Surgery is the most common method of treating skin cancer. How this is done depends mostly on the size of the cancer. Small cancers can be removed by cutting them out (excision), or by a technique known as curettage and electrocautery.

Larger tumours are more likely to be cut out (excised) and the skin replaced with a skin graft as necessary.

A type of surgery called margin-controlled excision (or Mohs' micrographic surgery) is used in a small number of hospitals in the UK.

Many small skin cancers are removed by simple surgery. The surgeon, dermatologist or nurse specialist will remove the lump and also some normal-looking skin around it to try to ensure that the cancer has completely gone.

You will have stitches that may need to be removed a week to ten days after your operation. But many surgeons use stitches that dissolve and don’t need to be removed.

If the cancer is fairly small, the operation will usually be done under local anaesthetic and you will probably be able to go home the same day.

The wound will be covered by a dressing. The staff at the hospital will discuss with you how to take care of the area and the dressing.

Much less commonly, if the tumour is large or spreading, a larger area of skin may have to be removed. You may then need to have a skin graft or, less commonly a skin flap, to cover the wound. Skin grafts and flaps are layers of skin taken from another part of the body and placed over the area from which the skin cancer has been removed.

A skin graft is a very thin layer of skin. The surgeon (often a plastic surgeon) will take a layer of skin from another part of the body (known as the donor site). The inner thigh is a common place to take the skin from. The skin is then put over the area where the cancer has been removed.

A skin flap is a slightly thicker layer of skin, which is taken from an area very close to the wound where the cancer has been removed. The flap is cut away but left partly connected so it still has a blood supply. It is moved over the wound and stitched in place. This is a very specialised type of surgery and you may have to travel to a different hospital to have it.

If you have a skin graft you can probably go home the same day. But if the graft is large, or you have a skin flap, you may have to stay in hospital for up to four days. With a skin graft you will normally have a dressing over the area to press the graft down. This helps it to create a good blood supply from the blood vessels underneath.

A skin graft for the face will usually be taken from behind the ear or the neck area to try to get a good match for the skin colour. The area where the graft has been placed will look very noticeable to begin with, but will heal within about a week or so. It will then fade so that it is less obvious. Sometimes a graft is taken from the thigh area: this takes about two weeks to heal. The area from which the graft was taken will also become less noticeable when it has healed.

If there is evidence that squamous cell carcinoma has spread, you may need to have some lymph glands removed. This operation, called a lymphadenectomy, is done to see whether there are any cancer cells in the lymph glands. If cancer cells are present, removing the lymph glands can also help to prevent further spread. This is quite a large operation and is done under a general anaesthetic. It is only necessary for a small number of people who have squamous cell carcinoma and is not usually necessary for anyone who has basal cell carcinoma.

After a lymphadenectomy, tubes (drains) are in place to allow fluid to drain from the wound. The drains will be removed a few days after the operation.

Occasionally this operation may cause swelling of the area. The swelling is called lymphoedema and happens because lymph fluid cannot drain properly from the area after the lymph nodes have been removed.

This means scraping away the cancer and using heat or electricity to stop any bleeding. First you will be given a local anaesthetic. When the area is numb, the doctor will scrape away the cancer using a spoon-shaped instrument called a curette. An electrically heated loop or needle is then applied to cauterise the wound (stop any bleeding) and destroy any remaining cancer cells.

After this treatment, you may develop a scar that is different from your normal skin colour. Any scarring may be more noticeable if you have fair skin.

This is very specialist surgery and is only available at a few hospitals in the UK. Your specialist may refer you to one of these centres if they think that this technique may be necessary in your case. In Moh’s surgery, the tumour is removed piece by piece. As each piece is removed, it is examined under a microscope straight away. Skin tissue is gradually removed until there are no signs of any cancer cells. This technique aims to remove as little healthy skin as possible, while making sure that the all cancer has been taken away.

Moh’s surgery is particularly useful for basal cell cancers that have come back in the same place, or where the doctor thinks that the cancer has begun to spread into the surrounding area. It is also sometimes used for skin cancers on the face (to minimise the effects of surgery) or for large skin cancers. The procedure is often done under local anaesthetic and you are usually allowed to go home the same day. However, if you are having a large tumour removed, you may also need to have a skin graft or flap to cover the wound and so may have to stay in hospital for up to four days.