Skin Cancer Surgery

Skin cancers can appear like any skin lump or lesion in the early stages.
Slow growth, redness, irritation, change in shape over time can indicate a skin cancer.
Skin cancers are usually painless but can case irritation, bleeding, crusting or loss of eyelashes.

The most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma.
Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common skin cancers.
Rarer skin cancers include sebaceous gland carcinoma or melanoma.
Skin cancers can grow and invade the surrounding tissues, damaging the eye and eye socket.
Some have the potential to metastasize or spread to other parts of the body or are faster growing.

Skin cancers and suspicious skin lesions require an assessment.
Often a biopsy is taken to diagnose the type of skin cancer and determine the timeframe and extent of treatment.

Most skin cancers around the eyelid are cured with surgery.
Other non-surgical options, such as radiotherapy or immunotherapy are considered in certain circumstances.
Loss of vision or significant damage to the eye is uncommon but possible if appropriate treatment is not performed.

The aim of surgery is to completely excise the skin cancer with a rim of normal tissue to prevent recurrence.
The skin cancer is often examined on the day (frozen section) by a pathologist.
The eyelid defect is repaired to protect the eye and maintain good vision and comfort.
The reconstruction techniques utilised depend on the amount of tissue lost and the location.
Techniques are chosen to achieve the best cosmetic result and minimise scarring.
Surgery is performed as a day case with twilight sedation and local anaesthetic.
Most procedures take approximately 60 to 90 minutes.

A dressing is usually required overnight but may be needed for up to 5 days if a skin graft is used.
Bruising of the eyelid can be obvious for the first week.
Driving can be resumed after 24 hours unless an eye pad is still required.
Light exercise is encouraged from the first day but vigorous activity may be resumed within 1 to 2 weeks.
Discomfort is usually mild and treated with simple analgesia.

Complete removal of the skin cancer with good healing of the eyelid is achieved in the majority of cases.
Larger skin cancer excision will have a slower recovery over months.
The eyelids will be red or swollen for a few weeks.
Tearing or ocular irritation may occur in the first few weeks.
Infection, chronic pain or bleeding are uncommon.
There may be permanent loss of eyelashes in the area of surgery.
Visual loss or recurrence of the skin cancer is rare, even there has been complete removal.
Watering of the eye may occur if the lacrimal system has been damaged by the skin cancer or the surgery and may require further surgery.
Further eyelid reconstruction may be required if there is an abnormal position of the eyelids or an unusual healing response.

Sun protection by wearing a hat, wraparound sunglasses and long sleeve shirts is important
Avoid long periods in direct sunlight or at times of high UV index.
Always apply a high protective sunscreen (al least SPF 30), even in winter. Repply every 2 hours or after swimming.
Have regular skin checks by your GP or dermatologist, at least once per year, if you have had a skin cancer.
Present for a check-up with your doctor if you notice suspicious skin changes.