Skin Cancer Treatment Understanding Your Options

Skin cancer is the most common form of cancer in the United States, affecting millions of people each year. Fortunately, when detected early, most types of skin cancer can be effectively treated with excellent outcomes. At Dermatology Associates of the Bay Area, our board-certified dermatologists and PAs provide comprehensive, personalized treatment plans for both melanoma and non-melanoma skin cancers, using state-of-the-art techniques to achieve the highest cure rates while preserving healthy tissue.

This page outlines the most common treatment modalities available today, including Mohs micrographic surgery, surgical excision, electrodessication and curettage (ED&C), topical therapies such as fluorouracil cream and imiquimod, and radiation therapy. Understanding these options can help patients feel more confident and informed about their care.

Mohs Micrographic Surgery

What it is:
Mohs surgery is the gold standard treatment for many types of non-melanoma skin cancers, particularly basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). This highly specialized technique allows us to remove skin cancer layer by layer, examining the tissue under a microscope in real time.

Advantages:

Highest cure rate of any skin cancer treatment (up to 99% for certain tumors).
Maximizes tissue preservation, removing only cancerous cells.
Especially valuable for tumors on the face, ears, nose, lips, and other cosmetically or functionally sensitive areas.

When used:
Mohs surgery is recommended for cancers that are recurrent, aggressive, have poorly defined borders, or are located in cosmetically sensitive or high-risk areas.

Surgical Excision

What it is:
Surgical excision is a standard and effective treatment method for melanoma and non-melanoma skin cancer. During this procedure, the dermatologist surgically removes the cancer along with a margin of surrounding healthy skin to ensure all malignant cells are eliminated.

Advantages:

Provides a high cure rate.
Allows for complete dermatopathologic evaluation of the specimen.
Often curative with one procedure.

When used:
Excision is a mainstay for melanoma management, as well as for many BCCs and SCCs. The margin size depends on the type, size, and depth of the cancer.

Electrodessication and Curettage (ED&C)

What it is:
Also known as “scrape and burn,” this procedure uses a sharp instrument (curette) to scrape away cancerous tissue, followed by cauterization (electrodessication) to destroy any remaining malignant cells and control bleeding.

Advantages:

Quick, cost-effective in-office treatment.
No suturing is required.
High cure rates for small, low-risk cancers.

When used:
ED&C is generally reserved for small, superficial basal cell and squamous cell carcinomas on low-risk body sites such as the trunk or extremities. It is not typically used for melanoma or cancers on the face.

Dermatology Associates of the Bay Are Procedure in Action shot

Topical Chemotherapy: Fluorouracil Cream

What it is:
Fluorouracil (5-FU) cream is a topical chemotherapy agent that works by interfering with the DNA of cancer cells, causing them to die off. Patients apply the cream at home, usually twice daily for 2-6 weeks.

Advantages:

Non-invasive and needle-free.
Excellent for treating superficial cancers or precancerous actinic or solar keratoses.
Can treat multiple spots or areas, such as the face, in a single treatment cycle.

When used:
5-FU is typically used for superficial basal cell carcinomas and actinic keratoses. It is not used for invasive SCCs or melanoma.

Topical Immunotherapy: Imiquimod

What it is:
Imiquimod cream stimulates the body’s immune system to attack and destroy cancerous or precancerous cells. Like 5-FU, it is applied at home over several weeks.

Advantages:

Harnesses the body’s immune response.
Non-invasive, no cutting or stitches.
Useful for patients who may not be suitable candidates for surgery.

When used:
Imiquimod can be used for certain superficial basal cell carcinomas, actinic keratoses, and, in some cases, for in situ melanoma (lentigo maligna) under close medical supervision. It is not effective for invasive cancers.

Radiation Therapy

What it is:
Radiation therapy utilizes high-energy beams to target and destroy cancer cells. A radiation oncologist typically administers it in a hospital or specialized treatment center.

Advantages:

A non-surgical option for patients who are unable to undergo surgery.
It can be highly effective, especially for small or localized cancers, such as those on the tip of the nose.
Preserves surrounding tissue without surgery.

When used:
Radiation may be used for basal cell or squamous cell carcinomas in patients who are poor surgical candidates, for cancers located in challenging areas like the nose or ear, or as an adjunctive therapy following surgery for deeply invasive skin cancers at high risk for metastasis.

Choosing the Right Treatment

The best treatment approach depends on several factors, including:

Type of cancer (melanoma vs. non-melanoma).
Size, depth, and location of the tumor.
Patient’s overall health and medical history.
Cosmetic or functional considerations.

At Dermatology Associates of the Bay Area, we tailor each treatment plan to meet the individual’s needs. For some patients, surgery provides the highest chance of cure. For others, topical therapies or radiation may be more appropriate. Often, treatments are combined to optimize results.

Why Early Detection Matters

Regardless of the treatment method, early detection remains the single most important factor in achieving successful outcomes. When caught early, both melanoma and non-melanoma skin cancers are highly curable. We recommend:

Regular self-skin checks.
Annual full-body skin exams by a board-certified dermatologist or experienced dermatology PA.
Prompt evaluation of any new, changing, or non-healing spots.

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Comprehensive Care at Our Practice

Our team offers a comprehensive range of skin cancer care, encompassing prevention, screening, and advanced surgical techniques. With expertise in Mohs micrographic surgery, excisional surgery, topical therapies, and coordinated care with oncologists and radiation specialists, we ensure that each patient receives the highest standard of care in a compassionate and supportive environment.