The most common treatment for skin cancer involves surgery. Any type of surgery, including Moh’s surgery, leaves a scar. While scars usually fade within a year or two, they remain and can be embarrassing. Recent medical advances provide ways to reduce the scarring and leave your skin close to the way it was before the skin cancer surfaced. Depending on the location and size of your scar, your doctor will discuss different options for minimizing your scar.
Treatments with Minimal Scarring
Topical Chemotherapy Treatments - This type of treatment is a cream you use at home to treat superficial cancers, such as basal cell carcinoma and squamous cell carcinoma that has not spread beyond the epidermis. Topical creams leave less scarring than excision, however, you still need to follow proper wound care to prevent infection and further skin damage.
Photodynamic Therapy - This treatment is also for basal cell carcinoma and squamous cell carcinoma. The cancer is covered or injected with specific drugs, which become active when exposed to light. After several hours or days, the area is exposed to various light sources. This causes little scarring but does make your skin very sensitive to sunlight and you need to be vigilant about staying out of the sun. The treatment is painful and you may require pain medication.
Radiation Therapy - Radiation can be used to treat all types of skin cancer, including melanoma. It uses high-energy photons to destroy the skin cancer and some surrounding tissue. You normally receive radiation therapy in several visits over a period of weeks. Radiation therapy leaves minimal scarring when done properly.
Laser Surgery - A type of treatment for superficial skin cancer, this may leave white scars when several layers of skin are destroyed. For superficial laser treatment, you might not see any scarring.
Cryosurgery - This treatment involves freezing the cancerous tissue to destroy it. It is sometimes repeated several times. While less invasive than other types of skin cancer surgery, it can cause scarring.
Excision and Moh’s Surgery
When tumors are removed through excision or Moh’s surgery, there is usually scarring. Moh’s surgery, because only the cancerous tissue is removed and minimal surrounding tissue is touched, might have less scarring than if surgical excision was used on the same tumor.
Recent medical advances are helping to reduce the scarring associated with these surgeries.
New stitching - Changing the way doctors stitch wounds can help reduce scarring. A new technique, called a barbed stitch uses a continuous thread rather than individual stitches, similar to the stitching on a baseball. This technique reduces the scarring.
Dermabrasion and lasers - Immediately upon closing a wound internally, your doctor uses either an abrasive device or a laser to "sand" the edges of the wound and then stitches the top of the wound. This helps new skin cells cover the wound and blend with the surrounding skin. This can’t be used on the eyelids or lips but can be used on other areas of the face. It works best on fair-skinned people. It greatly reduces scarring. A study published in the Journal of Drugs in Dermatology in Oct. 2013, showed laser treatments for scarring after the surgery significantly improved scarring.
Skin substitutes, which are made of animal proteins is used in skin grafts. While these don’t necessarily reduce scarring, they do eliminate the need for a second surgical site.
When discussing your options for skin care treatment, it is important to include post-surgery concerns, such as scarring. Your doctor should be able to tell you how much scarring to expect for each option and ways to reduce the scarring, especially if your surgical site is clearly visible and you are concerned about the appearance of the wound.
"New Methods Aid in Minimal Scars for Skin Cancer Patients," 2008, March 12, Staff Writer, SkinInc.com
"What Does Post-Operative Care Involve?" Date Unknown, Staff Writer, University of Rochester Medical Center