Skin Lesions: Evaluation, Removal, and When to Be Concerned

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A skin lesion is any abnormal growth or area of skin that looks or feels different from the surrounding tissue.

Common types include:

• Moles (nevi)
• Cysts
• Lipomas (fatty lumps under the skin)
• Skin tags
• Keratoses (thickened skin growths)

Most lesions are harmless, but some may need further evaluation.

You should have a lesion evaluated if it:

• Is growing or changing in size, shape, or color
• Has irregular borders or multiple colors
• Bleeds, crusts, or does not heal
• Becomes painful or irritated
• Appears suddenly and continues to change

These features can sometimes be associated with skin cancer and should not be ignored.

Certain types of skin cancer, including Melanoma, may present with specific warning signs.

A helpful guide is the ABCDE rule:

• A – Asymmetry: One half looks different from the other
• B – Border: Irregular or uneven edges
• C – Color: Multiple colors or uneven pigmentation
• D – Diameter: Larger than a pencil eraser (though smaller lesions can still be concerning)
• E – Evolving: Changes over time

If you notice any of these features, prompt evaluation is recommended.

Evaluation typically includes:

• A detailed history and physical exam
• Assessment of the lesion’s appearance and changes over time
• In some cases, a biopsy to determine the exact diagnosis

Biopsy is a simple procedure that provides definitive information.

Many skin lesions can be safely removed with a minor in-office procedure.

During excision:

• Local anesthesia is used to keep you comfortable
• The lesion is carefully removed
• The area is closed with sutures when needed
• The tissue may be sent for analysis

Procedures are typically quick and well tolerated.

Not all lesions need to be removed. Removal may be recommended if:

• There is concern for cancer or precancerous changes
• The lesion is growing or changing
• It causes discomfort or irritation
• It is cosmetically bothersome

Your doctor will help determine the best approach based on your individual situation.

• Mild soreness or swelling is common
• Most patients return to normal activities quickly
• Wound care instructions are provided
• Results from pathology are reviewed to confirm diagnosis

Scarring is usually minimal and depends on the size and location of the lesion.

For trusted, in-depth information, visit:

• Skin Cancer Foundation – Early detection and prevention
• Cleveland Clinic – Diagnosis and treatment of skin conditions

Are most skin lesions cancerous?
No. The majority are benign, but evaluation is important to be sure.

Does removal hurt?
Local anesthesia is used, so discomfort during the procedure is minimal.

Will I have a scar?
A small scar is possible, but care is taken to minimize its appearance.

How do I know if I need a biopsy?
Your doctor will recommend a biopsy if there is any uncertainty about the diagnosis.