Five Things to Know If You've Been Diagnosed with Skin Cancer on Your Face

Woman examining her face for signs of cancer

It's important to consider your treatment options carefully if you've been diagnosed with skin cancer on the face.

“Keep your face always toward the sunshine — and the shadows will fall behind you,” Walt Whitman once wrote. But what the poet didn’t account for is that years of regular sun exposure can cast a shadow of their own, in the form of skin cancer.    

The face is a common area where skin cancer develops. That primarily has to do with too much exposure to the sun and tanning bed use.

Fortunately, most skin cancers, regardless of location, have an excellent prognosis. But that doesn’t mean you shouldn’t carefully weigh all of your options, says Memorial Sloan Kettering dermatologic surgeon Erica Lee. It is your face, after all, and the outcome of your care can affect how you feel about yourself.

To learn more, we spoke with Dr. Lee about what she thinks people with facial skin cancer need to know before they seek care.

1. Know which type of skin cancer you have.

One of the most important things to know about skin cancer is that there are different types. Knowing which one you have will inform your doctor’s treatment recommendations.

The vast majority of skin cancers on the face are either basal cell carcinoma or squamous cell carcinoma. “Basal cells tend to grow slowly, but some subtypes may grow deeper than others,” says Dr. Lee. “If you have a basal cell carcinoma, get it treated in a timely way, but there’s no need to rush to the doctor that same week.” Certain forms of squamous cell carcinoma can grow quickly, she says, so it’s important to discuss timing with your doctor.

Melanoma is less common but more serious. “Melanoma is a different situation entirely,” Dr. Lee cautions. “If you have melanoma, make an appointment with a specialist right away. Early treatment is usually recommended.”

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2. Consider getting a second opinion on pathology.

How do you know if you should get a second opinion? Start by asking your doctor if the pathology was definitive.

The first step in diagnosing skin cancer is a skin biopsy. The tissue sample taken during the biopsy is sent to a pathologist, who then examines the cells under a microscope. Pathologists are usually certain about their diagnoses. But there are instances when the cancer cells look unusual or the pathology is inconclusive for some other reason.

How do you know if you need a second opinion if no one has told you to get one? “Start by asking your doctor,” says Dr. Lee. One way you might phrase the question is, “Was the pathology definitive?” If the doctor says no, that’s your cue to seek out a second opinion on your pathology.

You can also review the pathology report yourself. Sometimes the report will say the diagnosis is inconclusive. Also be on the lookout for phrases such as “most in keeping with” or “features of,” says Dr. Lee. This is terminology indicating that the pathologist formed a hypothesis but wasn’t absolutely certain.

“One of the benefits of coming to MSK for care is that we review the pathology,” says Dr. Lee. “Most of the time we confirm the original diagnosis, but occasionally we do see differences.”

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3. Start your care with a fellowship-trained dermatologic surgeon.

This may seem like a no-brainer, but when it comes to skin cancer treatment, you’re better off beginning your care with a board-certified dermatologist. Choosing a dermatologist with fellowship training in skin oncology and dermatologic surgery is also important.

“Sometimes people go right to a plastic surgeon when they have something on their face,” Dr. Lee explains. “But skin cancer can grow wider than anticipated, making complete removal tricky.”

Dermatologists who have completed a dermatologic surgery fellowship tend to have the most experience with facial cancers.
Erica H. Lee dermatologist

One way to ensure that you get the best cosmetic outcome is to seek out a dermatologist with experience in treating facial skin cancer. “Dermatologists who have completed a dermatologic surgery fellowship tend to have the most experience with facial cancers,” Dr. Lee says. “Ask your dermatologist for a referral to a dermatologic surgeon or seek treatment at a medical center with dermatologic surgeons on staff.”

Fellowship-trained dermatologic surgeons are experts in delicate skin-sparing procedures that can better preserve your appearance while also making sure that all of the cancer is removed. They are also skilled in reading pathology, Dr. Lee points out, which gives them an excellent understanding of how cancer grows so they can ensure that they are removing all of it.

And if you do need a plastic surgeon, a dermatologic surgeon will be able to advise you.  

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4. Ask about your skin cancer treatment options.

Among the most common treatments for facial skin cancer is Mohs surgery. Mohs involves removing the cancer in thin layers. This approach helps preserve surrounding healthy tissue and has a very high cure rate.

“Mohs can be a lengthy process, taking several hours or longer,” says Dr. Lee. “I do everything I can to keep my patients comfortable and inform them of how things are going at each step.”

Mohs Surgery and Other Dermatologic Surgeries
MSK is a leading center for Mohs surgery and other dermatologic surgeries. Learn more about our approach to care.

Dr. Lee adds that not everyone with skin cancer on the face will need Mohs surgery. “There may be other treatment options that are right for you. It’s OK to ask. And if you do have options, ask your doctor to explain the pros and cons of each before you make your decision,” she says.

Sometimes Mohs really is the best option for facial cancer, however. That’s typically the case with skin cancer on the nose or eyelid. “The nose and the eyelid are tougher areas to treat for a variety of reasons,” says Dr. Lee. “It takes finesse to achieve excellent cosmetic results in these areas. Removing a cancer from the eyelid also has a lot of challenges related to how the eyelid functions and feels to the patient after the surgery.”

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5. Seek comprehensive care if your skin cancer is complicated to treat.

Complicated skin cancer may require the expertise of multiple specialists. Plastic surgeons may get involved when the cosmetic challenges are significant. An ocular surgeon or an oculoplastic specialist may be needed if you have an especially difficult-to-treat skin cancer close to the eye. A head and neck surgeon may join your care team if there is nerve involvement or if the cancer is too extensive for local anesthesia. 

“The beauty of a comprehensive cancer center like MSK is that the expertise is all here,” says Dr. Lee. “We have a multidisciplinary program especially for people with complex skin cancer. You can usually see all of your doctors on the same day and in the same location. The dermatology team works with you to coordinate your appointments with your schedule.”

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Commenting is disabled for this blog post.

I had biopsies of a flat beige spot on my cheek and a scaly shin colored spot on my nose. The office just called and said they are both precancerous. What does this exactly mean?

can my surgeon see the extent of my skin cancer after a biopsy but before mohs?

Do you work with a plastic surgeon in the same office

Dear Heidy, you can learn more about MSK’s approach to treating skin cancer and the collaboration between our dermatologists and plastic surgeons on this page. If you are interested in arranging a consultation to learn more, you can make an appointment online or call 800-525-2225. Thank you for your comment and best wishes to you.


My wife Helen was a patient and had breast cancer 3 times and was treated by MSKCC Dr Hudis. My son moved for work to Richland Washington. What are his best options for treatment of basil cell there? It is on the side of his nose and the doctor there wants to do radiation. Is that a good way to treat basil cell? My son said they are concerned if they do Moh surgery it may go to deep.

Yours truly,

Joe Caleca

I have a BCC on my face in an area that requires complex surgery. Would I be a candidate for treatment with "Erivedge" and do you prescribe that drug?

Steve, thank you for reaching out. Erivedge (vismodegib) is sometimes prescribed by doctors at MSK. It is decided upon after consultation and truly deciding if a patient is not a surgical candidate and weighing the pros/cons of the treatment.If you would like to consult with an MSK expert, you can make an appointment online or call 800-525-2225 to learn more. Thank you for your comment.

Have a 3mm diameter BCC on the side of my nose. My regular Dr. recommended Mohs surgery and told me a skin graft from my cheek would be necessary. When I asked if I was a candidate for radiation therapy he said yes, I could do that if I preferred. Of course I'd prefer to not have surgery and a scar, so I scheduled radiation, but I am concerned about the side effects of radiation. The irradiated area is 10mm larger than the BCC. That seems like a large area to me. I am concerned about my teeth and sinuses. Yesterday I visited with a Mohs surgeon who said I should seriously reconsider having the radiation therapy. Is it unsafe or unproven?
Thank you

Dear Seyek, we’re sorry to hear about what you’re going through. We are not able to offer medical advice on our blog, but if you’re interested in arranging a consultation with one of our skin cancer experts, you can make an appointment online or call 800-525-2225. Thank you for your comment and best wishes to you.

I’m a past MOHS patient from Toronto Ontario
I had the rare form of basal cell carcinoma. The one that goes down deep & spreads out like a root of a tree. Morpheaform I think it was called.
My surgery was in Jan of this year. I’m so grateful I chose the Mohs procedure. Yes it was scary to have a scar especially as a woman on my face who has never worn makeup. I’m so grateful & wanted to share my experience. Our face heals quite quickly and very well. It’s essential that patients follow their surgeons after care instructions. Today nobody can even see where I had 18 External stitches. Best decision I’ve made, not to mention I’m cancer free

Dear Kim, thank you for sharing your experiences. Best wishes to you.

I was diagnosed with melanoma on my right cheek by my local dermatologist. I went to MSK and it was confirmed, Dr Lee performed the surgery. She did a fantastic job. It has been only 3 months and you can hardly see the scar. She is kind, compassionate and explains every step of the way. So grateful to her and her wonderful staff.

Dear Eileen, we’re so glad to hear that you’re doing well and were happy with your care. We will forward your comment to Dr. Lee. Thank you for sharing your experiences.

I've had about 40 (no exaggeration) skin cancers since 1984, mostly basal cell and a few that were squamous cell. All were successfully removed, most with Mohs surgery. I'm begiining to wonder if it would be beneficial to see an MSKCC dermatologist for screening going forward. I'm vigilant about this, but concerned about the number of skin cancers that I've had.

At age 57 I had Mohs surgery on my nose to remove some BCC. While, at first the scar was horrifying, it has healed beautifully and I rarely give it another thought.
Following that incident I had a full body check done by my dermatologist. She had no concerns until the very end when I pointed out a very small mole on my arm that just seemed a little darker than my many others.
The biopsy results revealed that it was a “spitz” mole, also sometimes referred to as childhood melanoma. She said it was NOT melanoma but that it shared many characteristics with melanoma, hence, she wanted it removed. The mole was removed (much more crudely than the Mohs procedure), seemed to have clear borders and I was sent on my merry way. I’ve always been left with a nagging worry; should another pathologist have looked at the slides? Does her explanation make sense? Any input?

Dear Amy, unfortunately we are not able to answer individual medical questions on our blog. We recommend you consult with another dermatologist who is familiar with your medical history and who can give you an examination for a second opinion. If you’re interested in coming to MSK, you can make an appointment online or call 800-525-2225. Thank you for your comment and best wishes to you.

ok i had a biopsy and it came back that i had squamous cell carcinoma so they did in office surgical and my pathology came back good but i was never told what stage it was, just wondering because i am finding more spots at other locations and i'm nerves that i will have to go back in

Dear Sherry, we recommend that you discuss this with the doctor who gave you your diagnosis. Thank you for your comment and best wishes to you.