Is Curettage and Electrodesiccation Painful?

Reviewed on 10/20/2020

Curettage and electrodesiccation (C and E) is used to treat skin cancer
Curettage and electrodesiccation (C and E) is used to treat skin cancer

You may not feel pain during the procedure because of the numbing agent applied over the area. Once the anesthesia wears off, some amount of pain may be experienced because the procedure involves scraping of the tissue and sealing bleeding with cauterization (using the heating effect of electric current).

The person may experience persistent pain if

  • There is an infection of the site.
  • There is swelling over the site of the procedure.

Sometimes, pain may arise weeks after the procedure from the scar tissue that forms over the site. In any case, it is always prudent to inform your doctor if the pain is severe, throbbing, and accompanying swelling or oozing of the surrounding areas.

How is the curettage and electrodesiccation procedure done?

The procedure is done under local anesthesia. After the area is numbed, the doctor may shave off a part of the mass or lesion and send it away for lab examination (biopsy).

Curettage: The surgeon then scrapes at the remaining tumor with a spoon-shaped instrument called a curette till all the abnormal tissue is gone. The typical “feel” of squamous cell or basal cell carcinoma guides the doctor as to how much to scrape.

Electrodesiccation: A cautery is a small probe with an electric current running through it. The cautery is used to burn or destroy the tissue and seal bleeding vessels in the area. This entire process is called electrodesiccation.

Once the tumor is curetted away, the surgeon uses electrocautery to burn and seal the base of the wound formed during the curetting. He will also curette a surrounding rim of healthy tissue. This prevents bleeding of the area and seals the margins of the healthy tissue.

Once done, the site is bandaged with gauze and petroleum jelly. 

Post-procedure care: You must keep the wound bandaged and dry. Daily dressings with petroleum jelly and gauze may be needed for up to two weeks. The wound will take three to six weeks to heal completely and will leave a scar.

What are the pros and cons of the procedure?

The main advantage of the procedure is that it can be done in an outpatient setting and takes less than one hour. Other advantages are that no stitches are needed, and it is relatively inexpensive.

The disadvantages of the procedure are as follows:

  • The procedure leaves a cigarette burn-like scar.
  • The scar may sometimes pain and ooze for up to six weeks after the procedure.
  • The tumor may recur at the site, needing additional procedures.
  • The procedure cannot be performed if the cancer is in the hair follicles, head, scalp, or anywhere in the midline of the face.
  • We also cannot use this procedure to treat large, poorly defined, or recurrent tumors.

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References
https://www.uptodate.com/contents/minor-dermatologic-procedures?sectionName=CURETTAGE%20AND%20ELECTRODESICCATION

https://www.uptodate.com/contents/treatment-and-prognosis-of-low-risk-cutaneous-squamous-cell-carcinoma?

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