Skin cancer removal (surgery) (Surgical excision of skin cancer)
An operation to cut out a skin cancer with a margin of surrounding skin, so it can be examined under a microscope and, where possible, fully removed.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- The operation removes the visible cancer plus a margin of normal skin, which is then checked under a microscope.
- Surgery cannot guarantee a cure — the histology result tells you whether the edges were clear, and some cancers still come back over time.
- You usually wait one to three weeks for the microscope result, which guides whether you need more surgery or other treatment.
- Choose a team that works within a skin cancer multidisciplinary team (MDT) and arranges proper histology and follow-up.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Removes the visible skin cancer and allows the edges to be checked under a microscope
Very large, deeply invasive or widely spread cancers may need treatment beyond simple excision, decided at an MDT.
Keep the dressing dry and the area rested. Some pain, bruising and oozing is normal. Follow advice on painkillers and when you can get the wound wet.
A clear, named route to get your histology result and ask questions.
Keep the dressing dry and the area rested. Some pain, bruising and oozing is normal. Follow advice on painkillers...
Stitches are often removed around 5–14 days depending on the site. Avoid stretching the wound and heavy activity...
You are told the type of cancer and whether the margins are clear. If they are not, you may be offered further...
The scar settles and fades over several months. Grafts and flaps take longer to soften and may stay numb.
What is skin cancer removal (excision)?
Skin cancer removal is an operation that cuts out a skin cancer along with a margin of normal-looking skin around and beneath it. The aim is to remove the whole cancer and then check it under a microscope to see whether the edges (margins) are clear.
The most common skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Melanoma is less common but more serious and is usually removed in two stages: first a biopsy to make the diagnosis, then a wider operation. Your team will choose the margin and method based on the type of cancer, how it looks under the microscope and where it is on the body.
Surgery is the main treatment for most skin cancers found early, but it is not the only option, and no operation can promise that a cancer will never come back. The microscope result, not the operation itself, tells you whether the cancer was fully removed.
For cancers on the face or other tricky areas, a technique called Mohs surgery may be used. The surgeon removes thin layers and checks each one under the microscope during the same visit, so they take the least tissue needed to clear the cancer.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Standard excision vs Mohs surgery
| Feature | Standard excision | Mohs surgery |
|---|---|---|
| Margin check | After surgery, in the lab | During surgery, same visit |
| Tissue removed | Set margin all round | Least needed to clear |
| Best for | Most BCC/SCC on the body | Face, recurrent or unclear edges |
| Time on the day | Shorter | Often several hours |
| Repeat surgery if margins not clear | May be needed | Usually avoided |
Your skin cancer team will advise which method suits your cancer, its site and its type.
Preparing for your surgery
- Make sure you have seen a clinician who works within a skin cancer multidisciplinary team and that any diagnostic biopsy result is back.
- Tell the team about blood-thinning medicines (such as aspirin, clopidogrel, warfarin or DOACs) and any supplements; do not stop them without advice.
- Mention diabetes, problems with healing or scarring, and any allergies to local anaesthetic, plasters or antiseptics.
- Ask where the scar will be, how big it may be, and whether a graft or flap might be needed.
- Arrange a lift home if you may have sedation or a general anaesthetic, or if the area will be heavily dressed.
- Ask whether you can keep taking your usual medicines and whether you need time off work for the site involved.
What happens
Most skin cancer excisions are done awake under local anaesthetic. The area is numbed with an injection, the cancer and its margin are cut out, and the wound is closed with stitches. The removed tissue is sent to the laboratory.
Larger cancers, awkward sites or anxious patients may need sedation or a general anaesthetic. If a graft or flap is planned, the operation takes longer and a second wound (the donor site) may be created.
With Mohs surgery, the surgeon removes a thin layer, you wait while it is checked under the microscope, and further layers are taken only if cancer cells remain at the edge. The wound is closed once the margins are clear.
For some melanomas, a sentinel lymph node biopsy may be done at the same time under general anaesthetic to check the nearest lymph nodes.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Very large, deeply invasive or widely spread cancers may need treatment beyond simple excision, decided at an MDT.
- People who cannot stop or safely manage blood thinners may need their plan adjusted first.
- Sites where surgery would cause unacceptable damage may be better treated with radiotherapy or other options.
- A lesion that has not been properly diagnosed should be biopsied before a definitive operation is planned.
Delay surgery if…
- There is active infection at or near the planned site.
- Blood-thinning medication needs reviewing and cannot be managed safely yet.
- The diagnostic biopsy result is not yet available to guide the margin and method.
- You are unwell or have uncontrolled conditions (such as poorly controlled diabetes) that impair healing.
Alternatives to discuss
- Mohs micrographic surgery for face, recurrent or ill-defined cancers.
- Radiotherapy where surgery is unsuitable or refused.
- Curettage and cautery, cryotherapy, photodynamic therapy or topical creams for selected low-risk superficial BCCs.
- Active surveillance in frail patients with slow-growing low-risk cancers, after MDT discussion.
- Systemic or targeted treatment for advanced or metastatic disease.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Removes the visible skin cancer and allows the edges to be checked under a microscope
- Gives a clear histology report on the type of cancer and whether margins are clear
- Often curative for early, completely excised BCC and SCC, though this is never guaranteed
- Mohs surgery can spare healthy skin in delicate areas such as the face
- Provides staging information when a sentinel node biopsy is done for melanoma
Risks & complications
- Pain, bruising and swelling around the wound for a few days
- A permanent scar, which may be longer than the cancer itself
- Temporary numbness around the wound
- Needing a dressing and stitch removal, and time off some activities
- Wound infection needing antibiotics
- Bleeding or a collection of blood (haematoma) under the wound
- Margins reported as not clear, so further surgery is needed
- Wound breakdown, or partial failure of a skin graft or flap
- Damage to a nearby nerve causing lasting numbness or weakness (depends on site)
- A noticeably poor or thickened (keloid) scar
- The cancer coming back at the same site despite clear margins
- Spread of cancer found later that was not detectable at the time of surgery
The biggest uncertainties are whether the margins come back clear and whether the cancer could come back or spread over time, neither of which surgery alone can settle. Ask what type of cancer is suspected, what margin is planned, what happens if the edges are not clear, and how you will be followed up. For melanoma and higher-risk SCC, ask whether your case is being discussed at a skin cancer MDT.
Published figures to discuss
Outcomes depend heavily on the type of cancer, how it looks under the microscope, its size and site, and whether the margins come back clear. Reported figures vary between studies and centres, so the numbers below are cautious ranges to support discussion, not promises about your own result. Margins reported as clear lower but do not remove the chance of recurrence.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Incomplete excision of BCC (margins not clear) | Roughly 1 in 10 with a 2–3 mm margin, falling to about 1 in 20 with a 5 mm margin in pooled data | Wider margins clear more cancers but remove more skin; the right margin depends on the cancer and site (British Association of Dermatologists; systematic review). | British Association of Dermatologists — BCC management guidelines 2021onlinelibrary.wiley.comPublished figure |
| Local recurrence after excision of BCC | In the low single digits (around 3% across studies), higher after incomplete excision | Most recurrences in the review had margins under 3 mm; complete excision lowers but does not remove the risk. | Surgical margin of excision in BCC: systematic review — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Local recurrence after wide excision of melanoma | Low (under 1% in one large series of around 1,200 patients) | Depends on melanoma thickness and features; overall outlook is driven by stage, not just the local scar. | Surgical margin of excision in BCC: systematic review — PMCpmc.ncbi.nlm.nih.govPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery from a skin excision is usually quick, but the part that matters most is the wait for the microscope result, which confirms whether the cancer was fully removed.
- A sore, bruised or tight wound for the first few days
- Numbness around the scar that may slowly improve
- A pink, firm scar that gradually pales over months
- Anxiety while waiting for the histology result, which is common and understandable
Aftercare
- Keep the wound clean and dry as instructed, and change dressings as advised.
- Take painkillers as recommended and avoid activities that stretch or knock the wound.
- Watch for signs of infection — increasing redness, heat, swelling, pain or discharge — and report them.
- Protect the healing scar from the sun and use sun protection on your skin generally.
- Attend your stitch-removal and result appointments, and make a note of any questions.
- Make sure you know your histology result and the follow-up plan before you are discharged.
- Learn how to examine your own skin and lymph nodes, and report new or changing lesions.
- Diagnostic biopsy result back before surgery
- Spare dressings and any prescribed ointment
- Painkillers at home
- Stitch-removal appointment booked
- Date you will get the histology result
- Clinic contact number for problems
- Lift home arranged if sedation or general anaesthetic
Scars and how they heal
Skin cancer surgery always leaves a scar, and to clear the cancer the scar is usually longer than the lesion you could see. On the body scars are often a straight line; on the face a flap or graft may be used to keep the appearance as good as possible. Scars are pink and firm at first and usually fade over several months, though some people form thickened or keloid scars. Good sun protection helps the scar settle.
⚠ Get urgent help if…
- Increasing redness, heat, swelling, pain or pus from the wound (possible infection)
- Bleeding that does not stop with gentle pressure
- A wound that splits open or a graft that turns dark or lifts
- Spreading redness with fever or feeling generally unwell
- New numbness, weakness or drooping near the wound
- A new lump near the scar or in nearby lymph nodes
- A new, changing or bleeding skin lesion anywhere on your body
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the whole cancer has been removed with clear margins on the microscope report and the wound heals well. The histology report, not the operation, confirms the type of cancer and whether the edges are clear; this usually takes about one to three weeks.
Clear margins greatly reduce the chance of the cancer coming back at that site, but they do not guarantee it. Some cancers recur, and people who have had one skin cancer are more likely to develop another, which is why follow-up and self-checks matter.
For early, completely excised BCC and many SCCs, surgery is often a lasting treatment, but recurrence at the site or elsewhere remains possible, especially for higher-risk or recurrent cancers. For melanoma, the outlook depends heavily on how deep it was and whether it had spread, and follow-up may continue for years. No one can promise a permanent cure, which is why ongoing skin checks are part of good care.
Combining with other procedures
Skin cancer removal is sometimes combined with reconstruction (a flap or graft) in the same operation, and for melanoma with a sentinel lymph node biopsy for staging. Depending on the histology, surgery may be followed by further excision, radiotherapy, or in some cases medicines, decided at a skin cancer MDT.
Follow-up & long-term care
You should be told your histology result and given a clear follow-up plan. Follow-up depends on the cancer type and risk: low-risk BCC may need little or none, while higher-risk SCC and melanoma usually need regular reviews over years to look for recurrence and new cancers. You should know who to contact if you notice a change between appointments.
- Examine your own skin and lymph nodes regularly, as advised by your team.
- Use sun protection and avoid sunbeds to lower the risk of further skin cancers.
- Attend all follow-up appointments for the recommended period.
- Report any new, changing, non-healing or bleeding skin lesion promptly.
Revision and secondary surgery reality
- If the microscope shows the edges are not clear, further surgery or another treatment is often needed.
- A flap or graft can partly fail and occasionally needs a repeat procedure.
- Having one skin cancer raises the chance of needing treatment for another in future, so surveillance is part of care.
- For melanoma, further surgery or treatment may follow depending on staging and MDT advice.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- A clear, named route to get your histology result and ask questions.
- A written follow-up plan based on the type and risk of your cancer.
- Advice on wound care, signs of infection and sun protection.
- Teaching on how to check your own skin and lymph nodes.
- MDT review and onward referral for higher-risk cancers or if margins are not clear.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether it is a simple excision, Mohs surgery, or excision with a flap or graft
- The seniority and specialty of the surgeon (for example dermatological, plastic or Mohs surgeon)
- Local versus general anaesthetic and any sedation
- Theatre or treatment-room and facility fees
- Laboratory (histology) fees and any specialist pathology
- Number of lesions treated and the complexity of the site
- Follow-up appointments, dressings and any further surgery if margins are not clear
- The surgeon's fee and which procedure it covers
- Facility or theatre fee
- Anaesthetic or sedation fee if relevant
- Histology (laboratory) fee and who reports it
- Cost of any reconstruction (flap or graft)
- Follow-up appointments and dressing changes
- What happens — and what it costs — if the margins are not clear or a complication occurs
On the NHS? Suspected and confirmed skin cancers are treated on the NHS, usually through urgent referral pathways; private care is used mainly for speed or choice and should meet the same standards of histology and MDT review.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being told the cancer is 'cured' on the day, before the histology result is back.
- No clear explanation of what happens if the margins are not clear.
- No discussion of the scar size, position or the chance of needing a graft or flap.
- No agreed follow-up plan or advice on checking your own skin.
- Higher-risk cancers treated without skin cancer MDT input.
Marketing red flags
- Claims that surgery 'guarantees a cure' or that the cancer 'definitely won't come back'.
- Promises of 'scarless' skin cancer removal.
- Offering destructive treatments (freezing, creams) for a lesion that has not been properly diagnosed.
- No mention of histology, margins or MDT review.
- Pressure to pay for a quick private procedure without discussing the standard NHS pathway.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- What type of skin cancer do you think this is, and how was it diagnosed?
- What margin will you take, and what happens if the edges are not clear?
- Will I need a graft or flap, and where will the scar be?
- Is my case being discussed at a skin cancer MDT?
- How will I be followed up, and for how long?
- What is my personal risk of it coming back or of getting another skin cancer?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Can I have skin cancer removed on the NHS?
Does removing it mean I am cured?
How long do the results take?
What happens if the margins are not clear?
Will I have a big scar?
Why might I need a lymph node biopsy?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Non-melanoma skin cancer: treatment NHS — Melanoma skin cancer: treatment British Association of Dermatologists — BCC management guidelines 2021 British Association of Dermatologists — cutaneous SCC guidelines 2020 Surgical margin of excision in BCC: systematic review — PMC Cancer Research UK — Tests for melanoma
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Mole or skin lesion removal · Basal cell carcinoma surgery · Burns reconstruction · Local flap reconstruction · Melanoma surgery (wide local excision)