How skin cancer is treated depends on the type, size, and how deep it has grown

The main treatments for skin cancer are surgery to remove the growth, radiation therapy that uses high-energy beams to kill cancer cells, chemotherapy given as a cream or by mouth, and immunotherapy that helps your immune system fight the cancer. Which treatment your doctor recommends depends on whether you have basal cell carcinoma, squamous cell carcinoma, or melanoma — the three most common types — and whether the cancer has spread beyond the skin.

Most skin cancers caught early are treated with a single procedure in a doctor's office. More advanced cases may need a combination of treatments or referral to a specialist called an oncologist (a doctor who treats cancer).

Key Takeaways

  • Surgery to remove the cancerous area is the most common first treatment and often the only one needed for early-stage skin cancer.
  • Your doctor will examine the growth and may take a small sample (called a biopsy) to confirm it is cancer before deciding on treatment.
  • Basal cell and squamous cell carcinomas have high cure rates when caught early, while melanoma requires more aggressive treatment.
  • Some treatments can be done in a dermatologist's office, while others require a hospital or cancer center.

Surgery to remove the cancer

Surgery is the standard first treatment for most skin cancers. The surgeon removes the cancerous area along with a margin of normal-looking skin around it to make sure all cancer cells are gone. The size of the margin depends on the type and depth of cancer.

There are several surgical methods. Excision means cutting out the growth and closing the wound with stitches. Mohs surgery is a specialized technique where the surgeon removes the cancer layer by layer, checking each layer under a microscope before removing the next one — this method removes less healthy skin and is often used on the face or other visible areas. Curettage and electrodesiccation involves scraping away the cancer with a curette (a sharp instrument) and then using electrical current to destroy remaining cancer cells; this works well for small basal cell carcinomas.

Most of these procedures take 30 minutes to an hour and are done in a dermatologist's office with local anesthesia (numbing medicine). You go home the same day. The wound heals in one to three weeks depending on the size.

Radiation therapy

Radiation therapy uses focused beams of high-energy radiation to kill cancer cells. It is typically used when surgery is not possible — for example, if the cancer is in a location that would be difficult to operate on, or if the patient is not healthy enough for surgery. It may also be used after surgery if the cancer was deep or if there is a high risk it will return.

Radiation is given in multiple sessions over several weeks, usually five days a week. Each session lasts 15 to 30 minutes. You do not stay in the hospital. Side effects can include redness, peeling, and irritation of the treated skin, similar to a sunburn. These effects usually fade after treatment ends.

Topical chemotherapy creams

Topical chemotherapy means chemotherapy medicine applied directly to the skin as a cream. The most common is 5-fluorouracil (5-FU), which you apply to the affected area once or twice daily for two to four weeks. Another option is imiquimod, which boosts your immune system's ability to fight the cancer cells.

These creams are used for early-stage basal cell carcinomas and squamous cell carcinomas, especially when there are multiple small cancers or when surgery is not an option. The treated area becomes red and may blister or peel — this is a sign the medicine is working. Healing takes several weeks after you stop applying the cream.

Topical chemotherapy is done at home, but you need a prescription from your doctor and regular check-ins to make sure the treatment is working.

Immunotherapy

Immunotherapy helps your own immune system recognize and destroy cancer cells. For skin cancer, immunotherapy drugs can be given as an injection into the tumor, as a cream applied to the skin, or as a pill or infusion for melanoma that has spread.

Checkpoint inhibitors are a type of immunotherapy used mainly for advanced melanoma. They work by removing the "brakes" that cancer cells use to hide from the immune system. These drugs are given as infusions (medicine dripped into a vein) every two to four weeks. Side effects can include fatigue, rash, and in rare cases, serious immune-related problems, so you need close monitoring by an oncologist.

Treatment for melanoma

Melanoma is more serious than basal cell or squamous cell carcinoma because it spreads more easily. Early-stage melanoma is usually treated with surgery to remove the tumor and a margin of healthy skin. If the melanoma is thicker or has spread to lymph nodes, your doctor may recommend additional treatment such as radiation, immunotherapy, or targeted therapy (drugs that attack specific mutations in the cancer cells).

If melanoma has spread to distant parts of the body, treatment usually involves immunotherapy or targeted therapy rather than surgery. Your oncologist will order imaging tests such as CT scans or PET scans to see where the cancer has spread, and this information guides the choice of treatment.

What to expect during and after treatment

During treatment, you will have regular appointments with your doctor to check how the cancer is responding and to manage any side effects. After treatment ends, you will need follow-up visits — how often depends on the type and stage of cancer. Your doctor will examine your skin and may order imaging tests if there is concern about recurrence.

You can reduce the risk of skin cancer returning or developing new skin cancers by protecting your skin from the sun: wear sunscreen with SPF 30 or higher, wear protective clothing, and avoid the sun during peak hours (10 a.m. to 4 p.m.). Self-checks of your skin once a month help you spot new growths early.

Frequently Asked Questions

Will I need more than one treatment?

Most early-stage basal cell and squamous cell carcinomas are cured with surgery alone. Melanoma and more advanced cancers often need a combination — for example, surgery followed by radiation or immunotherapy. Your doctor will discuss the full treatment plan with you based on the type and stage of your cancer.

How long does it take to recover from skin cancer surgery?

Most people return to normal activities within a few days. The wound heals in one to three weeks. You may need to keep the area dry and avoid strenuous activity for the first week. Stitches are usually removed in one to two weeks.

What are the side effects of radiation therapy?

The treated skin becomes red, dry, and may peel — similar to a sunburn. These effects usually appear after a few weeks of treatment and fade within a few weeks after treatment ends. Rarely, radiation can cause long-term changes to the skin texture or color.

Can skin cancer come back after treatment?

Basal cell and squamous cell carcinomas have low recurrence rates when treated early. Melanoma has a higher risk of returning, especially if it was thick or had spread to lymph nodes. Regular skin checks and sun protection reduce the risk of both recurrence and new skin cancers.

Do I need to see a specialist or can my regular doctor treat it?

A dermatologist (skin specialist) can diagnose and treat most early-stage skin cancers. If you have melanoma or advanced cancer, your dermatologist will refer you to an oncologist. Your primary care doctor can help coordinate your care and manage any other health concerns during treatment.