The method of lesion removal depends on many factors, such as where the lesion is located and whether or not it's dangerous. Lesions are almost always removed surgically, but some are better left in place because of the dangers posed by their removal, such as with some brain lesions. Many lesions are also temporary and heal on their own or with the help of oral or topical medication. If it's decided that a lesion should be removed for safety or because the patient wants it removed for cosmetic reasons, then the location will determine the exact type of surgery required.
One of the most common types of lesions is skin lesions, which are also called cutaneous lesions. Skin lesion removal is usually an outpatient procedure and can sometimes be done right in a doctor's office if the lesion isn't cancerous or suspicious. Lidocaine or other numbing agent is usually injected around the spot before removal. The lesion typically is then either burned off, which is far less common today than it used to be, or excised with a scalpel in a procedure called a shave excision.
For skin lesion surgery when there's the threat of cancer or cancer is known to be present, an outpatient procedure in a hospital might be necessary. The lesion first is numbed with one or more injections before it's excised. When there's concern about cancer, the layer of skin directly beneath the lesion may also be removed. This is called elliptical excision and is a deeper cut than one made with shave excision. This type of surgery helps to make sure that any cancer cells in the skin beneath the lesion are also detected.
The removed portion normally is tested to check for cancer cells in both the lesion and the normal skin so further treatment can be determined. If the normal skin shows the presence of cancer cells, another deeper excision might be performed. Other methods of treatment, such as radiation, chemotherapy or drug therapy, might also be necessary.
Lesions also can appear other places in the body besides the skin. Colon lesions, for example, are common and are typically detected through a colonoscopy. These lesions are typically removed surgically when they're found in order to reduce the risk of cancer.
Some brain lesions can be removed surgically, while others might be in a part of the brain that make the surgery too risky. The chief reason for brain lesion removal is the fear that the lesion is or will become cancerous. When removal is too risky, lesions often are treated with radiation or chemotherapy to help kill cancer cells.
Liver lesions may also be removed surgically to prevent cancer from forming or spreading. A lesion can appear on almost any surface inside or outside the body, and whether or not lesion removal is an option depends on the degree of risk the procedure carries and whether or not there's a risk of cancer.
Some other common types of lesions, such as herpes lesions and AIDS lesions, can heal on their own or with medication. Herpes lesions can include cold sores on and around the mouth or genital area. AIDS lesions can appear anywhere on the skin and are used by doctors to judge the progression of the disease. Lesions found in herpes, AIDS and other illnesses that affect the immune system aren't typically candidates for lesion removal because they come and go during different stages of the illnesses.