Curettage is a medical procedure that uses a spoon-shaped surgical instrument called a curette to scrape and remove tissue from a body cavity or surface. It’s one of the most versatile techniques in medicine, used by gynecologists, dermatologists, dentists, and orthopedic surgeons for everything from diagnosing abnormal bleeding to removing skin cancers and bone tumors. The basic principle is always the same: a small scooping or scraping tool removes unwanted or abnormal tissue while leaving healthy tissue intact.
How the Procedure Works
The curette itself has been around since 1843, when a French gynecologist named Recamier designed the first one as a small scoop with a long handle. Modern curettes come in dozens of shapes and sizes depending on the job. Some have sharp edges for scraping, others connect to suction devices, and they range from a few millimeters wide for delicate dental work to larger instruments designed for the uterine cavity. Some are rigid metal, others are flexible plastic.
Regardless of the specialty, curettage follows the same logic. The surgeon positions the curette against the tissue to be removed, then uses a controlled scraping or scooping motion to separate it from the underlying surface. In gynecological procedures, the doctor rotates the curette 360 degrees while pulling it along the uterine walls in repeated passes. A gritty texture against the curette signals that the target tissue has been fully removed. In skin procedures, the curette is drawn across a lesion in short strokes, taking advantage of the fact that abnormal tissue is often softer than healthy skin and separates more easily.
Gynecological Curettage (D&C)
The most well-known form of curettage is dilation and curettage, commonly called a D&C. It’s one of the most frequently performed invasive procedures in the United States. The procedure happens in two steps: first, the cervix is gradually widened using small rods or medication, and then a curette is inserted through the cervix into the uterus to remove tissue from the uterine lining.
A D&C serves both diagnostic and therapeutic purposes. Doctors use it to investigate unexplained uterine bleeding by collecting tissue samples for analysis. It’s also used to remove remaining tissue after a miscarriage, to treat excessive bleeding, and as a method for first-trimester pregnancy termination. In non-pregnant patients, the goal is to remove the outermost functional layer of the uterine lining while preserving the deeper base layer, which regenerates the lining each menstrual cycle.
Anesthesia for a D&C varies. Some are done under general anesthesia, others with spinal or epidural numbing, and some with local anesthesia injected into the cervix. When general or spinal anesthesia is used, you’ll typically need to fast for eight hours beforehand. A related technique, vacuum aspiration, achieves similar results using suction rather than scraping. Cochrane reviews have found both methods are safe and effective, with no significant differences in complication rates. Vacuum aspiration is slightly faster, by roughly one to two minutes, which can matter when local anesthesia is used.
The risk of uterine perforation (the curette accidentally passing through the uterine wall) ranges from 0.1% to 4%, depending on the specific procedure and individual factors. When curettage is performed during or after pregnancy, surgeons must be careful not to scrape too deeply, as removing tissue beyond a certain layer can lead to scarring and adhesions inside the uterus.
Skin Curettage
Dermatologists use curettage to remove a variety of skin lesions, from warts and benign growths to certain skin cancers. The procedure is typically done in an office under local anesthesia. After numbing the area, the doctor uses a small, sharp curette to scrape away the abnormal tissue.
For basal cell carcinomas, the most common type of skin cancer, curettage is frequently paired with electrodesiccation, a technique that uses an electric current to destroy remaining cancer cells and stop bleeding. When performed by experienced physicians, this combination achieves cure rates above 90%. Recurrence rates are higher for tumors on the nose, around the nose, and on the forehead, where the skin’s contours make complete removal more difficult. Cosmetic results tend to improve over time as the wound matures, and significant complications beyond occasional raised scarring are uncommon.
Dental and Periodontal Curettage
In dentistry, curettage targets the infected or inflamed tissue inside periodontal pockets, the gaps that form between teeth and gums when gum disease progresses. Subgingival curettage (below the gumline) is often combined with root planing, a process that smooths the tooth root surface to help gums reattach. Together, these procedures remove bacterial plaque, calculus, trapped food debris, and diseased soft tissue from the pockets. This basic treatment approach can control the progression of periodontitis and prevent further loss of the bone and tissue that support your teeth, even in moderate-to-severe cases.
Bone Tumor Curettage
Orthopedic surgeons use curettage to treat benign bone tumors and cyst-like lesions. The surgeon opens a window in the bone and uses curettes to scrape out the abnormal tissue from inside the cavity. Compared to removing an entire section of bone, curettage preserves more of the bone’s structure and typically leads to better long-term function, though it does carry a somewhat higher chance of the tumor returning locally.
To reduce recurrence, surgeons often use additional methods after scraping, such as applying extreme cold, chemical agents, or bone cement to the cavity walls to destroy any remaining tumor cells. The empty cavity can then be filled with bone graft material or cement to restore strength, though research on 42 patients with benign bone tumors found that even unfilled cavities have a strong capacity to generate new bone and remodel to sufficient strength for daily activity. Larger tumors (roughly over 70 cubic centimeters) tend to have higher complication rates regardless of technique.
Recovery After Curettage
Recovery depends heavily on where the curettage was performed and how extensive it was. Skin curettage sites heal from the bottom up, and the wound is left open rather than stitched in most cases. You’ll want to wash the area gently once or twice a day with cool water and soap, avoiding alcohol, peroxide, iodine, or antibacterial cleansers, all of which can damage healing tissue and slow the process. A scab will form and peel away on its own, typically within one to three weeks.
After a D&C, most women experience some cramping and light bleeding for several days. Strenuous activity should be limited to prevent reopening the wound. Recovery from bone curettage is longer and depends on the size and location of the cavity. Weight-bearing may be restricted while the bone regenerates, a process that can take weeks to months.
Across all types, the general principles of aftercare are the same: keep the site clean, avoid harsh chemicals on healing tissue, limit physical strain, and watch for signs of infection like increasing redness, swelling, or fever.