding.


The most common type of excision is an elliptical excision, where Dr. Tina will design an incision in the shape of an ellipse. This helps minimise tension on the wound and orient the resulting scar along existing skin creases, making it less noticeable.


Dr. Tina will mark the area to be excised and administer a local anaesthetic injection to numb the skin. Using a scalpel and sharp scissors, she will carefully cut around and under the lesion, including a margin of healthy tissue. The excised lesion will be sent to the pathology laboratory for examination by a pathologist who will provide a report to Dr. Tina in a few days.


During the procedure, there may be some bleeding, which Dr. Tina can control by cauterising the blood vessels. The edges of the incision will then be stitched together using sutures, typically in two layers. Dr. Tina will provide instructions on wound care and inform you when to have the stitches removed.

Excisional Biopsy

Primarily diagnostic, this procedure entails the complete removal of a skin lesion to obtain a comprehensive tissue sample for histopathological analysis. It's especially critical when the nature of the lesion is ambiguous or there's a suspicion of skin cancer, including when a melanoma is suspected. In such cases, an excisional biopsy ensures that the entire lesion, along with a margin of normal surrounding tissue, is examined to provide a precise diagnosis.

The biopsy is aimed at confirming the presence, type, and extent of the disease, offering crucial insights for planning further treatment.


The main goal here is therapeutic, focusing on the complete removal of a lesion, typically one that has already been diagnosed as malignant or is problematic in some way.

Excision serves as a form of treatment for skin cancers like basal cell carcinoma, squamous cell carcinoma, or melanoma. The procedure involves removing the lesion along with an appropriate margin of healthy tissue to ensure all cancerous cells are eradicated.

This method is intended to cure or significantly manage the condition, unlike an excisional biopsy, which may necessitate additional treatment based on the findings.

In summary, while an excisional biopsy is conducted to diagnose the nature of a lesion, including suspicions of melanoma, an excision is performed to remove a known or assumed problematic lesion, such as skin cancer, with the intention of treatment and cure.

  1. The procedure starts with marking the area around the lesion.
  2. A local anaesthetic is then injected to numb the area.
  3. The lesion, along with a margin of surrounding tissue, is removed and sent to a pathology lab.
  4. There may be some bleeding, which is managed by the doctor.
  5. The wound is then closed, often with sutures.
  6. Dressing is applied.
  7. Post-operative care instructions are provided, including when to remove the stitches.

It is impossible to excise a skin lesion without leaving some form of scarring. Surgical techniques aim to minimise scarring, taking into account factors such as the skin's tension lines to make scars less noticeable. Some individuals might experience keloid or hypertrophic scarring, where scars are larger and thicker than normal.

Skin doctor checking patient's skin for biopsy area

Aftercare Instructions for Skin Excision

How should I care for the wound after a skin excision?

After the skin excision, it’s important to take proper care of the wound. Here are some guidelines to follow –

  • The wound may be tender after the local anaesthetic wears off. This is normal and should improve within 1-2 hours.
  • Leave the dressing in place for 48 hours, unless instructed otherwise by Dr. Tina. Avoid activities that strain or stretch the area until the stitches are removed and for some time afterward.
  • If there is any bleeding from the wound, apply firm pressure with a clean folded towel for 20 minutes without removing the dressing. If bleeding persists after this time, contact Dr Tina’s clinic or seek urgent medical attention.
  • Keep the wound dry for the first 48 hours. After this period, you can gently wash and dry the wound as directed by Dr. Tina. 
  • It is normal for the wound edges to be slightly pink and tender to the touch. However, if the wound becomes increasingly red or painful, consult Dr. Tina as it may be a sign of infection and require antibiotics.
  • Initially, the scar may appear red and raised, but over several months, it typically fades in colour and size.
  • Remember to follow any specific post-operative instructions provided by Dr. Tina and attend follow-up appointments as scheduled. She will monitor your healing progress and address any concerns you may have.


Book in for a skin consultation with Dr Tina for an individualised treatment plan.  Your best treatment will often depend on your age, gender, triggers and causes of your condition.


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Call us on 07 3852 4878 or simply book an appointment