Skin cancer radiation or surgery gone wrong. What are your options?

Two years ago I was diagnosed with basal cell carcinoma on the tip of my nose. I opted for radiation and now my nose is a big ugly mess. About 4 weeks post radiation therapy a large section of skin on my nose peeled off. Now I have a lot of very visible cysts and the the original cut on the tip of my nose is always open and a second small incision that the dermatologist made has never closed. The plastic surgeon has told me twice that there is nothing that can be done because the radiation changed the molecular structure of the skin and it will never heal properly. Is there anything that can be done? I was 62 when the radiation was done and now I am 64.

My heart goes out to you on this. And I’m sure everyone reading this feels the same way. This is a tough one. None of us would want to accept that nothing can be done. And, almost always there is a path to improvement, even if it’s slow and not perfect. Each skin cancer situation is so unique, that it wouldn’t be fair to give advice without knowing all the details. However, there are some general principles that apply here and I’ll try to help you with those.

First things first:

Try to talk to your doctor and the team you already have in place. I can hear from above that you’ve already tried that. Ask the team that is telling you that nothing can be done, some more questions:

  • First, was a bacterial culture sent on the open wound area? Bacteria are not always obvious and will keep a wound from healing. I can’t emphasize the importance of this enough. And it is simple and inexpensive to do. Your primary care doctor or dermatologist, if not the plastic surgeon, can send this.
  • Anything that your doctor or you are putting on the wound that could be irritating it! Irritating chemicals in skincare products or prescription creams may keep a wound from healing.
  • Are steroid creams being used? If so, talk to your doctor about weaning off them because they will aggravate skin thinning and poor healing over time.
  • Is your nutrition maximized? Protein, vitamins and minerals support the healing process. And NOT smoking. Even 1 cigarette a day will affect wound healing on the face.

What to do when a surgery or other treatment goes wrong:

  • It’s really important to look for other resources!
  • A good, experienced Mohs (specializes in skin cancer surgery) surgeon may have ideas.
  • Is there a wound healing clinic close by or at a larger hospital complex within driving distance.
  • A great nutritionist or naturopath can contribute ideas to facilitate healing.
  • 1-3 more consults with good dermatologists or plastic surgeons may yield helpful ideas.
  • A national recognized clinic, like the Mayo or Cleveland Clinics, will have surgeons, wound clinics and more. Could you drive to one?

The first step is to get the wound to close and heal. The second step is to work with the texture and appearance of the wound. Please stay in touch.

Hope this helps,  Dr. I



Dr. Brandith Irwin, MD

Ask me your skincare question!

Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

  • All our content is written and researched by myself.
  • My medical office in Seattle has treated thousands of patients for 15+ years.
  • This site is not affiliated or financially tied to any product, treatment or device.
Ask Me Something
SkinTour Skincare
One of the best investments in your skin is your daily skincare. Why? Because you can prevent many problems with blotchy skin color, lack of glow, texture, some types of acne, and fine lines with good skincare products. You can also correct some of these problems with effective skincare products. Great skincare is often more expensive because quality ingredients are expensive. Some companies spend on research/development which benefits all of us and adds to the cost. Are they worth it? In general - yes! I have handpicked some of what I consider to be the best skin care products, and offer them for sale on SkinTour's shop. This is based on my team and I's testing and research at our clinic. Many of the products are in my own regimen. What could be better than using skin care products a dermatologist uses?!