Cryosurgery Cryosurgery can be used to treat benign surface lesions, sun damage and is occasionally used for the treatment of some forms of skin cancer. Liquid Nitrogen is applied to the skin either with a cotton applicator or via a pressurised spray to freeze the surface layers. After treatment there is a local inflammatory reaction. With a short freeze there is some discomfort then the site swells slightly and feels like a burn before settling after a few hours and the surface layers then peel over a few days. An intense treatment is painful and may require local anaesthesia. A blister will form which may require regular dressings whilst it heals over 10-14 days. Electrosurgery High frequency ultrasound is applied to the surface of the skin via a small electrode to heat the surface layers. This treatment may be used alone for benign surface lesions or in combination with curettage to remove a variety of lesions from small keratoses to some forms of skin cancer. Topical or local anaesthesia are usually required. There is a surface wound which requires regular wound care whilst it heals. Excision Formally excising a lesion is often the most appropriate procedure depending on the likely pathology. Local anaesthesia is required and usually the wound is repaired with sutures. Sometimes the sutures are buried and are absorbed over a few weeks or surface sutures may be used which require removal after a number of days depending on the site and size of the wound. The wound may be left to heal naturally and require regular dressings, but this option is fully explained at the time. Local Flaps and Grafts Occasionally a lesion may be of a size or in a site where the best functional and/or cosmetic outcome will be achieved by the use of a local skin flap or a skin graft. We use these techniques commonly and if it may be relevant to your care then the options will be discussed fully with you at your consultation. Mohs’ surgery Mohs’ micrographic surgery is considered the most effective technique for treating many basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), the two most common types of skin cancer. The procedure is done in stages, including lab work, while the patient waits. This allows the removal of all cancerous cells for the highest cure rate while sparing healthy tissue and leaving the smallest possible scar.