Radiotherapy for skin cancer

Radiotherapy uses high-energy x-rays to destroy the cancer cells, while doing as little harm as possible to normal cells. It may be used to treat some skin cancers.

Having radiotherapy for skin cancer

Radiotherapy uses x-rays to destroy the cancer cells, while doing as little harm as possible to normal cells.

It is sometimes used instead of surgery to treat basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin. You usually have external beam radiotherapy for skin cancer. Occasionally, a type of internal radiotherapy called brachytherapy might be used.

Radiotherapy is particularly useful if surgery might be too difficult or affect your appearance. For example, it may be used for skin cancer that:

  • affect parts of the face, such as the nose
  • affect large areas
  • are deep in the skin.

Radiotherapy is not recommended for young people with skin cancer. This is because it can cause skin changes that may become more noticeable over time.

Radiotherapy is occasionally used when a non-melanoma skin cancer has spread to other places. This can include lymph nodes or an organ such as, the lungs. Sometimes it may be given after surgery if there is a risk that not all the cancer cells have been removed.

You have radiotherapy in the hospital outpatient department. Depending on the type and size of skin cancer, you may only have 1 treatment session. But usually several sessions are needed. You may have radiotherapy each day, 5 days of the week, for 1 or more weeks. Your doctor will discuss your treatment plan with you.

If you are having brachytherapy your doctor will explain more about it.

Getting support

Everyone has their own way of dealing with a diagnosis and the different emotions they may experience. Macmillan is here to support you. If you would like to talk, you can:

Side effects of radiotherapy for skin cancer

Radiotherapy affects only a small area of skin being treated and does not make you feel unwell. Your radiographer or nurse will explain the side effects and give you advice to help manage them.

Effects on the skin

The treated skin will be red and inflamed for up to 1 month after treatment. During this time, it will look as though the treatment has made things worse rather than better. This is normal. After a few more weeks, the area dries up and forms a crust or scab. Over time, the scab peels away, leaving healed skin underneath.

At first, this new skin will look pinker than the skin around it. But it should gradually fade to look more like the skin around it. If you have fair skin, the treated area may become slightly paler. If you have dark skin, the area may get darker or paler. We have more information about radiotherapy skin reactions.

Hair loss

If you have radiotherapy to an area where hair grows, it will cause the hair in the treated area to fall out. This is often permanent. You can talk to your doctor about whether your hair is likely to grow back after treatment.

We have more information about radiotherapy.

About our information

  • References

    Below is a sample of the sources used in our skin cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    National Institute for Health and Care Excellence (NICE) NICE pathways: Skin Cancer Treatment overview. (updated 2020) 

    Institute for Health and Care Excellence (NICE). Sunlight exposure: risks and benefits. NICE guideline [NG34] Published:2016.

    British Journal of Dermatology. British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma. 2020.

    National Institute for Health and Care Excellence (NICE) Cemiplimab for treating metastatic or locally advanced cutaneous squamous cell carcinoma [TA592] Published: 07 August 2019. 

    BMJ Best Practice. Overview of Skin Cancer. (updated 2019)

    British Association of Dermatologists. Service Guidance and Standards for Mohs Micrographic Surgery (MMS). 2020.


  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor James Larkin, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected. Our aims are for our information to be as clear and relevant as possible for everyone.

You can read more about how we produce our information here.