A diagnosis of skin cancer can feel overwhelming—but it’s also one of the most treatable cancers, especially when detected early. Advances in dermatology and oncology have led to highly effective therapies that target cancer cells precisely while preserving as much healthy skin as possible.

Understanding your treatment options is key to making informed decisions and achieving the best possible outcome. This guide explores the main treatments for skin cancer—surgery, radiation therapy, and immunotherapy—along with how doctors choose the best approach for each case.

How Treatment Decisions Are Made

Individualized treatment planning
No two cases of skin cancer are alike. Your treatment plan depends on several factors:

  • The type of cancer (basal cell carcinoma, squamous cell carcinoma, or melanoma)

  • The stage and depth of the tumor

  • The location on the body

  • Your overall health and immune status

  • Whether the cancer has spread to lymph nodes or organs

Goals of treatment

  • Remove or destroy all cancer cells

  • Preserve appearance and function

  • Prevent recurrence or spread

  • Support long-term skin health and quality of life

Surgical Treatments

Surgery remains the first-line treatment for most skin cancers. It physically removes the tumor and provides tissue samples for lab analysis to confirm complete removal.

Excisional surgery

What it is:
The most common method for removing small to medium skin cancers. The surgeon cuts out the tumor along with a small margin of normal-looking skin (typically 1–2 millimeters).

When it’s used:

  • Basal cell carcinoma (BCC)

  • Squamous cell carcinoma (SCC)

  • Early-stage melanoma

Recovery and results:
The wound is closed with stitches or a skin graft, depending on size. Most patients heal within 2–3 weeks. Success rates exceed 95% when margins are clear.

Mohs micrographic surgery

What it is:
A specialized, layer-by-layer surgical method where the surgeon removes thin sections of skin and examines each under a microscope in real time until no cancer cells remain.

Why it’s effective:

  • Maximizes cancer removal

  • Minimizes removal of healthy tissue

  • Ideal for delicate or visible areas like the face, nose, lips, ears, and eyelids

When it’s recommended:

  • High-risk or recurrent BCC/SCC

  • Tumors with unclear borders

  • Areas where preserving appearance and function matters

Cure rates:
Up to 99% for new skin cancers and 95% for recurrent ones.

Curettage and electrodessication

What it is:
A minimally invasive procedure where the tumor is scraped away (curettage) and the area is cauterized (electrodessication) to destroy residual cancer cells.

Best for:

  • Small, superficial basal or squamous cell carcinomas

  • Non-facial areas such as trunk or limbs

Advantages:
Quick, cost-effective, and doesn’t require stitches—but it may leave a small white scar.

Cryosurgery (cryotherapy)

What it is:
Cancerous tissue is frozen using liquid nitrogen, destroying abnormal cells.

When it’s used:

  • Precancerous lesions (actinic keratoses)

  • Very superficial cancers

Benefits:

  • No cutting or anesthesia required

  • Fast recovery
    Limitations:
    Less precise—so it’s used mainly for small, early lesions.

Sentinel lymph node biopsy

Purpose:
In melanoma and some advanced squamous cell carcinomas, doctors may perform this biopsy to see if cancer has spread to nearby lymph nodes.

How it works:
A small amount of radioactive dye is injected near the tumor to identify the “sentinel” node—the first node cancer cells would reach. It’s then removed and examined under a microscope.

Radiation Therapy

Radiation therapy uses high-energy X-rays or electrons to destroy cancer cells. It’s often recommended when surgery isn’t possible or when residual cancer remains after removal.

When radiation is used

  • In older patients or those unable to undergo surgery

  • When the cancer is in hard-to-operate areas (eyelids, ears, nose)

  • For recurrent cancers or tumors with deep invasion

  • After surgery, to eliminate microscopic cancer cells left behind

Types of radiation therapy

External beam radiation:
A machine delivers focused radiation beams to the tumor site. Treatment typically takes place over several short sessions across 2–6 weeks.

Brachytherapy:
Radioactive sources are placed close to or within the tumor for localized exposure. Used mostly for small, defined areas.

Side effects and care

  • Skin redness or irritation (like a sunburn)

  • Temporary hair loss at the site

  • Fatigue or peeling skin

Most side effects fade within weeks. Moisturizers, gentle skincare, and sun protection help recovery.

Topical and Local Therapies

For early or superficial cancers, certain prescription creams and gels can destroy abnormal cells without surgery.

Common topical options:

  • Imiquimod (Aldara): Boosts immune response to fight cancer cells.

  • 5-fluorouracil (Efudex): A chemotherapy cream that kills rapidly dividing cells.

  • Ingenol mebutate (Picato): Used for actinic keratosis (precancerous spots).

Advantages:
Non-invasive, minimal scarring, and convenient for multiple small lesions.

Limitations:
Not suitable for deep or aggressive cancers and requires close follow-up.

Photodynamic Therapy (PDT)

How it works:
A light-sensitizing medication is applied to the skin, then activated by a specific light wavelength to destroy cancer cells.

Ideal for:

  • Precancerous lesions (actinic keratoses)

  • Superficial basal cell carcinoma

Benefits:

  • Targets only diseased cells

  • Minimal damage to surrounding healthy tissue

  • Cosmetic results are excellent

Side effects:
Temporary redness, burning, or peeling that resolves within days.

Immunotherapy

Immunotherapy harnesses your body’s own immune system to fight cancer. It’s been a game-changer, particularly for advanced melanoma and some aggressive squamous cell carcinomas.

How it works

Cancer cells often evade immune detection by hiding behind “checkpoints”—molecules that prevent immune cells from attacking normal tissue. Checkpoint inhibitors release these brakes, allowing the immune system to recognize and destroy cancer cells.

Common immunotherapy drugs

  • Pembrolizumab (Keytruda) and nivolumab (Opdivo): block PD-1 protein, enhancing immune attack.

  • Cemiplimab (Libtayo): approved for advanced cutaneous squamous cell carcinoma.

  • Ipilimumab (Yervoy): targets CTLA-4 checkpoint, used alone or with PD-1 inhibitors for melanoma.

When immunotherapy is used

  • Stage III–IV melanoma (spread to lymph nodes or organs)

  • Recurrent squamous cell carcinoma not responsive to surgery or radiation

  • High-risk patients with persistent disease after standard care

Possible side effects

  • Fatigue, rash, or flu-like symptoms

  • Inflammation of lungs, liver, or thyroid (rare but serious)
    These are managed with close monitoring and, when needed, corticosteroids to calm immune reactions.

Targeted Therapy

Targeted therapy focuses on specific genetic mutations driving cancer growth. Instead of killing all fast-growing cells (like chemotherapy does), it attacks cancer at its molecular source.

For melanoma

Around 40–50% of melanomas have mutations in the BRAF gene. Targeted drugs such as:

  • Vemurafenib (Zelboraf)

  • Dabrafenib (Tafinlar)

  • Trametinib (Mekinist)

These can shrink tumors quickly and improve survival, especially when combined with immunotherapy.

For non-melanoma cancers

Research into genetic markers for basal and squamous cell carcinomas is ongoing, but early studies on hedgehog pathway inhibitors like vismodegib (Erivedge) and sonidegib (Odomzo) show strong results for advanced BCC.

Chemotherapy

While not the first choice for skin cancer, chemotherapy can be useful when other treatments fail or when cancer has spread widely.

Topical chemotherapy:
5-fluorouracil cream for actinic keratoses and early cancers.

Systemic chemotherapy:
Intravenous drugs (like cisplatin or dacarbazine) are sometimes used for advanced or metastatic skin cancer when immunotherapy isn’t suitable.

Combination therapy:
Doctors may combine chemotherapy with immunotherapy or radiation for aggressive cases to boost effectiveness.

Reconstructive and Cosmetic Care

Skin cancer treatments can leave scars, especially after large surgeries. Reconstructive surgery helps restore both function and appearance.

Options include:

  • Skin grafts or flaps to replace removed tissue

  • Scar revision to improve cosmetic results

  • Laser resurfacing or microneedling for smoother healing

Emotional recovery is just as important—patients are encouraged to join support groups or counseling to cope with post-treatment anxiety.

Lifestyle and Follow-Up Care

Lifelong vigilance
Even after successful treatment, people who’ve had skin cancer are at higher risk of recurrence.

Post-treatment plan:

  • Dermatology visits every 3–6 months for the first two years

  • Annual full-body exams afterward

  • Self-skin checks monthly using mirrors or phone photos

Healthy lifestyle choices

  • Continue using sunscreen daily

  • Eat antioxidant-rich foods

  • Stay physically active

  • Avoid smoking and excess alcohol

These actions improve recovery, immune strength, and overall skin resilience.

Emerging and Experimental Therapies

Oncolytic virus therapy
Modified viruses like T-VEC (talimogene laherparepvec) selectively infect and destroy melanoma cells while stimulating immune response.

Cancer vaccines
Researchers are developing vaccines that train the immune system to recognize skin cancer antigens before tumors form.

Gene therapy
Future approaches may repair or silence damaged genes responsible for cancer development, offering new hope for prevention and cure.

Key Takeaways

  • Surgery remains the cornerstone of skin cancer treatment, offering high cure rates.

  • Radiation and topical therapies help when surgery isn’t possible.

  • Immunotherapy and targeted therapy have revolutionized treatment for advanced melanoma and aggressive non-melanoma cancers.

  • Regular follow-up and lifestyle care are crucial for long-term success.

Skin cancer treatment today is more precise, effective, and patient-focused than ever before. With early detection and a personalized plan, recovery is not just possible—it’s probable.