The incidence of skin cancer is increasing due in part to increasing sun exposure. Most skin cancers can be effectively treated with a single minor procedure.
Basal cell carcinoma (BCC)
BCC is the most common type of skin cancer in the UK. Most of these tumours are effectively treated with a short operation, under local anaesthetic (with you awake), as a day-case procedure. Most need no further treatment and do not recur.
Squamous cell carcinoma (SCC)
SCC is the second most common type of skin cancer. Again these tumours can be effectively treated with a single short procedure under local anaesthetic (with you awake), as a day-case. There is a small chance that skin SCC can spread to other parts of the body and your doctor will discuss this with you. For this reason you may be offered regular follow-up.
Moles are a normal feature of the skin and the vast majority are not dangerous. However there are a few signs that should prompt a review by your doctor or specialist:
- If you spot a new mole (as an adult)
- If an existing mole is large (greater than 6-7mm)
- If a mole changes in colour (becomes darker or loses colour)
- If a mole changes in size (larger or smaller)
- If a mole changes in shape (becomes irregular)
- If a mole becomes itchy, irritates or bleeds
Moles with the above features should be assessed by a doctor and if there is any doubt as to the diagnosis then you should be referred to a specialist (Plastic Surgeon or Dermatologist) for assessment and the mole should be removed and sent for examination under the microscope.
Malignant melanoma is a type of skin cancer. The treatment of melanoma is normally surgical and involves removal of the melanoma and a margin of surrounding skin to reduce the risk of recurrence and spread. This can usually be done under local anaesthetic (with you awake) as a day case procedure. Your specialist will then arrange for follow-up for 1-5 years depending on the type of melanoma. Further treatment is occasionally required.
Minor skin surgery
Skin lesions can be removed in clinic in a short local anaesthetic procedure that takes 20-30 minutes. Some lesions are best treated by shave or curettage, leaving a small superficial wound (like a graze) that heals in a week or so. This tends to heal very nicely and can leave a mark that is difficult to see. Others are treated by cutting them out (excision) and closing with stitches. This leaves a short linear scar. Fortunately problems after surgery are uncommon and we will discuss this with you in clinic. Follow-up is included in the cost of treatment, including any removal of stitches and any nursing care. If if the skin lesion is sent to the laboratory then we will write to you afterwards with the report and arrange consultant follow-up if required.
Skin grafts and flaps
Plastic Surgeons occasionally use skin grafts and flaps to close wounds after removal of skin lesions.
A skin graft is a piece of skin taken from one body site (common ‘donor sites’ include the neck or in front of or behind the ear) and transferred to another body site (such as the face) to close or cover a wound. The graft gains a blood supply from the wound bed and heals. The donor site is usually closed with stitches. Skin grafts usually heal in 1-2 weeks and mature over the next 6-18 months.
A skin flap is a piece of skin transferred with its blood supply intact. This is a common technique in the face after removal of skin cancers. Usually the donor site and the flap is closed with stitches and heals within 1-2 weeks. A flap tends to provide a better skin match than a graft because it is taken from adjacent skin.