Curettage is a treatment involving controlled scraping of the skin. The doctor uses an instrument called a curette to scrape off outer layers of the skin. The base layers of the skin are usually left intact. From there the skin can regenerate and heal.
Immediately following curettage, the skin can look like a graze. In a sense the curette technique is a very controlled graze.
Can a curette be used for skin cancers?
Limited numbers of skin cancers can be treated with the curettage technique. These are selected skin cancers that grow only on the outer skin surface. Cancers growing into the deepest skin layers are not suitably treated with curettage.
Curettage is also used for benign lesions such as some premalignant sun damaged lesions as well as warts and selected moles and birth marks. The knowledge of which skin lesions can be managed with the curette and which cannot is actually quite involved and requires much training.
My doctor wants to combine curettage with another treatment modality?
Commonly curettage is combined with cryotherapy or electrodessication (ED). The idea here is that after the curette has scraped off all apparent abnormal cells, the 2nd modality kills a further layer of tissue, thus further reducing the risk of the cancer persisting or recurring. ED is a burning treatment. It has the advantage that it stops most bleeding. However, it can lead to scarring. Cryotherapy does not help surface bleeding but rarely results in scars.
Are there side effects of curettage?
Every treatment can have side effects and the curette is no different. It heals like a graze. Bleeding can occur after the treatment and the area can get infected. At odd times the area can become an ulcer and be very slow to heal. This complication mostly occurs on the leg. A resultant scar is actually quite uncommon after curettage. The area may end up looking more pale than surrounding skin. This may be more related to the cryotherapy often used in conjunction with curettage.
Curette treatment does not always work, even when combined with cryotherapy or ED. If you feel your cancer has persisted or grown back following curette treatment, it is essential that you return to your doctor. Surgical excision may be required.
This is a very different usage of the curette. Here the instrument is used to further identify how far the cancer has spread its roots. When this technique is used, surgical excision always follows.
Dr. Anthony Dixon