What are the options for syringoma removal?
The options for syringoma removal and treatment are:
- Excision. This is a Technique performed by using a Scalpel. This is the traditional method of removing syringomas but it is not generally in use nowdays because it is invasive and prone to cause scarring and infections.
- Superficial Electrofulguration. By using this technique syringoma are removed safely by using a mild electrical arc
- Superficial syringoma ablation by using cosmetic lasers.
- Cryotherapy by freezing the syringoma off
Excision is usually used to remove a sample of the skin which will be sent to a Lab to determine whether the lesion is benign or not.
However by doing so the lesion itself is removed. Nowadays, there is little point on using this technique for Syringoma removal, because normally excision for biopsy is not strictly necessary as these lesions are quite easy to recognise.
The main problem with excision using a scalpel is that it will almost always leave a permanent scar. Tbis is beause an excision using a scalpel almost inevitably damage the inner part of the dermis and a permanent scar is normally left after the procedure.
In rare cases the dermatologist may be very precise and find it possible to use the scalpel with a high degree of precision and accuracy wich will result in the removal the Syringoma without leaving any trace after healing.
Electrcofulguration is one of the preferred methods for Syringoma removal, this is because these lesions are epidermal therefore a superficial ablation using an electrical cautery machine shold suffice to remove the lesions without leaving any marks after healing.
The instrument to be used for the ablation needs to be quite precise and the dermatologist should opt for an instrument which is quite low power. In this way the syringoma can be leveled off easily.
If the lesion is levelled off properly and there are no infections during healing, the Syringoma will be gone only after one session at the Clinic.
Lasers for Syringoma removal operate in a the similar fashion as normal electric desication seen above for syringoma removal by superficial ablation. Procedures using ablative lasers are usually far more expensive than conventional electricofulguration. This is due to the amount of traning necessary in order to operate a dermatological ablative laser and also the cost of the laser machine itself (which can range from 10K USD up to 50K USD).
Said that the outcome of laser syringoma removal and syringoma removal by electrofulguration are the same if both performed properly.
One of the advantages of using Either Electrcal dessication or laser removal is that usually one session will suffice for the complete removal of the Suringoma. Remember that the outcome of the prcedure is very dependant on the ability of the equipment operator.
Cryotherapy is generally used to remove both benign and non benign lesions. Because it can be used to remove malignant lesions it is also referred as cryosurgery.
The way Cryo threpy works to remove Syringoma is by freezing them off. Despite the fact that this technique is used mainly to treat medical conditions it is also used by some dermatologists to remove Syringoma.
The use of custom formulated peels is one of the best way fo treating and removing the syringoma. It is used in Clinics and the preferred peel option in clinics is the use of TCA, This is because using the appropriate concentration of TCA on these lesions will lead to the ablation of the Syringoma wtihin one sessions (Provided that concentration used is appropriate). If the TCA concetration is too high this treatment can esily lead to scarring as TCA is a very strong Chemical Ablator.
The main issue with TCA is that is almost always lead to swelling which at time can turn out quite severe. Also the person who applies the TCA solution should be able to recognise when is the right time to neutralize the effect of the TCA.
Of course this is not difficult for a trained and experianced nurse or physician.
Different peels to TCA should be used for home Syringoma removal. The ones for this applications can be Mandelic, Pyruvic and Glycolic Acid. The reason to avoid the use of TCA for home use is because it is considered too strong for home use. Also the risks associated with their use is far lower and the the ablating effect of the above peels can be symply stopped by wiping them off and rinsing with water.
The only disadvantage of using Custom made preels is that multiple applications may be required to achieve complete removal. In some cases of not paticularly raised Syringoma a single application should suffice. In most cased more than one application are required to achieve the complete disappearance of the Syringoma.