Moles and naevi
Excluded
- Long standing lesions, where appearance is the prime motivation for seeking removal of cystic, non-pigmented naevi
Allowable
- Where there is a suspicion of neoplastic change or doubt about the diagnosis
- Symptomatic lesion (regularly infected, traumatised by rubbing on clothes or being regularly cut whilst shaving)
- Large congenital hairy naevi
- Disproportionately large and obviously extremely unsightly pigmented naevi
Sebaceous cysts
Excluded
- To be debated
Allowable
- To be debated
Acne scarring
Excluded
- Generalised poor skin texture following burnt-out acne of the type amenable to treatment by resurfacing techniques (chemical peels, dermabrasion or laser)
Allowable
- Deep ‘pits’ or specific ‘ice pick’ scars may be treated by excision if associated with ingrowing hairs or repeated local infection
Skin tags (Fibroepithelial polyps, pedunculated naevi)
Excluded
- Small, non-pigmented typically axillary and fibroepithelial polyps around the neck and flexures
Allowable
- Large, symptomatic or traumatised lesions
- Pyogenic granuloma – in reality many of these in adults are often malignant melanomas or squamous cell carcinomas
Xanthelasmata
Excluded
- Where improvement in appearance is the factor prompting referral and serum cholesterol is normal
- Xanthelasmata do not cause functional problems
Allowable
- In the presence of a previously raised but controlled serum cholesterol, non smoker and thus when the lesions are a possible manifestation of demonstrable disease
Spider naevi and small cutaneous vascular anomalies
Excluded
- Spider naevi. The treatment is by laser but they are excluded under local dermatological protocols
Allowable
- Congenital vascular anomalies including haemangiomas which can occasionally present as an emergency
- Repeated bleeding from a vascular lesion
- Repeated ulceration of a vascular lesion
- Rapid growth and functional impairment