Even a minor procedure in your dermatologist’s office can be a little scary or even a little intimidating. So I thought today I would show you what we actually do and the instruments that we use to do a minor procedure like scraping off a wart or taking off an unimportant skin growth or mole, and perhaps by seeing that these things aren’t all that scary. Next time you have to go for a procedure like this, it will just be a little bit less anxiety for you. So to start with, we take some alcohol, of course, and we use the same alcohol to clean the skin where we’re going to be working, and we also use it to clean the top of this bottle of anesthesia because, if we’re going to scrape something off, we don’t want you to have any discomfort. Take a syringe, and these things have all been opened but they all come sterilized. If I take the top off the syringe, and I pull back on the plunger, I can bring air in and then I take the needle and put the needle in the top of the anesthesia, and I push the air into the bottle. I then turn it over and you will be able to see the anesthesia coming into the syringe but this needle is much too large to be used to put the anesthesia into the patient, so we take a very tiny needle and this needle is probably one-fifth the diameter and, as you can see, this is a tiny, tiny needle with a very small tip and, when I put this into your skin and put the anesthesia in, it’s not very painful and you’ll barely feel it at all so, at this point, we’ve actually put the anesthesia into the skin and we’ve made the skin numb. Then it’s time to take an instrument and scrape off the wart or the growth, and the most common instrument we use is called a curette, and a curette is really a circular or a round knife. This is the back of it, and it’s kind of blunt, but this is the front, and the front of the curette is this round, very sharp edge and, with that, if there’s a bump on my skin and I start to scrape, that bump will come off whether it’s a wart or a mole. Sometimes we can’t remove it just by scraping. Sometimes we need a scalpel blade, and this is a small one, it’s very sharp, and don’t forget the skin has been injected with local anesthesia, so it’s completely numb, and sometimes we use a sawing motion with that blade to actually cut off the growth. Obviously, there’s a small amount of bleeding so we use gauze to control the bleeding, and then we take a special liquid, and this is called Monsel’s solution which is an iron compound and, on a Q-tip, we take some of that iron compound and we touch it to the skin where’s it bleeding and the iron causes the blood to clot. It’s a little bit like an advanced or stronger styptic pencil that people use to stop nicks from bleeding after they’ve shaved. Then, of course, a Band-Aid is in order with some topical antibiotic ointment, a regular Band-Aid on the area that’s been removed, and it’s then best to get healing with an antibiotic ointment and Band-Aid applied to keep the ointment there 3-4 times a day for a period of a week to two weeks. That’s all that’s involved in having these small procedures done and, no matter how familiar you are with the instruments, of course, you’re going to have a little bit of anxiety, but I hope that this introduction just makes your next procedure a little bit easier for you.
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