This leaflet answers common questions about your minor (small) operation for your skin problem. This may involve removal of a small sample of skin that will help with making a diagnosis or may involve the complete removal of a skin lesion. Skin lesions are areas of skin that are growing abnormally or look different to the surrounding skin.
If you would like further information, or have any worries, please do not hesitate to ask your nurse or doctor.
Before the operation
Please avoid alcohol for 48 hours before and after your minor operation and do not smoke for one to two weeks before and after if you can. This will help promote good wound healing.
Blood thinning medications
If you are taking any blood thinning medications such as aspirin or warfarin you should have been given advice before the appointment on whether you must stop these medications for the procedure. If you are unsure, please ask your nurse or doctor.
In general, if you are taking warfarin, please ensure your warfarin blood level or internationalised normalised ratio (INR) is checked 24 to 72 hours before the date of the procedure. Your INR Level must be 3.0 or below for the procedure to take place.
Please contact your anticoagulation clinic (or the blood test unit) to arrange the test and inform them about the surgery. If your INR level is higher than 3.0, please contact the surgical bookings team to reschedule your procedure:
Telephone: 020 8216 5423 or 020 8216 4279.
Royal Free Hospital
Telephone: 0207 794 0500, extension 39601 or 33326.
If you are taking apixaban, rivaroxaban, edoxaban, or fondaparinux sodium, these may need to be stopped at least 24 hours before the procedure. Aspirin and clopidogrel do not usually need to be stopped before minor surgery but your doctor or nurse will advise you. They will also tell you when to restart any medicines after your procedure.
On the day of the operation
On the day of your procedure please eat and drink normally.
You can drive yourself or take public transport to and from the hospital on the day of your minor operation. However, if you are due to have surgery on your face, hands or feet, the dressings after surgery may impede your vision, and may make it difficult to use your hands or feet. In these cases, it is advisable for someone to drive you home or to attend with you. Cycling to and from the hospital is not advisable.
Please bring a list of all the medications that you are taking with you to the minor operations clinic and inform the doctor who is carrying out your procedure if:
- You are allergic to any medicines (you may need to check this with your GP).
- You have ever had any problems with local anaesthetic injections (for instance, at the dentist), or if you are prone to fainting.
- You are allergic to latex, rubber, or sticking plasters.
- You have a heart pacemaker or any electrical implants. This is important as we often use electrical equipment to reduce bleeding during minor operations.
Please note that the doctor or nurse who carries out your minor operation may not be the same as the clinician who saw you in clinic and requested the procedure.
What happens during the operation?
Before your minor operation, the procedure will be explained to you clearly and you will be asked to sign a consent form giving your permission for the operation to be carried out. We will also confirm that any risks and benefits of the procedure have been discussed with you.
You will then be asked to make yourself comfortable on the procedure couch. The clinician will clean your skin with a disinfectant solution. A local anaesthetic which numbs the skin will then be injected into the skin around the area that is being operated on using a fine needle. The local anaesthetic only numbs the affected area and does not put you to sleep. The local anaesthetic blocks any painful sensations, but you may feel touch and pressure during your procedure.
When the clinician is sure that the skin is numb and you cannot feel any pain, the procedure will begin. If at any point you feel any pain, let your clinician know. The procedure commonly lasts between 20-30 minutes but can take up to an hour or more
Once the sample of skin has been taken, your wound will usually be closed with stitches but occasionally the wound is allowed to heal itself with appropriate dressings(called secondary intention healing).
A dressing or plaster is then applied to the procedure site, and you will be able to go home.
After your operation
You will be given a letter for the practice nurse at your GP surgery explaining the details of your procedure and if any stitches need to be removed. Your stitches will need to stay in place for between seven to 14 days before being removed at your GP surgery. You will need to arrange this appointment yourself.
If you have received self-dissolving stitches during your procedure, these do not need to be removed.
We will also write to you and your GP with the results of your minor operation which can take up to four weeks but is usually less. Once we receive the histology results, we may decide that we need to see you again in the dermatology clinic. Details of any further appointments will be sent to you.
Caring for your wound
Your wound site usually needs to be covered for 24 to 48 hours. Sometimes you will be instructed to leave the dressing on for longer (particularly with larger facial procedures). Some wounds require a covering for longer periods; your doctor or nurse will give you precise instructions on wound care after your operation.
We advise that you avoid any exercise for at least one to two weeks after the procedure.
Once you have been instructed to remove the dressing, you can gently wash the wound with clean, soapy water or cooled, pre-boiled water. Soap or Dermol 500 can be used to wash the wound if needed.
We suggest that you avoid swimming until two to three days after all your stitches have been removed or have dissolved.
Common side effects
Minor operations on the skin are generally straightforward procedures. During the procedure, you may experience the following:
- A stinging feeling as the local anaesthetic injection is given, which usually lasts for several seconds.
- There is usually some bleeding during a minor operation which will be reduced with cautery (sealing the blood vessels by a heating/burning technique). There is also a small risk of bleeding after the procedure. The risk of bleeding is greater if you are taking medication to thin the blood.
After the procedure, you may experience the following:
- Some bruising and swelling which will resolve with time.
- The site of the procedure will be tender for several days, but this will lessen as healing progresses.
- There will be a scar where a cut in the skin has been made. Scars are permanent, but most fade over time.
Some people form lumpy scars called hypertrophic or keloid scars as their wound heals. Keloid scars are more likely to form on certain parts of the body and in certain types of skin. The doctor will discuss this with you when you attend the minor operations clinic.
There is always a general risk of infection if the skin is cut. A wound that is infected may have excessive yellowish or clear discharge or may become redder and more uncomfortable. Infected wounds often become more painful with time, rather than less uncomfortable. If you are worried about infection, you should contact your GP or the clinic where you had your operation using the phone numbers below.
Where will my procedure take place?
Minor operations are carried out at different hospital sites across the trust. Please check your appointment letter for which clinic you should attend.