Cautery and Curettage
The curette is an instrument that “scrapes” away the soft tissue that comprises the bulk of some skin cancers. Normal tissue is not affected by curetting. The Cautery (or diathermy) part of the procedure allows the surgeon to seal off any bleeding and at the same time “mop up” any residual tumor cells not removed by curetting.
“C and C”, as it is known, is used for superficial BCCs and superficial SCCs under 10mm not on the face or in hair bearing areas. It should never be used on a suspected Melanoma or invasive tumours.
Clearance rates of tumours are lower than for surgery (70% 5yrs vs 98% 5yrs respectively)
The resulting wound is similar to a burn and generally heals more slowly than a surgical wound. It generally results in a flat white scar 8mm greater in diameter than the skin cancer. C and C is not used in lesions greater than 10mm in diameter due to the false negative rate for invasive tumours on punch biopsies. (larger lesions have more chance of having had an invasive portion missed on the sample initialy sent to the lab)
Curettage, without Cautery, may also be used for a wide variety of benign skin lesions.