By Michael H. Gold, MD, FAAD, board-certified dermatologist and founder of Gold Skin Care Center Published October 14, 2026
Key takeaways
Superficial radiation therapy (SRT) uses low-energy X-rays to treat certain basal cell and squamous cell skin cancers without cutting or anesthesia.
SRT is not a treatment for melanoma, and it is not the right choice for every nonmelanoma skin cancer.
Surgery, including Mohs surgery, generally offers higher cure rates for most skin cancers. SRT is most often considered when surgery is difficult, risky, or not preferred.
Treatment involves a series of short sessions over several weeks, followed by long-term skin checks.
Superficial radiation therapy, or SRT, is a non-surgical way to treat certain basal cell and squamous cell carcinomas, the two most common types of skin cancer. Instead of removing the cancer with a scalpel, SRT delivers low-energy X-rays to the skin's surface layers to destroy the cancer cells, with no cutting and no anesthesia. For the right patient, it is a genuinely useful option. For others, surgery is the better choice.
At Gold Skin Care Center, SRT is one of several skin cancer treatment options we offer. Having more than one option under one roof matters, because the best treatment depends on the cancer, where it is, and the person who has it. This article explains how SRT works, who tends to be a good candidate, and the honest trade-offs.
What SRT is and how it works
SRT uses a focused beam of low-energy radiation that penetrates only a few millimeters into the skin. That shallow reach is the point: it treats cancers that sit in the upper layers of the skin while limiting exposure to deeper tissue.
According to the Skin Cancer Foundation's overview of basal cell carcinoma treatment, radiation therapy for skin cancer uses low-energy X-ray beams to destroy the tumor, with no need for cutting or anesthesia, and destroying the tumor usually takes several treatments over a few weeks.
SRT is different from the radiation therapy many people picture for internal cancers. It is delivered in a dermatology setting with a dedicated device, and it is designed only for superficial treatment of the skin.
Which skin conditions SRT treats
At our practice, SRT is used for:
Basal cell carcinoma (BCC): the most common skin cancer. It usually grows slowly and often appears on sun-exposed areas such as the face, ears, and neck. The American Academy of Dermatology has a clear overview of basal cell carcinoma.
Squamous cell carcinoma (SCC): the second most common skin cancer. It is more likely than BCC to grow deeper or spread if left untreated. See the AAD's guide to squamous cell carcinoma.
Keloids: thick, raised scars that can keep returning. SRT is sometimes used after a keloid is removed to lower the chance it grows back. Learn more on our keloid and hypertrophic scar page.
SRT is not used for melanoma. Melanoma requires a different treatment approach.
Who is a good candidate for SRT?
This is the most important part, so I want to be direct. For most basal and squamous cell carcinomas, surgery is the standard first choice because it removes the tumor and lets the lab confirm the cancer is gone. The Skin Cancer Foundation notes that with radiation there is no way to confirm that all of the tumor was destroyed, and that radiation is primarily used for BCCs that are hard to treat with surgery and for older patients or people in poorer health for whom surgery is not advised.
In practice, SRT tends to be worth discussing when:
Surgery would be difficult or risky, for example because of other health conditions, blood-thinning medication that cannot be paused, or difficulty tolerating a procedure.
The cancer is in a location where surgery could affect function or appearance, such as the nose, eyelids, ears, lips, or hands.
The patient is older and prefers to avoid surgery and the wound care that follows.
The cancer is superficial and has not grown deeply into the skin.
A keloid keeps returning after removal.
SRT is usually not the best choice when:
The cancer is large, deep, has poorly defined borders, or has returned after previous treatment. These often do better with Mohs surgery, which examines the tissue margins during the procedure.
The patient is young. Radiation can cause skin changes that develop over many years, so surgery is usually preferred for younger adults.
The area has already been treated with radiation.
The patient has certain genetic conditions that make the skin more sensitive to radiation.
Whether SRT makes sense for you is decided at an appointment, after a biopsy confirms the diagnosis and your provider reviews the type, size, depth, and location of the cancer.
What SRT treatment involves
Diagnosis. A skin exam and biopsy confirm the type of skin cancer.
Consultation. We review all of your treatment options, including surgery, and discuss whether SRT fits your situation.
Treatment planning. The area is mapped and the dose and number of sessions are set for your specific cancer.
Treatment sessions. You will come in for a series of short sessions over several weeks. You do not need anesthesia, and there is no incision to care for afterward. Most patients go about their day after each visit.
Follow-up. After treatment ends, you will return for checks to confirm the area has healed and the cancer has not returned, and for ongoing skin exams.
Side effects to expect
SRT does not involve a wound, but it does affect the treated skin. It is common for the area to become red, irritated, dry, or crusted during and shortly after the course of treatment, similar to a localized sunburn. These effects usually settle in the weeks after treatment ends.
Over the longer term, the treated skin can look different from the surrounding skin, including lighter or darker color, a change in texture, or small visible blood vessels. Your provider will walk you through what to watch for, how to care for the area, and when to call us.
SRT compared with other skin cancer treatments
The right choice depends on the specific cancer and on you. A good consultation should cover more than one option.
Why the setting matters
Skin cancer care goes better when the practice can offer, and honestly compare, more than one treatment. At Gold Skin Care Center, diagnosis, surgical options, SRT, and precancer treatments are all part of our medical dermatology care in Green Hills. That means your recommendation is based on what fits your cancer, not on the one treatment a clinic happens to offer.
Because SRT treats a diagnosed skin cancer, it is a medical treatment. We accept most major insurance plans, including Medicare and Medicaid, for medical dermatology. Coverage for a specific treatment depends on your plan, and our team can help you understand your benefits before you start.
What to do next
If you have been diagnosed with basal or squamous cell carcinoma, schedule a consultation to review your options, including whether superficial radiation therapy is a good fit.
If you have a spot that is new, changing, bleeding, or not healing, schedule a skin exam. A biopsy is the only way to know what it is.
Call (615) 383-2400 or use our scheduling form. If it is your first visit, read our guide to your first dermatology appointment.
Frequently asked questions
Does SRT hurt? There is no cutting or needle, and the sessions themselves are typically short. The treated skin can become sore, red, or irritated as the course goes on, and we will give you a plan to manage it.
How many SRT sessions will I need? It depends on the type, size, and depth of the cancer. Treatment is delivered in a series of sessions over several weeks, and your provider will give you a specific schedule.
Is SRT as effective as Mohs surgery? For most skin cancers, surgery, including Mohs surgery, has higher cure rates, and it lets the lab confirm the cancer was fully removed. SRT is a reasonable option for carefully selected patients, especially when surgery is difficult or not preferred.
Can SRT treat melanoma? No. SRT is used for certain basal cell and squamous cell carcinomas and for keloids, not melanoma.
This article is for general education and is not medical advice. Results vary, and every treatment carries risks. An appointment with a board-certified dermatologist or qualified dermatology provider is the best way to learn which options are right for you.
About the author
Michael H. Gold, MD, FAAD, is a board-certified dermatologist and dermatologic surgeon and the founder and medical director of Gold Skin Care Center in Nashville, which he established in 1990. He also founded the Tennessee Clinical Research Center and holds appointments as Clinical Assistant Professor at Vanderbilt University School of Nursing and Adjunct Assistant Professor at Meharry Medical College School of Medicine. Read Dr. Gold's full bio.
