Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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Understanding and Managing Dermatofibroma
- Nature of Dermatofibroma: Benign skin growths that are typically harmless but may require removal for cosmetic or comfort reasons
- Diagnosis: Characterised by the distinctive ‘dimple sign’ and usually diagnosed through clinical examination and dermoscopy
- Treatment Options: Excision removes the lesion and keeps the tissue available for examination. Ablative CO₂ laser can destroy it but leaves nothing to examine. Shave reduction can flatten it, with recurrence around 5% against roughly 1% after complete excision
- Recovery Process: Healing typically takes 7-10 days, with full skin remodelling occurring over 6 months
- Aftercare is Crucial: Proper wound care, sun protection, and scar management can significantly improve treatment outcomes
- Cost Considerations: Fees are quoted in writing at the consultation; insurers may cover removal where it is medically necessary
Table of Contents
- Understanding Dermatofibroma: Causes, Symptoms, and Diagnosis
- Professional Treatment Options for Dermatofibroma
- What to Expect During Dermatofibroma Removal
- Recovery Timeline and Healing Process
- Essential Aftercare Tips for Optimal Results
- Managing and Preventing Dermatofibroma Scars
- Is Removal Worth It?
- Cost and Insurance Coverage Guide
Understanding Dermatofibroma: Causes, Symptoms, and Diagnosis
Dermatofibromas are common benign skin growths that typically develop in the dermis layer of the skin. These firm nodules often appear following minor trauma, insect bites, or viral infections, though the exact cause remains unclear. They present as raised, round bumps that range from pink to brown in colour, usually measuring 3-10mm in diameter.
These lesions commonly appear on the lower legs, though they can develop anywhere on the body. When pressed from the sides, dermatofibromas typically show a characteristic dimpling effect known as the ‘dimple sign’, which helps healthcare providers in diagnosis. The growths extend deep into the dermis, making complete removal challenging without professional intervention.
Diagnosis typically involves clinical examination by a dermatologist, who will assess the lesion’s appearance, texture, and mobility. In some cases, dermoscopy may be used for detailed examination, revealing a characteristic central white patch with peripheral pigmentation.
Professional Treatment Options for Dermatofibroma
At London Skin Clinic, we offer several advanced treatment options for dermatofibroma removal. Surgical excision remains the gold standard for complete removal, involving careful extraction of the entire lesion under local anaesthesia. This method provides the highest success rate and allows for histological examination if required.
Laser is offered here, and the type matters. Ablative CO₂ laser can destroy a dermatofibroma; fractionated and non-ablative lasers cannot, and only soften the appearance and texture of the skin over it. The trade-off with any laser is that it leaves nothing to send to the laboratory, so it is unsuitable whenever the diagnosis is not certain. Excision is the only option that removes the lesion and keeps the tissue available for examination. Shave reduction can make a raised lesion less prominent but may leave part of it behind — recurrence after a shave runs at around 5%, against about 1% after complete excision. Cryotherapy is not used for dermatofibroma here. It destroys the lesion rather than removing it, so nothing reaches the laboratory, and it carries a higher risk of leaving a lasting change in skin colour.
Treatment becomes necessary when dermatofibromas cause discomfort, continue to grow, or affect appearance. Our specialists carefully evaluate each case to recommend the most appropriate treatment approach, considering factors such as lesion size, location, and patient preferences.
What to Expect During Dermatofibroma Removal
Before the procedure, our dermatologist will thoroughly cleanse the treatment area and administer local anaesthesia to ensure comfort. For surgical excision, we carefully mark the borders of the lesion and create a precise incision to remove the fibrous growth completely. The procedure typically takes 30-45 minutes, depending on the size and depth of the dermatofibroma.
The specimen is not automatically sent to the laboratory. Histology is requested where something in the history or the examination raises the possibility that the lesion is not a dermatofibroma — and where it is requested there is a further £180 charge. What excision preserves is the option of that examination, which the methods that destroy the lesion do not.
Immediately after treatment, we apply appropriate dressings and provide detailed aftercare instructions. Patients can typically return to normal activities the same day, though some restrictions may apply depending on the treatment method chosen.
Recovery Timeline and Healing Process
The initial healing phase typically spans 7-10 days, during which the treatment site may appear red and slightly swollen. Week one focuses on wound healing and keeping the area clean and protected. By week two, most patients notice significant improvement in comfort and appearance.
During weeks 3-4, the healing site continues to strengthen, though some pink coloration may persist. Full skin remodelling can take up to 6 months, during which time proper scar care is essential for optimal results.
Follow-up appointments are scheduled at 1 week and 1 month post-treatment to monitor healing progress. It’s important to note that while recurrence is uncommon after complete excision, new dermatofibromas may develop in other areas.
Essential Aftercare Tips for Optimal Results
Proper wound care is crucial for optimal healing. Keep the treatment site clean and dry for the first 48 hours. Apply prescribed antibiotic ointment as directed, and change dressings according to your doctor’s instructions. Avoid swimming, excessive sweating, and direct sun exposure for at least two weeks.
Silicone gel or sheeting is the scar measure with the best evidence behind it, and is worth starting once the wound has fully closed. Gentle massage of the area may begin once the wound has fully closed, typically after 2-3 weeks, to help prevent excessive scarring.
Activity restrictions generally mean avoiding strenuous exercise for one to two weeks and keeping the healing site out of direct sun.
Managing and Preventing Dermatofibroma Scars
Professional scar management begins immediately after healing. We offer various treatments including silicone sheets, topical treatments, and advanced laser therapy for optimal scar reduction. Early intervention typically yields the best results in minimising visible scarring.
For home care, we recommend daily sun protection and regular moisturising with recommended products. Gentle massage techniques can help improve scar appearance and maintain skin elasticity. Long-term care involves continued sun protection and regular skin monitoring.
Our clinic provides comprehensive scar treatment protocols, including combination therapy approaches when necessary. Regular assessment helps ensure the best possible aesthetic outcome.
Is Removal Worth It?
A dermatofibroma is usually a firm lump of under a centimetre that will not turn into anything dangerous. Excision replaces it with a linear scar longer than the lesion was wide, because the skin has to be closed in a straight line. That is the whole decision, and it is better stated plainly than buried.
Removal tends to be worth it when the lesion catches on clothing or a razor, when it is tender or itchy enough that you notice it, when it is growing or changing, or when its appearance genuinely bothers you rather than mildly annoying you. It also becomes the right call whenever the diagnosis is not certain, because excision is the only option that produces tissue for the laboratory.
Leaving it alone is reasonable when the lump is stable, painless and somewhere you rarely think about. Nothing is lost by waiting, and a dermatofibroma that has been unchanged for years is not storing up a problem.
The site matters more than most people expect. The lower leg is both the commonest place to find a dermatofibroma and one of the least forgiving places to put a scar: wounds below the knee heal more slowly and the resulting line is more likely to stay visible. A lesion there deserves a more careful conversation than the same lesion on the upper arm.
Cost and Insurance Coverage Guide
Treatment cost depends on the size and site of the lesion. Fees depend on the lesion and are quoted in writing at the consultation — see dermatofibroma removal for the clinic’s current guide pricing. The consultation itself is £100 and is charged separately. Where the specimen is sent for histology there is a further £180 charge. Some insurers cover removal where it is medically necessary — for example where the lesion is painful or interfering with function — but a dermatofibroma removed for appearance alone is normally self-funded.
We offer various financing options to help manage treatment costs, including payment plans and private medical insurance coordination. Factors affecting price include the complexity of removal, number of sessions required, and any additional treatments needed for optimal results.
During your consultation, we provide a detailed cost breakdown and discuss available payment options. Our team assists with insurance documentation when applicable, ensuring transparency throughout the process.
Frequently Asked Questions
Are dermatofibromas dangerous or cancerous?
Dermatofibromas are benign skin growths that are typically harmless. While they are not cancerous, it’s always recommended to have any new or changing skin lesions evaluated by a dermatologist to rule out any potential concerns.
Can dermatofibromas be removed without surgery?
Partly. Ablative CO₂ laser can destroy a dermatofibroma, and shave reduction can make a raised one less prominent, though recurrence after a shave runs at around 5%. Fractionated and non-ablative lasers do not remove it at all. What none of them does is leave tissue for the laboratory, which is why excision is preferred wherever the diagnosis is not certain. Recurrence after complete excision is about 1%.
Do dermatofibromas grow back after removal?
Rarely — recurrence after complete excision runs at about 1%. After a shave reduction it is closer to 5%, because part of the lesion can be left behind. New dermatofibromas may still develop elsewhere.
How painful is dermatofibroma removal?
The procedure is performed under local anaesthesia, minimising discomfort during removal. Post-procedure, patients may experience mild soreness or discomfort, which can typically be managed with over-the-counter pain medication.
What causes dermatofibromas to develop?
The exact cause is unclear, but dermatofibromas often develop following minor skin trauma, insect bites, or viral infections. They are more common in adults and can appear spontaneously without a specific identifiable trigger.
How long does it take to heal after dermatofibroma removal?
Sutures come out at five to seven days on the face, seven to ten on the scalp, seven on the neck, ten to fourteen on the trunk and upper limb, and fourteen on the lower leg. At three months the scar is often still pink, firm and more noticeable than people expect; by twelve months it has usually softened, flattened and faded, though scars continue to mature beyond a year in some people.
Is dermatofibroma removal covered by insurance?
Usually not. Most insurers treat the removal of a benign lesion as cosmetic and will not fund it. Cover becomes possible where there is a medical reason — the lesion is painful, catches and bleeds, or the diagnosis is uncertain and tissue needs to be examined. Insurers will want that reason set out in writing by the clinician before they agree.
Will removal leave a noticeable scar?
Professional removal techniques and comprehensive aftercare can minimise scarring. Our clinic offers advanced scar management treatments, including silicone sheets, topical treatments, and laser therapy to optimise healing and aesthetic outcomes.
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