I have a small, pin-had sized sabaceous hyperplasia on the tip of my nose. I have been advised that a shave biopsy can be performed to remove the lump followed by cauterizing the wound to stop bleeding. Presumably, after the procedure, there will be a crater wound and I'm concerned that cauterizing will leave a blood clot and encourage an indented scar - is this likely? And, how long will the crater from the excision generally take to "fill in"?
How Likely Is An Indented Scar After Biopsy Of Sabaceous Hyperplasia?
Doctor Answers 4
Scarring from excisional biopsy
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Biopsy of Sebaceous Hyperplasia
In practice, in this situation the best option is for the doctor caring for you to determine how to remove the lesion. Sebaceous hyperplasia, angiofibromas, intradermal nevi, as well as many other types of lesions, can be effectively treated by shave removal and light electrodesiccation of the wound. Any type of surgical procedure leaves a scar. Sometimes shave removal is the best option and sometimes excision and closure is the best option. Your doctor should take into account the factors that might impact wound healing and scarring and present you with the best option given the lesion being treated, the location, your skin type, etc. If you're still not sure, I would recommend that you ask questions of the doctor or even get a second opinion. But I still think that shave removal and light electrodesiccation is a good option for something like sebaceous hyperplasia on the nose. Of course, if there is any confusion as to what the lesion is (i.e. could it actually be a basal cell carcinoma), the specimen should be sent for pathological evaluation.
Scarring after biopsy depends on how its done.
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If your dermatologist is sure that the lesion is sebaceous hyperplasia, you will get the best cosmetic outcome with electrodesiccation followed by curettage. If the lesion grew rapidly and has any chance of being a basal cell skin cancer, a biopsy is needed.