Radiosurgical removal of a skin lesion (papilloma) - 1 lesion

Radiofrequency cauterization of cutaneous lesions is a minimally invasive dermatological procedure that uses radiofrequency current for the precise and controlled removal of superficial skin lesions.

Cutaneous papillomas (also known as skin tags) are soft, benign growths, typically pedunculated and a few millimeters in diameter, commonly found in areas exposed to friction, such as the neck, armpits, inframammary folds, and groin. Although painless and benign, they may become aesthetically bothersome, irritated, or prone to minor bleeding as a result of repeated mechanical trauma.

A papilloma is a benign epithelial growth that may be associated with viral infection (including certain HPV-related lesions) or degenerative processes. It occurs more frequently in individuals with genetic predisposition, obesity, diabetes mellitus, or metabolic disorders. Lesions may be solitary or multiple and often cause aesthetic concerns or local irritation.

Radiofrequency cauterization is considered the treatment of choice for the removal of these lesions, offering a safe, effective approach with excellent cosmetic outcomes.

Components Evaluated Before the Procedure

• Shape, size, and number of papillomas
• Anatomical location of the lesions (areas exposed to increased friction, such as the neck, axillae, inframammary region, and groin)
• Presence of inflammation, bleeding, or repeated trauma
• History of recurrence or tendency toward multiplication
• Differentiation from other skin lesions (e.g., warts, keratoses, pigmented nevi)

Purpose of the Procedure

• Removal of aesthetically bothersome or uncomfortable lesions
• Prevention of bleeding, irritation, or secondary local infection
• Achievement of an optimal cosmetic result with minimal scarring
• Diagnostic confirmation through histopathological examination when indicated

Indications

• Solitary or multiple papillomas located in areas prone to irritation
• Lesions frequently irritated by clothing, jewelry, or shaving
• Patient request for cosmetic removal
• Lesions that have recently increased in size or become symptomatic (itching, bleeding)

Relative Contraindications

• Active infection in the treatment area
• Lesions with suspicious features (rapid changes in color, shape, or borders)
• Uncontrolled coagulation disorders
• Pregnancy (for genital lesions suspected to be HPV-related)

Procedure

• The treatment area is properly disinfected.
• Local anesthesia is administered if necessary, depending on the size and location of the lesion.
• The papilloma is removed using a radiofrequency electrode.
• A sterile dressing is applied, and post-procedure care instructions are provided.

Procedure duration: 5–10 minutes

Healing time: approximately 5–7 days, during which a superficial crust forms and detaches naturally.

Post-Procedure Recommendations

• Avoid water exposure and friction in the treated area for the first 24–48 hours.
• Do not remove the crust; it will detach naturally.
• Apply a local antiseptic as recommended by your physician.
• Avoid sun exposure during the healing period.

Advantages

• Fast, precise, and virtually painless procedure
• Excellent cosmetic outcome without the need for sutures
• Low risk of recurrence when proper local care is maintained
• Multiple lesions can be treated during the same session
• No hospitalization or prolonged recovery period required

Sources:

https://pmc.ncbi.nlm.nih.gov/articles/PMC2840904/
https://pmc.ncbi.nlm.nih.gov/articles/PMC4835659/
https://journals.lww.com/ijd/fulltext/2007/52030/radiofrequency_ablation_in_dermatology.3.aspx
https://www.researchgate.net/publication/330628612_Comparative_study_of_efficacy_of_radiofrequency_ablation_electrodesiccation_and_cryosurgery_in_the_treatment_of_cutaneous_warts
https://www.aafp.org/pubs/afp/issues/2015/1001/p601.html