Skin Cancer Surgery

Learn everything about your treatment

Skin cancer is one of the most common types of cancer in the UK. Cancer is a disease which affects the cells of your body and because we have more than one type of skin cell, there is more than one type of skin cancer that exists

  • Overview

    What is skin cancer?

    . This skin cancer treatment overview will help you to understand the different types of skin cancer and the treatment options available for each type.

    Before you can understand the different types of skin cancer it is useful to first have a look at the layers of the skin and the cells it is made up of.

    Layers of the skin

    The top layer of the skin is known as the epidermis. There are three main types of skin cell in the epidermis:

    Types of skin cancer

    Basal Cell Carcinoma (BCC)

    As its name suggests, this cancer develops from the basal cells in the epidermis of the skin. It is the most common type of skin cancer in people with fair skin and is more common in those over the age of 75. Typically, a BCC will develop on an area of skin that has had regular exposure to the sun, e.g the head and neck. Initially, a BCC may have a pink, pearly shine, however this can vary from patient to patient. The lesion will grow slowly and may crust over. It is rare that a BCC will spread to other parts of the body, however if left untreated, it may cause damage to local structures as it continues to grow.

    Squamous Cell Carcinoma (SCC)

    This is a cancer of the keratinocytes. It is the second most common skin cancer in people with fair skin and is also more common in older people. It is typical for a SCC to develop on the face, particularly around the ears or lips. This lesion may start as a red or pink crusty area and grow to resemble a wart. Furthermore, the SCC may break down and bleed from time to time. As an SCC grows it progresses deeper into the skin and can destroy surrounding structures like the ear and the nose. It also has the potential to spread to other parts of the body, particularly the lymph nodes, if not treated in its early stages of growth.

    Malignant Melanoma

    This type of skin cancer develops from the melanocyte cells. While it is the least common type of skin cancer, it is also the most serious and the most likely to spread to other parts of the body. A melanoma often resembles a mole in the beginning; a small patch of dark pigment. It can grow on a normal part of the skin or on an existing mole. It will then usually begin to develop more suspicious characteristics like:

    Treatment options

    Surgical removal is generally the best treatment option for all types of skin cancer. Some of the additional treatment options available for each type of skin cancer can also be found below:

    This skin cancer treatment overview page gives a very short introduction into skin cancer treatment. For more information, you can visit the NHS website here.

  • Candidates

    Why choose to have skin cancer treatment?

    Skin cancer is a very serious disease. While severity differs with each type, all forms of skin cancer can cause damage to your health if left untreated. Below, you will find information about each type of cancer and reasons why skin cancer treatment candidates should seek treatment as early as possible.

    Basal Cell Carcinoma (BCC)

    BCCs are the most common type of skin cancer in people with fair skin. They generally develop on areas of the skin that have had a lot sun exposure like the head and neck. They often grow very slowly and rarely spread to other parts of the body. Despite this however, they can cause extensive damage to surrounding structures e.g. bones and tissues beneath the skin. To prevent this, it is vital to seek treatment as early as possible. Because they grow slowly and are at low risk of spreading, it is nearly always possible to treat BCCs successfully. If the BCC is not fully removed, it may come back again. So, while there are multiple treatment options available, the best option is usually to surgically cut out the cancer.

    Squamous Cell Carcinoma (SCC)

    SCC is the second most common cancer in people with fair skin and it usually grows on areas of the face such as the lips or ears. Similarly to a BCC, a SCC will cause extensive damage to surrounding structures as it grows wider and deeper into the skin. This may end up causing erosion of bones and tissues beneath the skin. Therefore, it is important to seek treatment as early as you can if you have SCC. SCC is more likely to spread to other parts of the body than BCC, in particular to the lymph nodes. When a cancer begins to spread within the body, it becomes harder to treat successfully. Consequently, it is so important to treat SCC as early as possible to prevent spread of the cancer. Surgically cutting out the SCC is the best treatment option.

    Malignant Melanoma

    This is the least common but most dangerous type of skin cancer. Melanomas can develop anywhere on the skin and can develop quite rapidly. As a melanoma grows deeper into the skin, it is more likely to spread within the body. When a melanoma begins to spread within the body it becomes more difficult to treat and death is a possible outcome. Therefore, urgent removal of the melanoma in its early stages of growth is the best treatment option to eliminate the cancer and prevent it spreading.

  • Procedure

    How is surgical skin cancer treatment performed?

    There are a number of different ways to treat skin cancer. The skin cancer treatment procedure your medical team decides to use will vary on the basis of which type and stage of skin cancer you have. Your medical team will discuss the options available to you and explain which option they think is the most appropriate for you. Sometimes, your team may be able to remove your skin cancer using a simple procedure at an outpatients appointment. Other times, it may necessary for a more extensive surgical approach. Consequently, the procedure time will vary.

    1. Consent

    Before you have any type of skin cancer treatment, you will have to give your consent to treatment in writing. You should read the consent form carefully to make sure you fully understand the procedure you are about to have, and the risks that come with it.

    2. Anaesthesia

    If your cancer treatment involves any type of surgery, you will be given an anaesthetic before the procedure. For a simple surgical excision, the surgeon will usually inject a local anaesthetic to numb the treatment area. You will therefore be awake for the procedure but you will not feel any pain. It will take a few hours after the surgery for the numbness to wear off.

    For more extensive surgical treatment, a general anaesthetic may be more appropriate for your surgery. In this case, you will meet with the anaesthetist and they will explain how the anaesthetic agent will work. You will be asleep for the surgery and will wake up slowly when it is over. You may feel groggy for a few hours after waking up, but this will wear off. Your memory and concentration may be affected for 1 to 2 days but this will also resolve.

    3. Skin cancer removal

    The actual surgical technique used to remove skin cancer will vary depending on the type and stage of the cancer. Your surgeon may use one of the following types of skin cancer treatment procedure:

    Mohs Micrographic Surgery (MMS)

    The Mohs Micrographic surgical technique allows the surgeon to slowly remove layer by layer of skin from the treatment area. They will use a microscope to check if there are any cancerous cells present on the last layer of skin that they remove. They will continue to do this until there are no cancerous cells present on the layer of skin removed.  This technique was designed to allow removal of skin cancer while preserving as much healthy tissue as possible. It is most suitable for use in basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs).


    Using a scalpel or a razor, your surgeon will cut or shave the cancerous growth from your skin. There are multiple ways in which your surgeon may do this including:

    Simple excision

    The surgeon will use a scalpel to remove cancerous skin growth and a small area of healthy looking tissue surrounding it. After the procedure, the skin that was removed is sent to a lab to check the grade of the cancer. Depending on the results of this, you may need further treatment.

    Wide excision

    The surgeon will use a scalpel to remove the cancerous growth and a wider perimeter of healthy looking tissue around it. They may also remove a deeper layer of skin than with a simple excision. The surgeon will then send the skin to the lab to check the grade of the cancer. Depending on the results, you may need further treatment. Surgeons often use this technique to treat malignant melanomas.

    Shave excision

    The surgeon will use a razor to shave or peel off the cancerous growth. Again, the surgeon will send the skin to the lab to check for the grade of cancer after the procedure. Depending on the results, further treatment may be necessary.

    4. Closing of Incisions

    Your surgeon will use stitches to close your wound where possible. In some cases with wide excisions, there may not be enough skin available to close the wound and reconstructive surgery using a skin graft may be necessary. Your surgeon will discuss this with you before the procedure if they suspect this will be the case for you. Reconstructive surgery is also a possibility at a later date if you are unhappy with the appearance of your treatment area after surgery.

    5. Return home

    Generally, you will be able to return home soon after your procedure. Your treatment area may remain numb for a few hours but the effects of the local anaesthetic will wear off with time.
    If you have more extensive skin cancer treatment, you may have to stay in hospital overnight.
    If you have any more questions about any skin cancer treatment procedure, you can contact your GP or oncologist directly.

  • Consultation

    What should I expect from my skin cancer treatment consultation?

    Your skin cancer treatment consultation will involve meeting a specialist surgeon or oncologist to discuss your condition and potential treatment options. If you choose to have private treatment to treat your skin cancer, a consultation can be arranged for you. During this skin cancer treatment consultation, your surgeon or oncologist will explain the procedure and any risks and complications it involves. They may ask to see a referral from a specialist health care professional, so make sure to take this with you.
    During this consultation, your oncologist or surgeon may ask a number of questions including:

    • What is your current health like?
    • Do you suffer from any other medical conditions?
    • Have you had any previous surgeries in the past?
    • Do you take any regular medications? (Including prescription, over-the-counter or herbal medications)
    • Do you smoke, drink alcohol or use recreational drugs?
    • Are you currently using or have used sun beds in the past?
    • Do you take protective measures when out in the sun? (E.g. using sunscreen or hats)

    It is important that you answer these questions as honestly as possible so that your medical team can make the correct choice about which treatment is best for you. So please try to be as open as honest as possible in your skin cancer treatment consultation.

    Questions to ask during your skin cancer treatment consultation

    This consultation is also an excellent time for you to ask your team any questions you have about the procedure. It is important that you have a good understanding of what the treatment involves, the risk and complications that may arise, and what your recovery will be like. Some questions you may like to ask may include:

    • What surgical technique do you think will work best for me?
    • Do you think my treatment area will require reconstructive work after the cancer is removed?
    • Will my skin cancer come back?
    • How can I monitor my skin to check for skin cancers in the future?

  • Risks and complications

    What are the main skin cancer treatment risks and complications?

    As with any surgery, there are some skin cancer treatment risks and complications that you should be aware of. It is vital that you are aware of all the risks and complications that could occur during and after your treatment. You must educate yourself on these before you make a decision on treatment.
    If your treatment plan involves surgical excision, the potential surgical risks include, but are not limited to, the following:


    Every type of surgery carries a risk of infection. Your medical and surgical team will do their best to prevent any infections occurring. If you were to develop an infection after surgical excision of a lesion, it will often be a minor wound infection. Your team will be able to treat it with a short course of antibiotics. Infections should not be left untreated as they can spread and become more severe. It is therefore important for you to be aware of the signs of infection so that you know when to seek medical help. These include:

    • Redness around the wound that gets worse over time
    • Redness that is beginning to spread away from the incision
    • Foul smelling discharge or pus coming from the wound
    • A temperature of over 38° C
    • Pain that is not relieved by painkillers

    Bleeding & Bruising

    There may be some minor bleeding from your wounds and bruising of the skin around it. This is common. However, in some cases, the bleeding may become more severe causing blood to collect beneath the skin and clot. The medical name for this is a haematoma. If you develop a haematoma, you will need to have further surgery to remove it. If you notice any other excessive bleeding or bruising you must notify your surgeon right away.

    Incomplete excision

    Some of the techniques your surgeon can use to remove your skin cancer involves two stages. Firstly, they start by removing the cancerous growth and a margin of healthy-looking tissue around it. Then, they send this skin to a lab after the procedure is complete to detect the presence of cancerous cells in the sample. Because this is done in a two stage process, there is the risk that they might have left cancerous cells behind on your skin, depending on what the results conclude. If this occurs, further surgery will be necessary to remove the remaining cancerous cells.

    General surgical complications

    There are general risks that come with all surgeries. These include nausea and vomiting, risks of anaesthesia, post-operative pain and blood clots. To reduce the risks of their occurrence, we advise you take your time choosing a qualified, experienced surgeon that you can trust.

    Damage to surrounding structures

    There is the risk that the surgery may cause damage to structures surrounding your treatment area. For example, nerve or gland damage.


    Surgical skin cancer treatment techniques often leave scars on your treatment area. In the first few months after your surgery, your scars will be pink and quite obvious. However, with time and a good scar care regimen, your scars will fade. Ask your surgeon for any scar care recommendations they may have.


    Unfortunately, there is always a risk that your skin cancer may reoccur. It is important that you are aware of this and check regularly for any signs of recurrence. Ask your surgeon about what symptoms to look out for. Your surgeon will generally recommend that you check your skin once a month. It is also vital that you attend any follow-up appointments that your doctor or surgeon scheduled for you.

  • Preparing for your treatment

    How can I prepare for skin cancer treatment?

    Preparation is key to ensuring you get a stress-free, speedy recovery after your treatment. Below is a list of some skin cancer treatment preparation tips we hope will help you get ready for your treatment.

    Household work

    Household work often involves exerting yourself more than you should during your recovery. After your treatment, you should try not to strain yourself by doing too much. Therefore, it can be beneficial to get some jobs around the house out of the way before you go into hospital. For example, you may like to do a general house clean, get the laundry done and take out the bins while you are fit to do so. Placing things you will need like crockery and food items at a level you can reach without bending or straining may also be useful.


    Grocery shopping can be another strenuous activity. After treatment, you may not feel up to going grocery shopping. Lifting heavy bags may be tiring or may place strain on your stitches (depending on their location). You may therefore want to do a big food shop to stock up before having treatment. You may also like to prepare some meal and freeze them so that you do not have to cook either.

    Children and Pets

    To help prevent over-exerting yourself after treatment, you may want to ask friends and family to help take care of any young children or pets for a few days.


    Depending on the kind of treatment you have had, you may not be to drive straight after the procedure. If you were given a general anaesthetic, you may not be able to drive from 5 to 14 days after your treatment. For your safety, it is sensible to arrange for someone to pick you up after your treatment and take you home.


    You may want to choose some pieces of clothing that will be loose and not restrictive around your treatment area.


    It is important that you maintain a healthy lifestyle after your treatment. This includes exercising regularly, reducing your alcohol intake and stopping smoking. Maintaining a healthy diet is also important. You should try to eat foods that are high in protein and low in sodium. Try to eat plenty of fresh fruits and vegetables. It is important that you stay hydrated by ensuring you drink plenty of water. You should also try to avoid consuming high amounts of sugar as you recover from your procedure. Keeping healthy will help you recover quicker.


    Depending on the location of your treatment area, you may want to have spare pillows to hand so that you can sleep propped up. This may be more comfortable and can help reduce any swelling after treatment.

    How can I prevent skin cancer?

    You cannot always prevent skin cancer developing. However, you can reduce the risk by taking some precautionary measures which include:

    • Avoiding overexposing your skin to UV light
    • Protecting your skin from the sun by using high-factor sunscreen
    • Avoiding getting sunburnt
    • Limiting the amount of time you spend in the sun
    • Avoiding the use of sun beds and sunlamps
    • Regularly checking your skin for signs of skin cancer.

    You can find more information on how to prevent skin cancer here.

  • Aftercare

    What can I expect after skin cancer treatment?

    Knowing what to expect after your treatment is an important part of understanding the procedure. Your surgeon or oncologist will be able to give you specific skin cancer treatment aftercare advice.

    After you have your treatment, your medical or surgical team will organise a follow-up appointment to check on your recovery. If you are due to receive results about the skin samples that were sent for lab testing after your treatment, you may get the results at this appointment. In addition, your surgeon will look at your wound site and remove any non-dissolvable stitches.

    How will I feel after treatment?

    This will depend on what kind of treatment you have had. If you have a local anaesthetic agent, you will be awake for the procedure but unable to feel anything in the treatment area. After surgery, you will feel completely normal apart from some numbness in the treatment area. This will wear off within a few hours. Your treatment area may begin to feel painful as the numbness wears off.

    If you are having more extensive skin cancer removal surgery you may have a general anaesthetic agent. In this case, you will be asleep for the duration of the procedure. You will wake up gradually when the operation is complete and will feel slightly groggy as the anaesthetic wears off. This will only last for a few hours. You may notice your memory and concentration are affected for a day or two after surgery. Again, these side-effects will wear off with time.

    When will I be able to return home after my treatment?

    This again depends on the type of treatment you have had. For simple surgical excisions, it is likely that you will be able to go home the same day. However, if your surgeon has to do a more complex surgical excision, you may have to stay in hospital overnight. You can ask your surgeon about this during your consultation.

    How will I get home after my surgery?

    It is advisable that you arrange for a family member or a friend to come pick you up from the hospital after you have your treatment. This is to ensure that you are safe if you have been given an anaesthetic, but also to make sure you have someone there to look after you after treatment.
    If you have been given an anaesthetic, you will not be able to drive yourself home straight after the treatment and may not be able to drive for a short period afterwards depending on your surgeon’s instructions.

    When can I return to work?

    Most patients are able to return to office work within 1 or 2 days after their procedure. This may vary however if you have a more physical job which will affect your treatment area. Your medical team will be able to give you more specific advice on this. Despite returning to work, you should try to rest as much as possible in the first few days after your surgery.

    When can I excercise again?

    You will be able to return to return to light activities from 7 to 21 days after your surgery. Your surgeon will be able to give you a more exact timeframe as this will depend on the location and size of your treatment area.

    How can I prevent recurrence of skin cancer?

    An important aspect of skin cancer treatment aftercare is prevention and monitoring. To prevent further skin cancers developing, it is vital that you take the proper precautions when out in the sun. This involves wearing a high SPF sun-screen, wearing a hat which shades your face and neck, and avoiding sitting in direct sunlight for prolonged periods of time. It is also vital that you attend all your regular follow-up appointments with your medical doctor. To monitor your skin for growth of further skin cancers you should check your skin regularly for any suspicious changes. Your surgeon or oncologist will tell you how often you will need to do this and when you should seek medical advice.

    How should I care for my scars?

    Your scars may be tender after your stitches are removed. They may appear pink and lumpy. Your surgeon may recommend daily scar massage with a scar gel or moisturiser to help smooth out and fade the appearance of your scars. As your scars get less tender you may be able to increase the pressure of your massage. It is important to keep your scars out of the sunlight or to use a high SPF sunscreen on them to avoid their discolouration. This will also help you to avoid developing further skin cancers.

    Remember that it is vital that you follow your specialist oncologist or surgeon’s skin cancer treatment aftercare advice.

  • FAQs

    Do I need a referral from my GP for skin cancer removal?

    If you are having private cancer treatment, your specialist oncologist or surgeon may require that you provide a referral letter. This referral letter may come from your GP, your dermatologist (skin specialist) or your NHS oncologist (cancer specialist).
    Your referral letter will help your surgeon or oncologist understand your condition better so that they may treat you in the appropriate way.

    What are the survival rates for skin cancer?

    Survival rates will vary depending on the type and stage of skin cancer that you have. With basal cell carcinomas (BCCs), once they are removed and lab testing detects no cancerous cells in the healthy tissue, that BCC is essentially, “cured”. Squamous cell carcinomas (SCCs) are also similar, however they can on occasion spread to the lymph nodes. Therefore, more regular follow-up is necessary with SCCs.

    Melanomas are more serious and can recur after treatment. This depends on what stage the melanoma is on initial diagnosis. The severity of melanomas can be determined by how thick they are. Thin melanomas (less than 0.76mm) generally have an excellent prognosis. Thicker melanomas are often associated with lymph node involvement at the time of diagnosis and have a poorer prognosis.

    Do sun beds cause skin cancer?

    Sunbeds give out harmful UV rays that can cause damage to your skin and make your skin look old and leathery. In addition and more importantly, they can cause damage to the DNA in your skin cells. Over time this damage can develop into skin cancer. Recent evidence has highlighted the dangers of using tanning beds. The evidence also suggests that sunbed use is a strong risk factor for developing skin cancer.

    Which surgical technique is best for me?

    Firstly, this will depend on the information your surgeon receives in the referral letter from your specialist doctor. If you do require surgical treatment, your surgeon will examine your skin to decide which technique is best to use. They will consider: the type, stage and measurements of your skin cancer. Furthermore, your current and past medical and surgical history will also be factors in their decision. Your surgeon will discuss with you which surgical approach they think is best and you can ask them any questions you may have.