Cryotherapy/ Cryosurgery

Cryotherapy is a freezing technique used to remove sunspots (sometimes considered early SCCs) and some superficial BCCs.

The doctor sprays liquid nitrogen onto the sunspot or skin cancer and a small area of skin around it, causing a burning or stinging sensation lasting a few minutes.

The liquid nitrogen freezes and kills the abnormal skin cells and creates a wound, which will be sore and red for a few days and may weep or blister until a crust eventually forms on the wound and the dead tissue will fall off after 1–4 weeks, depending on the area treated. New, healthy skin cells will grow and a scar may develop. Healing can take a few weeks, and the healed skin will probably look paler and whiter than the surrounding skin.

Sometimes the procedure may need to repeated more than once if the abnormal cells are deeper than anticipated.

Some skin spots and cancers can be treated using creams or gels prescribed by a doctor that you apply directly on the skin. These are called topical treatments. They may contain immunotherapy or chemotherapy drugs as their active ingredient.

Sunspots, superficial BCCs and some SCCs in situ (Bowen disease) can be treated using a cream called imiquimod. This is a type of immunotherapy drug that causes the body's immune system to destroy the cancer cells.

Imiquimod will be applied daily for up to 6 weeks under the direction of your doctor and can cause scabbing and crusting, which may be uncomfortable. The treated skin may become red and inflamed and may be tender to touch. Some people have a more serious reaction to imiquimod, but this is uncommon.

5-fluorouracil (5-FU)

This cream is used to treat superficial BCCs, sunspots and, sometimes, squamous cell carcinoma in situ (Bowen disease). It works best on the face and scalp.

While using the cream, you will be more sensitive to the sun and will need to stay out of the sun. The treated skin may become red, blister, peel and crack, and often feel uncomfortable. These effects will usually settle within a few weeks after treatment has finished.

Ingenol mebutate

This new type of topical chemotherapy for sunspots is a gel that you apply to the affected skin once a day for two or three days. Side effects can include skin reddening, flaking or scaling, mild swelling, crusting or scabbing, and blisters. These side effects should disappear within a couple of weeks after treatment has finished.

Surgery is the most common treatment for skin cancer. It is usually a quick and simple procedure that can be performed in clinic under local anaesthetic. More complex cases may be referred to be treated by a surgeon.

Your doctor injects a local anaesthetic to numb the affected area, then cuts out the skin cancer and some nearby normal-looking tissue (margin)  before closing the wound with stitches. A pathologist checks the margin to make sure the cancer has been completely removed. The results will be available in about a week. If cancer cells are found in the margin, further surgery may be required to minimise the chances of recurrence, though this is always a possibility.

Repairing the wound

For large skin cancers, a bigger area of skin needs to be removed, and the wound may covered with a skin flap or skin graft.

For a skin flap, nearby loose skin or fatty tissue is moved over the wound and stitched together. For a skin graft, a thin piece of skin from a similar appearing part of the body is stitched over the wound. These procedures may be performed in the office but equally may sometimes be done as day surgery in hospital under a local or general anaesthetic. We can organise referral to other specialists as needed for these.