How is Skin Cancer Treated?

This is the eighth page in the Understanding Skin Cancer Guide. This guide was developed by the HealthTree Education Team and was last updated and reviewed on May 14, 2026.

The treatment for skin cancer depends on several factors, including the type of skin cancer, the stage, the location and size of the tumor, the genetic features of the tumor (for melanoma), and your overall health.

Treatment often involves a combination of therapies. It is important to discuss all of your treatment options with your care team to make the best decision for your unique situation. Getting a second opinion from another oncologist or dermatologist is normal and encouraged.

Surgery for skin cancer

Surgery is the primary treatment for most skin cancers. The goal of surgery is to remove the entire tumor with clear margins (a border of normal tissue around the cancer). The type of surgery depends on the type, size, and location of the skin cancer:

Excision

The tumor is surgically cut out along with a margin of surrounding normal skin. This is one of the most common treatments for melanoma, squamous cell carcinoma, and some basal cell carcinomas.

Mohs micrographic surgery

A specialized surgical technique used most often for basal cell carcinoma and squamous cell carcinoma in high-risk locations (such as the face, ears, or hands) or for aggressive or recurrent tumors. During Mohs surgery, the surgeon removes the tumor layer by layer and examines each layer under a microscope until all cancer cells are gone. Mohs surgery has the highest cure rate of any treatment for BCC and SCC and preserves as much healthy tissue as possible.

Wide local excision

Used for melanoma, wide local excision removes the melanoma along with a larger margin of normal skin than standard excision. The size of the margin depends on the thickness of the melanoma.

Lymph node surgery

Sentinel lymph node biopsy (SLNB). Performed at the time of wide local excision for melanomas that meet certain criteria. Identifies and removes the first lymph node(s) to which the melanoma might have spread. If negative, no further lymph node surgery is needed.
Lymph node dissection. If lymph nodes are found to contain cancer, additional lymph nodes may be removed.

Curettage and electrodesiccation (C&E)

The tumor is scraped out with a curette (a sharp, spoon-shaped instrument) and the base is treated with an electric needle to destroy any remaining cancer cells. Used for small, low-risk basal cell and squamous cell carcinomas.

Radiation therapy for skin cancer

Radiation therapy uses high-energy X-rays to destroy cancer cells. It may be used for skin cancer when:

• Surgery is not possible or the patient prefers to avoid surgery
• The cancer is in a location where surgery would be difficult (such as around the eye)
• After surgery to reduce the risk of recurrence (adjuvant radiation)
• To treat cancer that has spread to lymph nodes or distant organs (palliative radiation)

Topical and local treatments for early skin cancer

For very early, superficial basal cell and squamous cell carcinomas, or for pre-cancerous lesions like actinic keratosis, non-surgical treatments applied directly to the skin may be effective:

• Topical chemotherapy (5-fluorouracil/Efudex). A cream or solution applied to the skin to kill cancer cells.
• Imiquimod (Zyclara, Aldara). An immune response modifier cream that helps the immune system destroy cancer cells. Used for superficial BCC and actinic keratosis.
• Photodynamic therapy (PDT). A light-sensitive drug is applied to the skin and then activated by a specific wavelength of light to destroy cancer cells. Used for actinic keratosis and some superficial skin cancers.
• Cryotherapy. Liquid nitrogen is used to freeze and destroy abnormal skin cells. Used for actinic keratosis and small, superficial skin cancers.

Targeted therapy for skin cancer

Targeted therapies are drugs that attack specific proteins or gene mutations in cancer cells. They are used primarily for advanced or metastatic melanoma:

BRAF and MEK inhibitors

Used for melanomas with a BRAF mutation (approximately 50% of melanomas). These drugs block the abnormal BRAF protein that causes cancer cells to grow:

• BRAF inhibitors. vemurafenib (Zelboraf), dabrafenib (Tafinlar), encorafenib (Braftovi)
• MEK inhibitors (used in combination with BRAF inhibitors). cobimetinib (Cotellic), trametinib (Mekinist), binimetinib (Mektovi)
• Combination BRAF + MEK inhibitor therapy is now the standard approach, as it is more effective and causes fewer side effects than BRAF inhibition alone.

KIT inhibitors

A small subset of melanomas (particularly mucosal and acral melanomas) have KIT mutations and may respond to KIT inhibitors such as imatinib (Gleevec).

Immunotherapy for skin cancer

Immunotherapy helps the immune system find and destroy cancer cells. It has revolutionized the treatment of advanced melanoma and is also used for other skin cancers:

Checkpoint inhibitors

The main type of immunotherapy used in skin cancer. These drugs block proteins that prevent the immune system from attacking cancer cells:

• Pembrolizumab (Keytruda). Approved for advanced melanoma, high-risk stage II–III melanoma (adjuvant), Merkel cell carcinoma, and cutaneous squamous cell carcinoma.
• Nivolumab (Opdivo). Approved for advanced melanoma, including in combination with ipilimumab (Yervoy).
• Ipilimumab (Yervoy). Blocks the CTLA-4 checkpoint. Used in combination with nivolumab for advanced melanoma.
• Cemiplimab (Libtayo). Approved for advanced cutaneous squamous cell carcinoma and basal cell carcinoma that has not responded to hedgehog pathway inhibitors.
• Avelumab (Bavencio). Approved for Merkel cell carcinoma.

Hedgehog pathway inhibitors

Used for advanced basal cell carcinoma that cannot be treated with surgery or radiation:

• Vismodegib (Erivedge)
• Sonidegib (Odomzo)

Oncolytic virus therapy

• Talimogene laherparepvec (T-VEC/Imlygic). A modified herpes virus injected directly into melanoma tumors that cannot be removed surgically. It destroys cancer cells and stimulates an immune response.

Treating metastatic skin cancer

For skin cancer that has spread to other organs, treatment is typically focused on controlling the cancer and extending life while maintaining quality of life. For metastatic melanoma, the combination of immunotherapy and/or targeted therapy has produced durable remissions in a subset of patients, outcomes that were not possible a decade ago. The choice of treatment depends on BRAF mutation status, PD-L1 expression, and individual patient factors.

Supportive and palliative care for skin cancer

Treating the symptoms of cancer and side effects of treatment is called supportive and palliative care. This is an important part of cancer treatment at every stage, not just at the end of life. Palliative care can include:

• Pain management
• Management of treatment-related side effects (such as skin reactions, fatigue, or immune-related side effects from immunotherapy)
• Wound care for tumors on the skin surface
• Nutritional support from a registered dietitian
• Physical and occupational therapy
• Mental health support and counseling

There is a common misconception that palliative care is only given at the end of life. Palliative and supportive care can be given at any time during cancer treatment.

Follow-up care after treatment

After skin cancer treatment ends, regular follow-up appointments are essential to watch for signs of recurrence and to detect any new skin cancers early. This typically includes regular full-body skin exams by a dermatologist, imaging as needed for higher-stage cancers, and monitoring for treatment-related side effects. People with a history of melanoma should have lifelong dermatologic surveillance.