Non-Melanoma Skin Cancers

Basal Cell, Squamous Cell, and Merkel Cell Carcinomas

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Duke dermatologists perform comprehensive skin screenings to detect skin cancers and use the most effective methods to treat them promptly. Our advanced training and seamless coordination with experts throughout Duke ensure that you receive the best possible treatment, whether your skin cancer is contained to a small area or has advanced and requires specialized care. We do everything possible to cure your skin cancer and minimize your risk of recurrence.

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Types of Skin Cancer

Knowing which type of cancer cell causes your skin cancer is important. Basal, squamous, and Merkel cell carcinomas are often referred to as the non-melanoma skin cancers. These are the most common forms of skin cancer and usually result from too much sun exposure.

Our dermatologists detect and remove all skin cancers and work closely with medical, surgical, and radiation oncologists when a more aggressive skin cancer is diagnosed. We believe that this team-based approach provides the most effective care possible for your skin cancer.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Treatments for Precancerous Lesions

Suspicious areas on the skin that may be related to sun damage (sometimes referred to as actinic keratosis) and very superficial cancer growths on the top layer of your skin may be treated with:

Cryosurgery

Liquid nitrogen spray freezes the suspicious area. A blister may form and fall off. New skin grows in its place.

Topical Chemotherapy Cream

Multiple applications of cream to the suspicious area destroy superficial cancer cells over time.

Photodynamic Therapy

A liquid drug is applied to the affected area and makes it sensitive to light. After an extended period of time, the area is targeted by a special light source, which removes the suspicious lesion.

Laser Surgery

A laser beam destroys the suspicious area and surrounding skin.

Treatments for Cancerous Lesions

Your doctor will develop a treatment plan for your skin cancer based on its location, how deeply it has penetrated the surface of your skin, and whether it has spread. Treatment options for basal, squamous cell, and Merkel cell carcinoma include:

Electrodesiccation and Curettage (ED&C)

A knifelike instrument, called a curette, is used to scrape away the layers of small cancerous lesions. An electric needle is then used to cauterize the wound. This stops the bleeding, seals the area, and destroys any remaining cancer cells.

Mohs Micrographic Surgery

This treatment is critical for high-risk skin cancers, especially on the head and neck. Layers of basal cell or squamous cell cancers are surgically removed and examined under a microscope to ensure no cancerous cells remain.

Radiation Therapy

X-rays destroy cancer cells or shrink tumors. This treatment may be used in select cases or to treat advanced basal-cell cancers.

Skin Grafting and Reconstructive Surgery

A skin graft from another part of your body is used to cover wounds after total removal of skin cancer. The grafting and reconstructive surgery promotes healing, restores the skin’s appearance and function, and minimizes the long-term impact of skin cancer surgery.

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Tests

Our dermatologists use the latest technologies to identify pre-cancerous moles and detect all types of skin cancer. Screening and diagnostic tests include:

Physical Exam

Skin cancers are typically first identified during a physical exam, and the site may be explored more closely using a high-powered microscope called a dermatoscope.

Total Body Photography

If you have several moles on your body, or a family history of skin cancer, our dermatologists may use mole-mapping technology to take sequential photographs of your body from multiple angles. The photographs allow your dermatologist to track changes in your skin and evaluate your skin cancer risk over time.

Biopsy

If skin cancer is suspected, a sample of tissue will be removed and examined for the presence of cancer. The type of biopsy you undergo will be determined by how deep into your skin your physician believes the basal or squamous cells have penetrated. A shave biopsy takes less skin, while a punch biopsy removes a deeper portion of skin.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Experienced Skin Cancer Care

The Duke Cancer Institute
The Duke Cancer Institute brings together the extensive resources of Duke University, Duke Health, and the Duke Comprehensive Cancer Center. We are committed to making innovative discoveries, developing new ways to prevent, diagnose, and treat cancer, and delivering those therapies in a patient- and family-centric way.

Expertise in Advanced Skin Cancers
While it’s rare for non-melanoma skin cancers to spread, it can happen, especially if they are not caught early. In addition, these cancers often grow locally and can damage structures on the face, including the nose and ears. Treating them effectively is crucial to ensuring the best possible outcome. We choose the best medical or surgical treatments for early and advanced skin cancers to ensure you receive the most effective care for your condition.

Targeted Therapy and Immunotherapy
For more advanced non-melanoma skin cancers, our team of medical oncologists can use various forms of immunotherapy and targeted therapy based on the genetic profiling of your cancer.

A Team Approach to Care
Your team may include medical, surgical, and radiation oncologists; otolaryngologists (ear, nose, and throat doctors); dermatopathologists (specialists who look at skin diseases at a cellular level); plastic surgeons; ophthalmologists; and radiologists, when their expertise is needed to develop the most effective treatment plan for you.

Expertise in Head and Neck Skin Cancer
Our experienced ear, nose, and throat surgeons are specially trained in removing skin cancers that involve the head and neck. Their expertise in working exclusively on the head and neck increases the likelihood that you will have positive outcomes for these complicated procedures.

Support for You and Your Family
Our comprehensive support services help you minimize the side effects of cancer treatment and help you and your family cope with the emotional and psychological effects of diagnosis and treatment. View all of our cancer support groups in our event calendar

This page was medically reviewed on 02/22/2023 by

Brent A. Hanks, MD, PhD | Medical Oncologist