Non-Surgical Skin Cancer, Keloid & Skin Treatment in Knoxville, TN

If you're facing Mohs surgery on the face, ears, or nose — or you've tried injections, cryotherapy, topicals, or excision and the problem keeps coming back — superficial radiation therapy may be the option you haven't been offered.

Superficial radiation therapy uses low-energy X-rays that deposit dose at the skin surface and only a few millimeters deep, sparing healthy tissue underneath. Treatment courses are tailored to the diagnosis. For non-melanoma skin cancers, prescribed doses are in the curative range — typically 50 to 60 Gy delivered over 15 to 30 short weekday sessions. For benign conditions like keloids, warts, and psoriasis, prescribed doses are far lower and treatment courses are correspondingly shorter, often 3 to 12 sessions. In every case, treatment is painless, requires no anesthesia, leaves no incision or stitches, and has no recovery time.

This is the only thing we do. Heelex was founded as the first U.S. clinic dedicated exclusively to superficial and low-dose radiation therapy for skin cancers and benign skin conditions. Decades of published research support these uses. We accept Medicare, BCBS, Aetna, Cigna, Humana, UnitedHealthcare, Tricare, and ChampVA — coverage is confirmed before your first visit. No physician referral is required.

Mohs Surgery Alternative

If a dermatologist or surgeon has recommended Mohs surgery for a basal cell carcinoma or squamous cell carcinoma, image-guided superficial radiation therapy is an alternative worth understanding before you book the procedure. For appropriately selected non-melanoma skin cancer, modern superficial radiation delivers cure rates over 90% — with published series reporting up to 98% local control (Cognetta 2014) — without an incision, anesthesia, or stitches. Many patients arrive at Heelex asking "before Mohs, what are my options?" or "is Mohs the only option?" — and for a meaningful share of BCC and SCC presentations, the honest answer is no.

The patients who most often benefit from a Mohs alternative are those with lesions on the face, ears, nose, eyelids, lips, or scalp; patients on anticoagulants; older patients in whom surgical wounds heal slowly; and anyone who has the choice and would prefer to avoid a procedural scar.

Skin Cancer Treatment for the Face — Without Scarring

Facial skin cancers — on the nose, the cheek, the eyelid, the lip, the ear, the temple — sit in cosmetically and functionally sensitive territory. Surgery in these regions can leave a visible scar, a notched lip, a pulled lower eyelid, or a depressed cheekbone. Image-guided superficial radiation therapy treats the lesion at the skin surface with a tightly conformed low-energy beam that spares the underlying structures and the surrounding skin. The cosmetic outcomes in published series are excellent, and most patients finish a course of treatment with no visible reminder that they ever had a skin cancer in that location.

Basal Cell Carcinoma (BCC) — Non-Surgical Treatment

Basal cell carcinoma is a malignant cancer of the basal keratinocytes and the most common cancer diagnosed in humans. It is malignant — never low-grade, never benign — and untreated lesions enlarge locally, eroding surrounding tissue. The good news is that when caught early, BCC is highly curable. Image-guided superficial radiation therapy delivers curative doses of low-energy X-rays directly to the lesion at the skin surface, with published cure rates over 90% in appropriately selected presentations.

A typical BCC course at Heelex is 15 to 30 short weekday sessions, with each visit taking a few minutes. There is no cutting, no stitching, no anesthesia, and no recovery window. You walk in, get treated, and go about your day.

Squamous Cell Carcinoma (SCC) — Non-Surgical Treatment

Squamous cell carcinoma is the second most common skin cancer and, like BCC, is highly curable when treated early. Image-guided superficial radiation therapy is a well-established non-surgical option, with published cure rates over 90% for appropriately selected SCC presentations. The protocol mirrors the BCC course — 15 to 30 short weekday sessions, painless treatment, excellent cosmetic outcomes.

SCC on the lip, ear, scalp, and lower leg — locations where surgical reconstruction is technically challenging or where wound healing is unreliable — is where the non-surgical option most often meaningfully changes the conversation.

Image-Guided SRT (IGSRT)

Image-Guided Superficial Radiation Therapy — IGSRT — is the modern evolution of superficial radiation for skin cancer. High-frequency ultrasound is integrated into the treatment workflow, allowing the team to visualize the depth and margins of the lesion before each fraction and to confirm response over the course of treatment. The result is more precise dosing, tighter margins around healthy tissue, and the documented 98% local control rate reported in the Cognetta 2014 published series — a control rate that compares favorably with traditional surgical excision in appropriately selected lesions.

Non-Surgical Skin Cancer for Patients on Blood Thinners

Patients on Eliquis, warfarin, Plavix, Xarelto, or any chronic anticoagulant face a real complication with surgical skin-cancer excision: bleeding risk during the procedure and impaired wound healing after. The standard workaround is to bridge or pause the anticoagulant, which carries its own clotting risks for patients on blood thinners for atrial fibrillation, prior stroke, or pulmonary embolism history. Image-guided superficial radiation therapy sidesteps the entire trade-off. There is no incision, no bleeding, no need to interrupt your anticoagulation. The treatment goes ahead while you remain on your prescribed regimen.

Skin Cancer Treatment for Seniors

For patients in their eighties and nineties, the questions around skin cancer treatment are different. Surgical wounds heal more slowly. General anesthesia carries higher risk. Lower-leg lesions in older patients can become chronic, non-healing wounds that linger for months. Image-guided superficial radiation therapy is gentle, painless, requires no anesthesia, and leaves no surgical wound to heal. For many of our oldest patients, it is the treatment that finally makes sense — a curative option that fits the realities of their other health considerations.

Recurrent Skin Cancer Treatment

A non-melanoma skin cancer that has recurred after a prior surgical excision or a previous Mohs procedure is a different clinical situation than a first presentation. The local tissue has already been altered. Margins are harder to read. Re-excision often means a larger procedure with a larger scar. Image-guided superficial radiation therapy is well-suited to the recurrent setting — it delivers curative dose directly to the lesion without re-entering the surgical field, and the imaging built into the modern IGSRT workflow helps the team confirm complete response over the course of treatment.

Keloid Prevention After Surgery

For patients with a history of forming keloids, the most important conversation happens before the next surgical procedure — not after. Post-excision superficial radiation therapy is the most evidence-supported prophylactic treatment for keloid recurrence. Surgery alone leaves keloids with a published recurrence rate above 50%. Adding 3 short sessions of low-energy radiation in the 24 to 48 hours after the excision drops recurrence to below 20% in most published series — and under 10% in several. If you are scheduled for a keloid excision, an earlobe procedure after piercing-related keloid formation, or any surgery where you have a personal history of keloid response, schedule the consult before the surgical date.

Warts That Resist Standard Treatment

Plantar warts, common warts, and periungual (around-the-nail) warts are caused by human papillomavirus (HPV). Standard treatments — cryotherapy, salicylic acid, laser, surgical paring — clear the surface tissue, but if even a small reservoir of HPV-infected cells survives in the deeper skin layer, the wart returns. Many patients cycle through months or years of repeat treatments without lasting clearance.

Superficial radiation therapy targets HPV-infected cells directly. The low-energy beam reaches the depth of the wart and damages viral DNA in infected keratinocytes, while leaving healthy deeper tissue untouched. No cutting, no burning, no chemical irritation, no scar.

This approach is particularly valuable for:

• Plantar warts that have failed multiple rounds of cryotherapy
• Periungual warts where surgical or laser destruction risks the nail matrix
• Patients with diabetes or peripheral vascular disease, where foot wounds heal poorly and cryogenic injury can become a serious problem
• Older patients and anyone wanting a painless, non-destructive option

A typical wart course is 3 to 7 short sessions over consecutive weekdays. Each session takes a few minutes. Most patients feel nothing during treatment.

Localized Psoriasis That Hasn't Cleared

Psoriasis is a chronic autoimmune skin condition driven by overactive T-cells that accelerate skin-cell turnover, producing the thick, scaly, inflamed plaques patients know well. Most patients are managed effectively with topical steroids, vitamin D analogs, phototherapy, or systemic biologics. But some plaques — particularly on the scalp, hands, feet, elbows, and knees — resist every line of treatment and remain symptomatic for years.

Superficial radiation therapy is a targeted, localized option for these resistant plaques. The low-energy beam suppresses the rapidly dividing skin cells driving the plaque and reduces the local inflammatory response, without affecting the rest of the body and without the systemic side effects of biologics or long-term steroid use.

This approach is particularly useful when:

• A single plaque or small area has failed topicals, phototherapy, and systemic therapy
• Systemic biologics are contraindicated or have caused side effects
• A symptomatic plaque is in a location that interferes with function (palms, soles) or is cosmetically distressing
• The patient prefers a localized, drug-free option

A typical course is 6 to 10 short sessions over consecutive weekdays. Most patients see meaningful clearance within weeks of finishing treatment.

"I had suffered for 24 YEARS with pustular psoriasis on my foot. I tried everything and nothing worked out — only worked for a short time. After going to Heelex for treatment my foot has been clear for 2 years!!! Heelex changed my life. Thank you to Heelex and their amazing staff!"

Note: melanoma is not treated with this modality, and very large or aggressive-subtype tumors may be better served by surgery — we review your pathology and tell you honestly whether you're a candidate. Read more about our dedicated keloid treatment program →