Other treatments for skin cancer

Curettage and electrodesiccation

Curettage and electrodesiccation (cautery) is used to treat some BCCs, small SCCs and areas of SCC in situ (Bowen’s disease).

The doctor will give you a local anaesthetic and then scoop out the cancer using a small, sharp, spoon-shaped instrument called a curette. Low-level heat will be applied to stop the bleeding and destroy any remaining cancer. The wound should heal within a few weeks, leaving a small, flat, round, white scar. Some people may have cryotherapy after curettage to destroy any remaining cancer cells.

Cryotherapy

Cryotherapy, or cryosurgery (freezing), uses extreme cold to treat sunspots, some small superficial BCCs and SCC in situ (Bowen’s disease). It is not suitable for some SCCs that have come back.

The GP or dermatologist sprays liquid nitrogen onto the sunspot or skin cancer and a small area of skin around it. You may feel a burning or stinging sensation, which lasts a few minutes. The liquid nitrogen freezes and kills the abnormal skin cells and creates a wound.

The treated area will be sore and red. A blister may form soon after. A few days later, a crust will form on the wound. The dead tissue will start to fall off 1–6 weeks later, depending on the area treated. New, healthy skin cells will grow and a scar may develop. The healed skin may look paler than the surrounding skin.

Your doctor will tell you about follow-ups to check if the skin cancer has come back. In some cases, the procedure may need to be repeated.

Photodynamic therapy

Photodynamic therapy (PDT) uses a cream that kills cancer cells when a special light is applied. It is used to treat sunspots, superficial BCCs and SCC in situ (Bowen’s disease). This treatment may have a high cost.

After gently scraping the area to remove any dry skin or crusting, the doctor applies a cream to the skin. After 3 hours, light is used to activate the cream, either using an LED light or by indirect sun exposure (daylight PDT). An LED light is usually used on the area for about 8 minutes. The area is then covered with a bandage. For skin cancers, LED PDT is usually repeated 1–2 weeks later. Daylight PDT works in a similar way – your doctor will give you instructions for how long to expose only the area with the cream to sunlight.

Side effects can include redness and swelling, which usually ease after a few days. PDT commonly causes a burning, stinging or tender feeling in the treatment area, particularly on the face. Your doctor may treat these side effects with a cold water spray or pack, or give you a local anaesthetic to help ease any discomfort.

Topical treaments

Immunotherapy cream

Imiquimod cream is a type of immunotherapy that causes the body’s immune system to destroy cancer cells. It’s used to treat sunspots and superficial BCCs. You may need a biopsy (if you haven’t had one) before using this cream. Your doctor will explain how and when to apply the cream. For superficial BCCs, the cream is often applied at night, usually 5 days a week for 6 weeks. Within days, the treated skin may get red, sore or tender. It may peel and scab over before it gets better. Some people experience pain or itching in the affected area, fever, achy joints, headache and a rash. If you notice any of these more serious side effects, stop using the cream and see your doctor immediately.

Chemotherapy cream

A cream called 5-fluorouracil (5-FU) is a type of chemotherapy drug used to treat sunspots and sometimes SCC in situ (Bowen’s disease). 5-FU works best on the face and scalp. Your doctor will explain how to apply the cream and how often. Many people use it once or twice a day for 2–4 weeks. It may need to be used for longer for some skin cancers.

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

Other treatments

As at October 2025, there are no Australian guidelines or recommendations on the use of topical radiation creams such as Rhenium-188. Information on its effectiveness and side effects is needed before it may be considered a standard treatment.

Radiation therapy

Radiation therapy (or radiotherapy) uses radiation to kill or damage cancer cells so they can’t grow, multiply or spread. It’s used as the main treatment for BCCs or SCCs that can’t be removed surgically, for large areas, or for people not fit enough for surgery.

You may have radiation therapy after surgery to reduce the risk of cancer returning. It should be started within 6 weeks after surgery.

Radiation therapy to treat skin cancer is given from outside the body (externally). It may use low-energy x-rays from a superficial x-ray machine or high-energy x-rays from a machine called a linear accelerator or LINAC. Different techniques and types of radiation may be used. You will have a separate planning session so the radiation therapy team can work out the best position for your body during treatment.

Treatment will usually start a couple of weeks after a planning session. During each treatment session, you will lie on a table under the radiation machine. Once you are in the correct position, the machine will rotate around you to deliver radiation to the area with the cancer. The process can take 10–20 minutes, but the treatment itself takes only a few minutes.

The number of treatments varies and may take 2–7 weeks to complete. Your treatment team will consider things such as the type and position of the skin cancer and your preferences and circumstances to tailor the best treatment course. Some people have 5 sessions a week for several weeks, while others may have a much shorter course of treatment.

Skin in the treatment area may become red, dry or moist, and sore 7–10 days after treatment starts, depending on how long you have treatment. This soreness may get worse after treatment has finished but it usually improves within 6 weeks. The treatment team will suggest creams or coverings to make you more comfortable.