Treatment Options for Skin Lesions: Surgery or Medication? - Surgery

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Hello, Dr.
Ke.
I would like to ask about my recent hospital visit.
The doctor mentioned that I have two smaller nevi and one stage 3 nevus that may become protrusive.
They are generally painless and not bleeding, but I am concerned about potential worsening.
I am unsure what to do and would like to know if continuing to apply ointment or using ligation will help reduce their size.
The doctor said that whether or not to proceed with surgery depends on how much I care about the situation.

Xiao Wu, 30~39 year old female. Ask Date: 2019/07/16

Dr. Ke Fangxu reply Surgery


If hemorrhoids do not cause severe bleeding or intense pain, there is no absolute need for surgery.
Maintaining a good diet and bowel habits can prevent worsening.
Conservative treatment has its limitations and a certain degree of effectiveness.
As the physician mentioned, whether to undergo surgery depends on how much you are concerned about the condition.

Reply Date: 2019/07/16

More Info


When it comes to managing skin lesions, particularly concerning moles or nevi, there are several treatment options available, including surgical intervention and topical medications. The decision on whether to pursue surgery or continue with topical treatments often depends on various factors, including the characteristics of the lesions, patient preference, and the potential for malignancy.

In your case, you mentioned having two smaller nevi and one that is more concerning, described as a stage 3 lesion. It's essential to understand that not all nevi require surgical removal, especially if they are asymptomatic (not causing pain or bleeding) and have not shown any signs of malignancy. However, the concern for potential changes in these lesions is valid, and monitoring them is crucial.


Treatment Options:
1. Topical Medications:
- While there are topical treatments available for certain skin conditions, such as retinoids or corticosteroids, their effectiveness in shrinking nevi is limited. These medications are more commonly used for conditions like acne, psoriasis, or eczema rather than for moles. If your doctor has prescribed a specific topical medication, it may help with inflammation or irritation but is unlikely to significantly reduce the size of a nevus.

2. Surgical Removal:
- Surgical excision is often recommended for nevi that show signs of change, such as asymmetry, irregular borders, multiple colors, or a diameter larger than 6mm. If your doctor has indicated that surgery is an option based on your concerns, it may be worthwhile to consider. Surgical removal not only alleviates anxiety regarding potential malignancy but also allows for histopathological examination of the lesion to rule out skin cancer.

3. Cryotherapy or Laser Treatment:
- In some cases, dermatologists may recommend cryotherapy (freezing the lesion) or laser treatments to remove or reduce the appearance of certain types of skin lesions. These methods can be effective for superficial lesions but may not be suitable for deeper or more complex nevi.


Monitoring and Follow-Up:
Regardless of the treatment path you choose, regular monitoring of your skin lesions is essential. Keep an eye on any changes in size, shape, color, or texture, and report these to your healthcare provider. If you notice any new symptoms, such as itching, bleeding, or crusting, seek medical advice promptly.


Patient Preference:
Ultimately, the decision to proceed with surgery or continue with topical treatments should be a collaborative one between you and your healthcare provider. If the lesions are causing you significant concern, discussing the potential benefits and risks of surgical removal may provide peace of mind. On the other hand, if you prefer to monitor the lesions and are comfortable with that approach, regular follow-ups can help ensure that any changes are addressed promptly.


Conclusion:
In summary, while topical medications may provide some relief for skin irritation, they are unlikely to effectively reduce the size of nevi. Surgical removal remains the most definitive treatment for lesions that raise concern for malignancy. It is essential to maintain open communication with your healthcare provider to determine the best course of action based on your specific situation and preferences. Regular skin checks and awareness of changes in your skin will empower you to make informed decisions about your skin health.

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