Surgery for skin cancer
About skin cancer surgery
Surgery is often used to treat skin cancer. It may be the only skin cancer treatment you need. This information is about surgery for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). These are the most common types of skin cancer.
For BCC or SCC skin cancer, the type of surgery you have depends on the size of the cancer and where it is. The aim is to remove the skin cancer safely and with the least amount of scarring. Your doctor or nurse will explain what to expect and how they can support you. They will give you information about:
- the type of surgery and what it involves
- where you will go to have it done
- how to look after the wound as it heals.
Melanoma surgery
Surgery is also the main treatment for a type of skin cancer called melanoma. We have separate information about melanoma surgery. This includes information about further tests or treatments you may need after surgery.
Related pages
Skin cancer excision
Most small skin cancers are removed in a minor operation called an excision. Most excisions are done using a local anaesthetic, and you can go home the same day.
The surgeon or dermatologist removes (excises) the cancer and some normal-looking skin around it. The normal-looking skin is checked under a microscope to make sure that the cancer has been completely removed. A larger skin cancer is more likely to be removed while you are under a general anaesthetic. The area of skin removed may be replaced with a skin graft or skin flap.
A type of surgery called Mohs micrographic surgery is also sometimes used. This is also called a margin-controlled excision. This is when layers of skin are removed until all the cancer is gone.
Skin grafts and skin flap
If the cancer is large or has spread, a larger area of skin may need to be removed while you are under a general anaesthetic.
The area of skin removed may be replaced with a healthy layer of skin from another part of the body. This healthy layer of skin is called a skin graft. Less commonly, you may need a skin flap surgery. This is when a slightly thicker layer of skin is used.
After a skin graft, you can usually go home on the same day. Some people may need a short stay in hospital. It depends on where the graft is and how big it is. You may need to stay in hospital for a few days after skin flap surgery.
What is Mohs surgery for skin cancer?
Mohs micrographic surgery is a specialised surgery. It is sometimes called a margin-controlled excision. Your doctors will refer you to a hospital that specialises in this type of surgery if they think you might need it.
During Mohs surgery, the surgeon removes the cancer in thin layers one at a time. They look at these layers under a microscope during the operation. They continue to remove layers until no cancer cells can be seen in the tissue. This technique makes sure that all the cancer cells are removed and that only a very small amount of healthy tissue is removed. It is often done under a local anaesthetic. You are usually allowed to go home the same day.
You may also need to have a skin graft or skin flap to cover the wound.
Mohs surgery can be used for skin cancers that:
- have come back in the same place after removal
- could not be fully removed
- are faster-growing and have begun to spread into the surrounding area
- are on the face, where it is important to remove as little tissue as possible to leave the smallest possible scar
- are larger– for example, if they are larger than 2cm.
Curettage and electrocautery
Curettage and electrocautery involves scraping away the cancer and using heat or electricity to stop any bleeding. It is usually only used for skin cancers that are small.
First, the doctor or nurse gives you a local anaesthetic to numb the area. Once the area is numb, the doctor scrapes away the cancer using an instrument called a curette. They then use an electrically heated loop or needle to stop any bleeding from the wound. This is called cauterising the wound. This also destroys any remaining cancer cells.
After skin cancer surgery
Before you go home, your hospital team will explain how to take care of the wound and the dressing. If necessary, they can arrange for a district nurse to change your dressing at home. Or they may advise you to go to your GP surgery or return to the hospital to have the dressing changed.
You may have stitches that need to be removed 5 to 14 days after your operation or once the wound has healed. Sometimes surgeons use dissolvable stitches that do not need to be removed.
If you had a skin graft or skin flap surgery, it's important to try to rest for the first 2 of weeks after surgery. You will need to allow time for the skin graft or skin flap to heal properly.
You can visit our Online Community skin cancer forum to talk with people who have been affected by skin cancer, share your experience, and ask an expert your questions.
Related pages
About our information
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References
Below is a sample of the sources used in our skin cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Keohane SG, Botting J, Budny PG, et al. British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma 2020. The British Journal of Dermatology. 2021;184(3): 401–414. Available from www.doi.org/10.1111/bjd.19621 [accessed May 2024].
Nasr I, McGrath EJ, Harwood CA, et al. British Association of Dermatologists guidelines for the management of adults with basal cell carcinoma 2021. The British Journal of Dermatology. 2021;185(5): 899–920. Available from www.doi.org/10.1111/bjd.20524 [accessed May 2024].
Sharma A, Birnie AJ, Bordea C, et al. British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma in situ (Bowen disease) 2022. The British Journal of Dermatology. 2023;188(2): 186–194. Available from: www.doi.org/10.1093/bjd/ljac042 [accessed May 2024].
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Samra Turajlic, Consultant Medical Oncologist.
With thanks to: Dr Stephanie Arnold, Consultant; Kerry Jane Bate, Advanced Nurse Practitioner; Dr Philippa Closier, Clinical Oncologist; Sharon Cowell-Smith, Macmillan Advanced Nurse Practitioner Skin Cancers; and Dr Benjamin Shum, Medical Oncologist.
Thanks also to the other professionals and people affected by cancer who reviewed this edition, and to those who shared their stories.
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