Skin Cancer Treatment Options

Diagnosis, treatment, done.

In reality, it is usually more nuanced than that.

Some skin cancers are treated with a relatively straightforward procedure and need little else afterwards. Others require a combination of treatments, monitoring, and decisions made over time. A lot depends on the type of skin cancer, where it is located, how deeply it has grown, and whether it has spread beyond the skin.

So the starting point is not really the treatment itself. It is understanding what kind of skin cancer is being dealt with and what is likely to matter most over the longer term.

The main types of skin cancer

Treatment starts with identifying the type of skin cancer involved.

Basal cell carcinoma (BCC)

The most common form of skin cancer. It is usually slow growing and less likely to spread to other parts of the body. It often appears as a persistent sore, a pearly bump, or an area that repeatedly crusts or bleeds without fully healing.

Squamous cell carcinoma (SCC)

It can behave more aggressively in some cases, particularly if it grows deeper into the skin or is left untreated. It may present as a scaly patch, a firm lump, or a sore that becomes thickened over time.

Melanoma

Carries a higher risk of spreading if not identified early. It often develops from a changing mole, although it can also appear as a new dark or unusual-looking lesion. Changes in colour, shape, size, or symmetry tend to be more significant than pain or discomfort.

Each behaves differently, which means treatment decisions are made differently as well.

Surgery for skin cancer

Surgery is one of the most common treatments for skin cancer.

The aim is usually to remove the cancer along with a margin of healthy tissue around it. In many cases, particularly with smaller or earlier skin cancers, this may be all that is needed.

Different surgical approaches may be used depending on the situation.

• Standard surgical excision removes the visible cancer together with a surrounding margin of tissue.
• Curettage and cautery involve scraping away the abnormal tissue before sealing the area with heat.
• Mohs surgery, which is often used in cosmetically sensitive areas such as the face, removes the cancer layer by layer while checking tissue under a microscope during the procedure.

This helps preserve as much healthy skin as possible while ensuring the cancer has been fully removed.

Radiotherapy as a treatment option

Radiotherapy is another important treatment option, particularly for non-melanoma skin cancers.

It may be used when surgery is not ideal, when a tumour is in a difficult area, or when preserving appearance and function is especially important. In some situations, radiotherapy may also be used after surgery to reduce the risk of recurrence.

Treatment is carefully planned so radiation is directed at the cancer while limiting exposure to surrounding tissue.

This is where a clear skin cancer treatment plan becomes important. The decision is not simply whether to use surgery or radiotherapy, but how each option fits the wider picture and what is likely to achieve the best balance between effectiveness and long-term outcome.

Immunotherapy and targeted treatments

Some skin cancers require treatment beyond the skin itself.

This is more commonly the case with melanoma, particularly if it has spread or carries a higher risk of recurrence.

Immunotherapy works by helping the immune system recognise and attack cancer cells more effectively. Targeted therapies focus on specific changes within cancer cells that help drive tumour growth.

These treatments are not appropriate for every patient. Their use depends on factors such as staging results, tumour biology, and overall health.

In practice, treatment decisions often evolve over time. A patient may begin with surgery, then later need immunotherapy or radiotherapy, depending on how the disease behaves.

Other non-surgical treatments

Not every skin cancer needs surgery or systemic treatment.

For some early or superficial skin cancers, more localised treatments may be appropriate. These can include cryotherapy, which uses freezing to destroy abnormal tissue, photodynamic therapy, which combines light-sensitive medication with targeted light exposure, and topical creams used for certain superficial lesions or precancerous changes.

These approaches are generally used in selected situations rather than for deeper or more aggressive disease.

How treatment decisions are made

Treatment planning is rarely based on one factor alone.

The type of skin cancer matters, but so does the size of the lesion, its location, the depth of invasion, whether nearby lymph nodes are involved, and the patient’s general health.

For example, a small basal cell carcinoma on the arm may be treated very differently from a melanoma near the scalp or eye.

This is why assessment matters. The aim is not simply to remove or treat the cancer, but to understand the wider context before deciding what should happen next.

In practice, this often means having private skin cancer care that reflects the individual patient rather than following a fixed pathway. As treatment progresses, that plan may also need to adapt depending on response, healing, and any changes that emerge over time.

What happens after treatment

Follow-up care depends on the type of skin cancer and the level of risk involved.

Some patients only need occasional skin checks after treatment. Others may require scans, ongoing monitoring, or additional therapy over time.

The purpose of follow-up is not just to look for recurrence. It is also to assess healing, monitor side effects where relevant, and identify any new suspicious changes early.

In melanoma, especially, monitoring often continues for several years.

Why early treatment matters

Skin cancer is often highly treatable when identified early.

That is particularly true for basal cell carcinoma and squamous cell carcinoma, which are commonly cured with local treatment. Melanoma can also be treated successfully when detected before it spreads.

The difficulty is that skin cancers do not always look dramatic at first. A persistent sore, a slowly changing mole, or a lesion that repeatedly crusts or bleeds can be easy to dismiss.

In practice, earlier assessment usually means simpler treatment and fewer decisions later on.

About Dr James Wilson

Dr James Wilson is a consultant clinical oncologist specialising in lung cancer, melanoma, skin cancer, advanced radiotherapy, and systemic cancer treatments. Based in a full-time private practice in London, he focuses on rapid access to assessment, treatment planning, and coordinated cancer care, with an emphasis on clear decision-making and continuity throughout treatment.