Skin cancer surgery can help treat the following conditions:
There are various types of skin cancer surgeries, and the common approaches are as follows:
Mohs micrographic surgery is a precise and specialised technique primarily used to treat specific types of skin cancer, such as basal cell carcinomas (BCC) and squamous cell carcinomas (SCC). This staged procedure involves meticulously removing thin layers of cancerous tissue one by one and promptly examining them under a microscope until no cancer cells remain.
It has good cure rates for non-melanoma skin cancers like BCCs and SCCs. Mohs surgery also prioritises the maximum preservation of healthy tissue, resulting in minimal scarring and favourable cosmetic outcomes. It is the ideal surgery for skin cancers at cosmetically sensitive sites, recurrent skin cancers, and aggressive skin tumours with indistinct margins.
This surgery involves removing skin cancer in stages under local anaesthesia. After each layer, the tissue removed is examined under the microscope until we reach healthy, cancer-free tissue in the margins.
At Lumine Dermatology & Laser Clinic, this procedure is carried out by a dermatologist with subspecialty training in Mohs surgery. The surgeon removes the skin cancer and examines the surgical margins under a microscope.
Wide local excision involves removing the entire cancerous area and a 3-10 mm margin of tissue surrounding it. It is used for BCC, SCC, and early-stage melanomas. After the surgery, the wound is closed with stitches. Wide local excision continues to be a viable treatment choice for skin cancers deemed lower in risk, particularly those in less aesthetically sensitive regions like the trunk and limbs.
Additionally, it is advantageous for certain skin cancers characterised by unpredictable growth patterns, such as melanoma and extramammary Paget’s disease.
In contrast to the horizontal sectioning method employed in Mohs surgery, wide local excisions utilise a "bread loaf" technique to section excised tissues. The margins assessed with this technique are typically smaller than those observed in Mohs surgery. This variance may contribute to the increased recurrence risk associated with wide local excisions, particularly for high-risk skin cancers.
Curettage and cautery can be employed for premalignant skin cancers or superficial basal cell carcinomas. The skin lesion is scraped off, and the base of the lesion is cauterised to remove any remnant abnormal cells.
This technique is less precise but may be suitable in select cases.
| Mohs Micrographic Surgery | Wide Local Excision |
| Preferred for non-melanoma skin cancers like BCC and SCC, with good cure rates compared to wide local excision | Typically chosen for tumours with irregular growth patterns such as melanoma or extramammary Paget's disease |
| More thorough examination of both peripheral and deep surgical margins for comprehensive cancer removal | Less thorough examination of peripheral and deep margins due to “bread-loafing” technique |
| Allows for maximal preservation of healthy tissue during tumour removal | Less tissue-sparing than Mohs Micrographic Surgery |
| Entire process, from tumour removal to microscopic examination and reconstruction, is completed on the same day | Delay between surgical excision and histology results, with the possibility of additional procedures if margins are found to be positive for cancer |
| Takes longer to complete and is done in stages | Quick to perform and in one sitting |
| Requires specialised skills and more tedious | Less tedious |
| More expensive | Less costly |
How long does it take to recover from skin cancer surgery?
Recovery time varies depending on the type of surgery performed, the location and size of the tumour, and your overall health.
For minor surgeries involving small, non-melanoma skin cancers, recovery will take 1-2 weeks. The wound care will be relatively straightforward, involving keeping the area clean and protected while it heals. Most patients can resume normal activities within a few days to weeks, with complete healing typically occurring within a few months.
For more extensive surgeries involving larger or more aggressive tumours, the recovery period can be longer, i.e., a few weeks to two months.
After skin cancer surgery, you must protect your skin from the sun and conduct regular self-examination. We will need to see you every few months post-surgery to monitor the scar for recurrence and for any new skin cancers. We may prescribe supplements to help minimise the risk of forming new skin cancers.
Will I have visible scars after skin cancer surgery?
This is a valid concern for our patients undergoing skin cancer surgery; at Lumine Dermatology & Laser Clinic, we reassure you that we will do our best to reduce your downtime and minimise scarring as much as possible.
One way to minimise scarring is to use techniques like Mohs surgery, which prioritises aesthetic outcomes by maximising tissue preservation. Following your dermatologist’s wound care instructions carefully, avoiding sun exposure to the healing area, and applying scar gels can help minimise the appearance of post-surgical scars.
If scarring is a concern, treatments available can help improve the appearance of scars, including laser therapy, microneedling radiofrequency, polynucleotide injections and, in some cases, surgical revision. These options can be discussed in detail during your follow-up appointments.
Are there alternative treatments to skin cancer surgery?
Depending on the type and stage of skin cancer, alternative treatments such as radiation therapy or topical medications may be considered. However, surgery remains a primary and effective option for many cases.
When is Mohs micrographic surgery appropriate?
