Skin cancer treatment depends on the type, size, location, and stage of the cancer, but most cases are highly treatable. For the two most common types, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), surgical removal is the standard approach and cures the vast majority of cases. Melanoma, the most serious form, may require surgery plus additional therapies like immunotherapy when it has spread beyond the skin.
Surgery: The Most Common Treatment
Most skin cancers are treated with some form of surgery. The simplest option is a standard excision, where a surgeon cuts out the cancerous tissue along with a margin of healthy skin around it. For smaller or less aggressive cancers, this is often all that’s needed. The wound is closed with stitches, and the removed tissue is sent to a lab to confirm clean margins, meaning no cancer cells were left behind.
For high-risk skin cancers, especially those on the face, ears, or nose, a specialized technique called Mohs surgery offers the highest precision. During Mohs, the surgeon removes one thin layer of tissue at a time, examines it under a microscope right there in the office, and maps exactly where cancer remains. If any edges still show cancer cells, another layer is taken from that specific spot. This continues until the tissue is completely clear. The process preserves as much healthy skin as possible, which matters enormously on the face, and it has a cure rate of up to 99% for BCC and SCC.
Mohs surgery is typically done under local anesthesia as an outpatient procedure. You stay awake throughout, and most people go home the same day. The actual removal is quick, but the repeated cycles of cutting and microscope examination mean you could be at the clinic for several hours.
Freezing and Light-Based Therapies
Not every skin cancer requires a scalpel. For precancerous growths and very early-stage BCC or SCC, cryotherapy is a quick alternative. Your doctor applies liquid nitrogen directly to the lesion, freezing and destroying the abnormal cells. It works best on thin, superficial lesions and is commonly used for precancerous spots called actinic keratoses. There’s no cutting involved, and the treated area typically blisters and heals on its own over a few weeks.
Photodynamic therapy (PDT) is another option for surface-level skin cancers. A light-sensitive chemical is applied to the skin and absorbed by the cancer cells. When a specific wavelength of light is directed at the area, it activates the chemical, which produces a reactive form of oxygen that kills the targeted cells. One downside: the photosensitizing agents can make your skin and eyes highly sensitive to light for up to six weeks after treatment, so you’ll need to take precautions during that window.
Radiation Therapy
Radiation is typically chosen when surgery isn’t a good fit. This might be the case for older patients, for tumors in locations where surgery would cause significant cosmetic or functional problems (around the eyelids, nose, or ear), or when a patient has health conditions that make surgery risky. It’s also used after surgery to destroy any remaining cancer cells in the area.
Treatment schedules vary widely depending on the size and type of tumor. Some patients receive a single session, while others come in for treatments spread over several weeks. A common schedule for BCC or SCC might involve 10 to 20 sessions over two to four weeks. Larger or more complex cases can require up to 30 sessions over six weeks. Each session is painless, though the skin in the treated area often becomes red, dry, or irritated as the weeks go on.
Immunotherapy for Melanoma
When melanoma has spread to lymph nodes or other parts of the body, treatment shifts from local removal to systemic therapy that works throughout the entire body. Immunotherapy has transformed advanced melanoma treatment over the past decade and is now the primary approach for stage III and IV disease.
The most widely used immunotherapy drugs are checkpoint inhibitors. Normally, cancer cells use molecular “brakes” on your immune system to avoid detection. These drugs release those brakes, allowing your T cells to recognize and attack the tumor. Three checkpoint inhibitors are currently approved for advanced melanoma. Two of them block a molecule called PD-1 on T cells, while a third blocks a different checkpoint called CTLA-4. They can be used alone or in combination.
Immunotherapy is given by infusion, typically every few weeks. Side effects can be significant because an unleashed immune system sometimes attacks healthy tissue too, causing inflammation in the skin, gut, liver, lungs, or other organs. These side effects are manageable in most patients but require close monitoring.
Targeted Therapy for Advanced BCC
Advanced basal cell carcinoma that can’t be removed surgically or has spread to other areas is rare, but it does happen. For these cases, two oral medications are available that block a specific growth signal called the Hedgehog pathway, which drives most basal cell cancers.
These drugs can shrink tumors effectively, but they come with a challenging side effect profile. Muscle spasms affect roughly two-thirds of patients, and about 60% experience hair loss and taste changes. These side effects are significant enough that more than one in four patients stop taking the medication because of them. Your doctor will weigh the benefits against quality-of-life impacts when considering this option.
How Survival Rates Vary by Stage
BCC and SCC that are caught early are almost always curable, and the vast majority never spread. Melanoma outcomes depend heavily on how early it’s found. The five-year relative survival rate for localized melanoma (still confined to the original site) is 97.6%. Once it reaches nearby lymph nodes, that drops to 60.3%. For distant melanoma that has spread to other organs, the five-year survival rate is 16.2%, though immunotherapy has been steadily improving outcomes for advanced cases. Across all stages combined, melanoma’s overall five-year survival rate is 90.5%, largely because most cases are caught early.
Recovery After Surgery
Most skin cancer surgeries are outpatient procedures with relatively straightforward recoveries. You’ll leave with a bandage over the wound and instructions for wound care at home, which typically involves keeping the area clean, dry, and protected. Stitches are removed at a follow-up appointment, usually within one to two weeks depending on the location. Areas with more tension on the skin, like the back or shoulders, may take longer to heal than facial wounds.
Activity restrictions are common in the first week or two. You’ll generally be asked to avoid strenuous exercise, heavy lifting, and anything that could stretch or strain the wound site. Your surgical team will give you a specific timeline for returning to activities like exercise and wearing makeup over the area.
Follow-Up After Treatment
Once you’ve had one skin cancer, your risk of developing another is significantly higher, making regular follow-up essential. The schedule depends on the type and stage. For melanoma in situ (the earliest form), a single follow-up visit after treatment may be sufficient. For more advanced melanoma, follow-up is much more intensive: appointments every three months for the first two to three years, then every six months, then annually. Some patients also receive periodic imaging scans during the first few years to check for recurrence.
Between scheduled appointments, performing your own skin checks monthly is one of the most effective ways to catch a new cancer or recurrence early. You’re looking for any new or changing spots, particularly ones that are asymmetric, have irregular borders, show multiple colors, are larger than a pencil eraser, or are evolving in size, shape, or color.