By Consultant Dermatologist, Bav Shergill

Topical treatments

Cream based treatments such as Efudix, Picato and Aldara are applied to an area of sun-damaged skin.  These drugs work in different ways but the end result is an excellent cure rate with the skin looking back to normal in the majority of cases.

The downsides are that the skin is very red and sometimes scabbed during the treatment protocol and for a few weeks afterwards.  We can find a strategy that works for you and fit it into your calendar.

Photodynamic therapy

Treatment involves applying a cream-based sensitiser to the skin where the cancer is situated. The skin is covered and left for about three hours.  In this time, cancerous cells take up the sensitiser, but healthy cells do not.   A 630nm wavelength light is then shone onto the skin, which destroys any cells that have taken up the sensitiser (the cancerous cells).  The skin can be reddened and sensitive afterwards, but it usually recovers within 1-2 weeks.

The advantages of PDT are that it treats early skin cancers that may not be apparent to the naked eye. There is virtually no scarring and the skin can appear rejuvenated and blemish free afterwards.

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Skin surgery

Some tumours can only be treated with surgery.  Simple surgery is undertaken with a local aneasthetic and takes 5-10 minutes.

Complex surgery requires moving skin to cover up the wound after removing the tumour (known as a skin flap) or even moving skin from one part of the body to repair a surgical wound (this is a skin graft).  Dr Shergill has had extensive training and many years of experience in these techniques.

Mohs surgery

This cutting-edge treatment requires specially trained dermatologists and can be used to remove most skin cancers, except for melanoma.

It involves removing the cancer and a thin layer of skin from underneath it. The layer of skin is then examined through a microscope to ensure that no cancer cells are remaining. If there are still cancer cells, then more layers of skin will be removed until there is no more evidence of any cancer remaining in the site.

This procedure minimises the amount of normal tissue that needs to be removed around the cancer, which means that there is less scarring and disfigurement than more traditional surgical methods.  It provides the best foundation for reconstructions and is often used on the face.

The procedure can be fully completed in a day and we can be certain that all malignant tissue is removed, so there is no need for further surgery.

The cure rates approach 99% for most primary (untreated) cancers with a slightly lower cure rate for secondary or recurrent (previously treated) cancers. This is better than for any other method of removing skin cancer.

Mr Bav Shergill is a Consultant Dermatologist and is one of a small number of dermatologists in the country who have received recognised training in Mohs surgery for the treatment of skin cancer.
Page last reviewed on 27/08/2017

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