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Concierge dermatology · London

Curettage and cautery of skin lesions, by a consultant dermatologist.

A quick, in-clinic procedure to remove benign and low-risk skin lesions — with dermoscopy first, so anything suspicious for melanoma is excised instead, not curetted.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why patients choose us

  • 01

    A dermatologist, dermoscopy first

    Every lesion is looked at through a dermatoscope by a consultant dermatologist — or a GP with formal dermoscopy training — before a curette goes near it.

  • 02

    Melanoma-suspicious? We stop.

    If a lesion is at all suspicious for melanoma, we do not curette. It goes for excisional biopsy so histology is intact.

  • 03

    Independent, and free

    We are paid by no clinic, so the recommendation is impartial and costs you nothing.

Indicative pricing

What curettage and cautery costs privately in London.

Indicative ranges across our partner clinics. Send a photo and the details and we quote firm figures across two or three options.

In short

A single benign lesion, dermoscopy and treatment: £350–£650, done in one visit.

Procedure Indicative range
Dermoscopy consultation only £200–£400
Curettage and cautery — single benign lesion £350–£650
Curettage and cautery — multiple benign lesions £500–£1,200
Curettage and cautery — superficial BCC (low-risk) £750–£1,400
Curettage and cautery — Bowen’s disease / AK £500–£1,100
Excisional biopsy (if C&C not appropriate) £600–£1,500

Prices vary by clinic, by which dermatologist does the case, by the number of lesions treated on the day, and by whether histology is required. We come back with a firm quote within one working day.

The problem

The right lesion, the right technique, and dermoscopy first.

Curettage and cautery is a quick, useful tool — but only for the right lesions. The commonest problem in the private market is using it on things that should be excised. We stop that.

  • Melanoma-suspicious lesion?

    It gets an excisional biopsy — never a curette. Curettage destroys the tissue the pathologist needs.

  • BCC on the face?

    A high-risk BCC on the face, ears, nose or lips needs Mohs surgery, not C&C. We say so.

  • Recurrent or infiltrative?

    A previously treated BCC or SCC that has come back, or an infiltrative subtype, needs excision — not another curette.

The journey

From dermoscopy to healing check — what happens, in order.

One clinician from first message to the healing review — including the histology result.

  1. 01

    Before

    You tell us what is going on

    A short, confidential form. Where the lesion is, how long it has been there, whether it bleeds, itches or has changed.

  2. 02

    Before

    We come back with a recommendation

    Within one working day: which clinician suits, whether curettage and cautery is appropriate, or whether an excisional biopsy is safer.

  3. 03

    On the day

    Dermoscopy first, in clinic

    A consultant dermatologist examines the lesion under a dermatoscope. If anything about it is suspicious for melanoma, curettage is abandoned and excision is arranged.

  4. 04

    On the day

    Local anaesthetic infiltration

    A small volume of lidocaine with adrenaline is infiltrated around the lesion. It stings briefly, then the area is numb within minutes.

  5. 05

    On the day

    Curettage and cautery

    A sharp or ring curette scrapes the lesion away, followed by electrocautery, hyfrecator or diathermy to stop bleeding and destroy any residual cells. For low-risk BCC, up to three cycles are performed.

  6. 06

    After

    Healing by secondary intention

    The wound is left open with a simple dressing. It heals over three to four weeks, forming a scab that separates on its own.

  7. 07

    After

    Healing check and histology

    Curetted tissue is sent for histology. A review confirms complete treatment, the final scar and — for skin cancers — the margin status.

Typical end-to-end: 1–2 weeks from enquiry to procedure. Full healing: 3–4 weeks.

When it helps

When curettage and cautery is the right technique.

The lesions we treat most with C&C — plus the one red flag that means excision instead.

  • Seborrhoeic keratosis

    Warty, stuck-on brown or black lesions. Benign, but often removed for cosmetic reasons or if catching on clothing.

  • Pyogenic granuloma

    A fast-growing, friable red bump that bleeds easily. Curettage and cautery is the standard treatment.

  • Superficial BCC — low-risk sites only

    For low-risk subtypes on the trunk or limbs. Not for high-risk areas (face, ears, nose, lips) or infiltrative or recurrent tumours.

  • Bowen’s disease (SCC in situ)

    Squamous cell carcinoma in situ. Curettage and cautery is an accepted option for thin lesions on the trunk or limbs.

  • Actinic keratoses — thicker lesions

    For hyperkeratotic AKs that have not responded to topical treatment or cryotherapy.

  • Warts refractory to cryotherapy

    Stubborn viral warts that have failed repeated cryotherapy — curettage debulks the lesion and cautery destroys the base.

  • Molluscum contagiosum

    Occasionally used for persistent or troublesome molluscum lesions in older children and adults.

  • Red flag: melanoma-suspicious lesion

    Any lesion suspicious for melanoma must go for excisional biopsy — not curettage. Curettage destroys the architecture pathologists need to stage it.

Options

Curettage and cautery is one of several options.

What each option actually involves — and which fits which lesion.

  • Curettage and cautery

    A sharp or ring curette scrapes the lesion away and electrocautery, hyfrecator or diathermy destroys residual cells and controls bleeding.

  • Excisional biopsy

    Full-thickness excision with sutures. Required for any melanoma-suspicious lesion, and preferred for high-risk BCC or SCC.

  • Mohs micrographic surgery

    Staged excision with margin-mapped histology. The gold standard for high-risk BCC on the face, and for recurrent or infiltrative tumours.

  • Cryotherapy

    Liquid nitrogen freezes the lesion. Good for AKs, warts and small seborrhoeic keratoses. Less effective for thicker lesions or superficial BCC.

  • Topical 5-fluorouracil

    A cytotoxic cream for AKs and thin Bowen’s disease. Takes weeks of daily application with brisk inflammation.

  • Topical imiquimod

    An immune-response modifier for superficial BCC and Bowen’s disease. Six weeks of nightly application.

  • Photodynamic therapy (PDT)

    A light-activated cream selectively destroys abnormal cells. Good cosmetic outcome for superficial BCC and Bowen’s disease on the face.

  • Dermoscopy consultation only

    An honest look under the dermatoscope to decide whether the lesion needs anything at all — no obligation.

Our vetted London network

A small panel of dermatologists, we picked them.

Consultant dermatologists (and GPs with formal dermoscopy training) across central, north, west and south London. Introductions are made privately, once we understand your case.

Selection criteria

How we choose every dermatologist in our network.

A modern London dermatology treatment room set up for curettage and cautery
Consultant-led dermatology
  • Consultant dermatologists, or GPs with formal dermoscopy training

  • Dermoscopy performed before every skin procedure

  • Histology sent on every skin-cancer case, with margin review

  • Melanoma-suspicious lesions never curetted — excised for intact histology

Safety and recovery

What to expect afterwards — honestly.

Curettage and cautery is a common, safe in-clinic procedure. The things worth planning are the scar, healing time on lower legs, and knowing what is normal.

  • Hypopigmentation is common

    The healed area often ends up paler than surrounding skin, especially on darker skin types. Discuss this before agreeing to the procedure on visible sites.

  • Hypertrophic and keloid scars

    A raised, thickened scar can form — more likely on the chest, shoulders, upper back, and in people with a keloid tendency. Not always predictable.

  • Delayed healing on lower legs

    Wounds below the knee heal slowly, especially in older adults, diabetics and those with poor circulation. Weeks, sometimes months.

  • Bleeding on anticoagulants

    Warfarin, DOACs, clopidogrel and even aspirin increase bleeding. Do not stop them without advice — the team plans around them.

  • Secondary infection

    A small proportion of wounds get infected. Warmth, spreading redness, pus or fever after day three is not normal — call the clinic.

  • Incomplete margin on skin cancer

    For BCC or Bowen’s disease treated with C&C, histology occasionally shows residual tumour. Re-excision or Mohs is then arranged.

  • Contact dermatitis to dressings

    Adhesive dressings and topical antibiotics can cause a red, itchy reaction around the wound. Usually settles with a different dressing.

  • Recurrence rates matter

    For low-risk superficial BCC, C&C has a higher recurrence rate than excision or Mohs. Acceptable for the right lesion — worth knowing.

  • Red flags

    Spreading redness, fever, heavy bleeding, or a lesion that regrows or changes at the treated site — call the clinic or your GP.

Reading your procedure note

Your procedure note in four parts. Read the last one first.

Whichever lesion was treated, the note the dermatologist sends you keeps to the same shape.

A UK consultant dermatologist reviewing a patient’s procedure notes

A quiet reminder

Dermatological language is precise and can read coldly — we translate it for you.

If you would like us to talk you through the note before your review, just ask.

  1. 01 Header

    Lesion and indication

    Which lesion was treated, where, and why — seborrhoeic keratosis, pyogenic granuloma, superficial BCC, Bowen’s disease and so on.

  2. 02 Technique

    Dermoscopy, LA and cycles performed

    Dermoscopic findings, the local anaesthetic used, and how many cycles of curettage and cautery were performed.

  3. 03 Findings

    Macroscopic and histology result

    What the lesion looked like and, for skin cancers, the histology result — subtype, margin status, and whether it was completely treated.

  4. 04 Impression

    Healing plan, review and follow-up

    Read this first: expected healing, dressing plan, when to be reviewed, and whether any further treatment is needed.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for curettage and cautery varies by insurer and by indication — usually funded when medically indicated (BCC, Bowen’s disease, symptomatic lesions), self-pay for cosmetic removal. We confirm cover before booking.

Frequently asked

Everything we get asked about curettage and cautery.

Quick answers on pain, scars, alternatives, and what happens if the lesion turns out to be something else.

  • What is curettage and cautery?

    A dermatological procedure that removes a skin lesion in two steps. A curette (a small spoon-shaped instrument) scrapes the lesion away, then electrocautery, a hyfrecator or diathermy is used to stop bleeding and destroy any residual cells. For low-risk basal cell carcinoma, the cycle is usually repeated up to three times.

  • Which lesions is it used for?

    Seborrhoeic keratoses, pyogenic granulomas, low-risk superficial basal cell carcinoma on the trunk or limbs, Bowen’s disease (squamous cell carcinoma in situ), thicker actinic keratoses, warts that have failed cryotherapy, and occasionally molluscum contagiosum. It is not used for anything suspicious for melanoma.

  • Why not use it for melanoma-suspicious lesions?

    Curettage destroys the tissue architecture pathologists need to diagnose and stage melanoma. Any pigmented or changing lesion that could be melanoma must have an excisional biopsy so the pathologist sees the whole lesion intact.

  • Does it hurt?

    The local anaesthetic injection stings briefly. After that the area is numb and you feel only pressure. Afterwards it is sore for a day or two — paracetamol is usually enough.

  • How long does it take to heal?

    The wound is left open to heal by secondary intention, which takes three to four weeks in most areas. Wounds on the lower legs, in diabetics or in older adults heal more slowly.

  • What does the scar look like?

    A flat, round, paler patch of skin. The colour difference is usually more noticeable on darker skin types. Occasionally the scar becomes raised (hypertrophic) or thickened (keloid), particularly on the chest, shoulders or upper back.

  • How does it compare to excision?

    Excision gives a linear scar and full histology, and is preferred for anything suspicious, high-risk, recurrent or on the face. Curettage and cautery is quicker, needs no stitches, but leaves a paler round scar and has higher recurrence rates for skin cancers.

  • What are the alternatives?

    Depending on the lesion: excision, Mohs micrographic surgery, cryotherapy, topical 5-fluorouracil or imiquimod, and photodynamic therapy. A good dermatologist walks you through which fits your lesion and your priorities before you decide.

  • What are the red flags after the procedure?

    Spreading redness beyond the wound, fever, pus, heavy bleeding, or a lesion that regrows or changes at the treated site — all reasons to call the clinic or see your GP.

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In practice, in London

Why private curettage cautery lesions moves differently in London

For curettage cautery lesions, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. Waiting lists on the NHS for curettage cautery lesions vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.

A typical private booking for curettage cautery lesions in London starts with a consultant conversation — sometimes in person on Harley Street or Marylebone, sometimes on video if that suits better. Any imaging or diagnostics happen at a nearby CQC-registered facility, and reports usually land within 24 to 72 hours. The whole loop, from first call to written report, is often done inside a fortnight. For curettage cautery lesions in particular, we bias towards consultants who do this every week rather than every month.

Honesty about expectations is part of the job. A private curettage cautery lesions appointment in London won’t change the underlying medicine — the guidelines, the consultants, and the equipment are largely the same as on the NHS. What it changes is speed, continuity, and the amount of time you get to actually talk through the findings. Everyone we route to is GMC-registered and works within CQC-regulated facilities.

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