However, due to under-diagnosis and the absence of required reporting, the true incidence of skin cancer in New Zealand is likely much higher than these conservative estimates suggest – highlighting the importance of effective skin cancer treatment across New Zealand.
- New Zealand’s ultraviolet (UV) radiation levels are exceptionally high, particularly when compared to countries at similar latitudes in the Northern Hemisphere. Several environmental and geographical factors contribute to this:UV levels here are approximately 40% higher than in comparable northern latitudes overall.
- The Earth’s elliptical orbit places the sun closer to New Zealand during summer, increasing UV intensity by around 7%.
- Lower ozone levels, due to more efficient ozone transport in the Southern Hemisphere, reduce our natural UV protection by about 10%.
- Cleaner air in New Zealand allows more UV radiation to reach the ground, resulting in an additional 20% increase in exposure.
The Most Common Types of Skin Cancer and Their Treatment Options
There are three common types of skin cancer, each with different characteristics and risks:
Basal cell carcinoma (BCC)
BCCs arise from basal cells located in the lower layer of the epidermis, and is often classed as a slow‑growing, non‑aggressive tumour that rarely spreads to other areas of the body. Most BCCs remain localised and are typically treated with surgical excision, though less invasive treatments may be suitable for early or superficial cases.
What causes a BCC
The primary driver behind a BCC is cumulative exposure to ultraviolet (UV) radiation, typically from the sun but also from tanning beds or past radiation exposure. Repeated UV damage can alter DNA in basal cells, triggering uncontrolled cell growth. Individuals with fair skin, especially those with freckles, light eyes or hair, are at heightened risk. Other risk factors include age, weakened immune function, or prior therapeutic radiation to the skin.
Skin Cancer Treatment Options for BCC
The choice of skin cancer treatment depends on the lesion’s subtype, stage, depth, size and location.
Wide local excision (WLE) and Mohs surgery
For most BCCs, a surgical excision is a common approach. The two primary surgical techniques are WLE and Mohs surgery. WLE is commonly used for low-risk BCCs, particularly those located on the trunk or limbs. Mohs surgery is the gold standard for treating BCCs in high-risk areas like the head, neck and nose and is also used for complex or recurrent lesions on the trunk or limbs. One of the key benefits of Mohs surgery is that it keeps the surgical wound as small as possible, which is crucial for sensitive areas on the face while having a higher cure rate.
Radiotherapy
Radiotherapy is a non-surgical treatment option for patients who are unable to undergo surgery. It has a cure rate of around 92% for previously untreated BCCs, however, it often results in poorer long-term cosmetic outcomes. It may also be used alongside surgery for high-risk or incompletely removed tumours, especially those with perineural invasion.
Squamous cell carcinoma (SCC)
SCCs typically appear as firm, scaly lumps or ulcerated lesions that can develop over weeks to months. It is the second most common type of skin cancer and is particularly common in New Zealand and Australia, with rates approximately ten times higher than in northern European countries. It originates from the squamous cells in the epidermis and can be locally destructive if left untreated – approximately 5% of SCCs spread to distant sites of the body.
What causes SCC
Chronic ultraviolet (UV) exposure is the primary cause of SCC – with repetitive sun exposure, UV radiation damages the DNA in our skin. Other factors that increase the risk of developing an SCC include fair complexion, older age, prior skin cancers, HPV infection, smoking, immunosuppression, and genetic disorders such as xeroderma pigmentosum.
Skin Cancer Treatment ptions for SCC
The treatment for most cases will require surgical excision but it does depend on the lesion’s size, depth, location, and the aggressiveness of SCC. Similar to BCC, the two surgical techniques for SCC are wide local excision (WLE) and Mohs surgery. Radiotherapy can be an alternate option should the patient be unable to endure a surgical procedure.
Curettage and cautery
This is a minimally invasive option that involves superficially scraping the cancer, often used when curative surgery isn’t suitable or desired. It may be appropriate for patients with significant health issues who prefer a less aggressive approach or are seeking palliative care. However, because no histological margin control is available, complete removal of the cancer can’t be confirmed; cure rates are lower than surgery, and scars can be broad and white.
Melanoma
Melanomas are more aggressive when not caught early, as it is more likely to spread to other parts of the body. It can appear as a new mole or arise within an existing one, often showing changes in size, shape, or colour.
What causes Melanoma
Melanomas are commonly caused by excessive UV exposure, especially from intermittent, intense sunburns, often during childhood or adolescence. People with fair skin, light-coloured eyes, and red or blonde hair are more at risk, particularly if they have a history of sunburns or have used tanning beds. Genetics also play a role; those with a family history of melanoma or who carry certain gene mutations may have an increased risk.
Skin Cancer Treatment options for Melanoma
Surgery remains the cornerstone of treatment for melanoma as it not only removes the tumour but also provides vital diagnostic and staging information. Even if the initial biopsy appears to have clear margins, these narrow margins may not be considered sufficient for complete melanoma management. A follow-up WLE procedure is typically recommended to ensure a safe margin around the original site.
Surgery is usually performed under local anaesthetic and involves removing tissue down to the fascia (a layer beneath the fat). The surgeon plans the incision based on the previous biopsy site, and the margin size is determined by the thickness and characteristics of the melanoma. Because of the elliptical shape needed to close the wound, a small melanoma can result in a noticeably long scar. For example, a melanoma just 1 cm wide may lead to a scar of around 9 cm, or even longer on cylindrical body parts like the arm.
For patients with advanced-stage melanoma, treatments may involve one or a combination of the following:
- Surgical metastasectomy to remove limited metastases.
- Checkpoint inhibitor immunotherapy (e.g. PD-1 inhibitors like pembrolizumab or nivolumab).
- Targeted therapies such as BRAF inhibitors (dabrafenib, vemurafenib) and MEK inhibitors (trametinib).
- c-KIT inhibitors like imatinib for specific mutations.
- Radiation therapy, particularly for symptom control or specific tumour sites.
Non-Invasive and Topical Skin Cancer Treatment
For certain superficial or early-stage cancers, such as SCC in situ, non-invasive skin cancer treatments can be an option. These include cryotherapy, which uses liquid nitrogen to freeze and destroy abnormal cells, and topical treatments like imiquimod or 5-fluorouracil (Efudix), which work by activating the body’s immune response to eliminate cancerous tissue.
Why Choose Skintel for Skin Cancer Treatment
At Skintel, we are dedicated to delivering skin cancer treatment with precision, advanced technology, and a commitment to clinical excellence. We routinely audit our procedures and actively engage in ongoing research to continually improve outcomes for our patients. Our lead surgeon, Dr David Lim, brings an exceptional level of expertise to the team, having successfully performed more than 10,000 skin cancer surgeries. He is a highly respected fellow of the Royal Australasian College of Physicians (RACP), the Australasian College of Dermatologists (ACD), the New Zealand Dermatologic Society Incorporated (NZDSI), and the American College of Mohs Surgery (ACMS). As an ACD and NZDSI-approved Mohs specialist, Dr Lim is widely recognised as one of New Zealand’s most trusted and experienced dermatologic surgeons.
At Skintel, we care for our patients through every stage of their journey, from initial diagnosis and personalised treatment to post-surgical care. We take a compassionate, patient-centred approach, offering tailored treatment plans designed to maximise comfort, support healing, and deliver the best cosmetic and clinical outcomes possible. Our team is committed to ensuring each patient receives the highest standard of care with professionalism and empathy. Above all, achieving the best possible outcome for every individual remains our top priority.
If you have any questions or would like to schedule a consultation, please don’t hesitate to reach out to us here. Our friendly team is always here to help.