Types of Surgery for Non-Melanoma

There are several kinds of surgery that are effective for skin cancer, including:

• Electrodesiccation and curettage: This used for non-melanoma skin cancers that are limited to the top layers of the skin (the epidermis and superficial dermis).  With this procedure, the area being treated is anesthetized with a local injection and the dermatologist uses an instrument called a curette to scrape away and destroy skin cancer cells.  The dermatologist will then use electrocautery (heat and electricity) to stop any bleeding and destroy any cancer cells at the base of the wound.  The wound is allowed to heal on its own, often resulting in a small, round, pale scar.  This type of procedure does not require stitches or any downtime and is very safe.
• Surgical excision: Surgical excision is used to treat the vast majority of skin cancers on the body that go beyond the first layer of the skin.  This procedure is performed with local anesthesia and is a simple outpatient procedure.  The dermatologist will excise or cut out the skin cancer along with margin of normal skin and then suture the wound.  The excised tissue is sent to the pathology lab where it is examined under the microscope by the pathologist to determine if edges are free of cancer.  This procedure is performed most often by a dermatologist or a dermatologic surgeon.

Mohs Surgery for Non-Melanoma »

• Mohs surgery:  In cases where the skin cancer is large or on the head, neck, hands, feet or genitalia, the doctor will often recommend Mohs micrographic surgery. This is an outpatient surgical procedure performed by dermatologists specially trained in Mohs surgery.  With this procedure, the surgeon is able to remove the skin cancer with a very conservative margin and study all the edges of the tissue under the microscope at the time of surgery.  In addition, the Mohs surgeon maps out the skin cancer as it is removed such that she or he can trace the cancer cells.  This not only allows for a more thorough evaluation of the tissue but also conserves health tissue.   Once the area is clear of cancerous cells the Mohs surgeon will perform the reconstruction.  This is all done with local anesthesia and is a very safe and effective way to treat skin cancer in functionally and cosmetically sensitive areas.