Shave biopsy and excision aftercare

Shave biopsy or excision is a minor procedure with a very low rate of complications. However, because it removes the top layer of skin, there is a risk of infection and scarring following treatment.

You can further reduce the risk of scarring and speed the wound healing by following these principles:

• Prevent the wound from drying out and forming a thick scab.
• Reduce the risk of infection.
• Encourage growth of healthy scar tissue.
• Prevent the scar tissue from becoming elevated.

The shave procedure removes the top layer of skin, leaving a raw patch which may bleed for the next 1-2 days.

Sometimes this raw patch is cauterised during the procedure, which reduces bleeding but may be uncomfortable and may secrete a yellow exudate as it heals. This is a normal part of wound healing and does not necessarily mean the wound is infected. If the wound feels tender and hot to touch, it can be a sign of infection, especially if the surrounding skin is red.

What to expect after treatment

Pain relief

It is very unusual for there to be significant pain following this procedure. If you need to take pain relief, avoid aspirin and non-steroidal inflammatory drugs such as naproxen, ibuprofen and diclofenac. These can cause bleeding.

If pain relief is required, we recommend paracetamol or paracetamol/codeine.

Wound dressing

Your wound will be dressed with either:

• Alginate dressing – made from seaweed – which absorbs blood and draws exudate away from the wound base, covered by a plastic film;
• A non-adherent ball or cotton gauze covered by plastic film, or
• A spray-on film (if your wound is an area where it’s not practical to stick on a dressing).

There may be a crepe bandage wrapped around the area to control bleeding. If so, leave this bandage on overnight.

Leave the dressing in place for 3 days and keep the wound as dry as possible. After 3 days, remove the dressing. If the dressing sticks to the wound, you can gently soak it with water. After removing the dressing, you can apply a Band-Aid if you find the wound unsightly, but this is optional.

If you have a spray-on dressing, it will gradually come away by itself as you wash the wound normally over the next few days.

Silicone gel

If you wish to minimise the risk of scarring and infection after removing the dressing, apply a silicone gel to the wound up to three times per day.

We recommend that you use a medicated gel such as Epicyn, which contains hypochlorous acid, although plain silicone gel also has beneficial effects.

Silicone gel assists wound healing by sealing the wound and preventing it from drying out and developing a thick, crusted scab. Hypochlorous acid has antibacterial properties and can help prevent infection of applied directly to the wound, even when it is still open. It also stimulates the activity of fibroblasts and keratinocytes, helping the wound to heal faster. Studies have shown that wounds treated with hypochlorous acid have less infection, exudate, pain and itching and less risk of keloid scarring.

For best results, apply silicone gel to the wound 2 or 3 times daily for up to three months.