PROBLEM

In general, chemical cauterization is done with phenol and trichloroacetic acid to destroy skin lesions. To simplify the procedure, micropipette and syringe outlet are stuffed with cotton wick for a better flow of chemical due to capillary action.[12] However, the corrosive effect of chemicals on metallic needle and on rubber/plastic cap of the piston leads to the leakage of chemicals if the chemical remained in the syringe for a long period. Hypodermic needle and tooth picks have been used for chemical cautery, but it requires frequent dipping into the chemical, which is not safe. Hypodermic needle is described as an alternative for safe, quick, and precise cauterization of multiple small skin lesions.

PROCEDURE

To procure this apparatus, there is a need of a hypodermic needle and cotton wick. The bevel tip of the needle is bent to get a little hook, and over it and its shaft, a small cotton twig is wrapped to get a small cotton bud applicator. The needle is ready to use for chemical cauterization [Figure 1A–D]. After this, the distal part of the needle is dipped into the chemical (trichloroacetic acid, carbolic acid, or desired chemical peeling agents), and the lesion is cauterized without frequent dipping of the needle. By this needle, a number of mini lesions can be cauterized by the vertical application of the needle without surrounding tissue damage. The needle hook is helpful in preventing the slippage of the cotton twig from the needle shaft, which is required for safe chemical application. The tip off needle with mini cotton bud is good for destroying mini skin lesions [Figure 2A–C]. The cotton bud and wrapped cotton on needle shaft act as a small instant cartridge of chemical and a better applicator because of its capillary action as compared to the needle and tooth picks. The spots size depends upon the angle of holding the needle during cautery. The needle can be guarded and capped with hypodermic needle for safety and sterility. Thus, a hypodermic needle with mini cotton ball is a good option for chemical cautery in office.

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Figure 1

(A)–(D) Hypodermic needle is customized into mini cotton ball applicator for chemical cautery

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Figure 2

(A)–(C) Fordyce spots are cauterized with hypodermic needle cotton bud

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POINTS TO LEARN AND ADOPT

1. It is cost-effective and is procured easily.

2. The hooked hypodermic needle gives a better fixation of cotton twig.

3. The stuffs used are readily available in the clinic.

4. There is no problem of frequent dipping of the needle during chemical cautery because of cotton twig as a mini chemical cartridge.

5. There is less or no chance of chemical injury.