# High-Intensity Focused Ultrasound in Dermatology: A Review with Emphasis on Skin Cancer Management and Prevention

## TL;DR

This paper reviews high-intensity focused ultrasound (HIFU) as a non-invasive treatment for skin cancer, highlighting its potential to safely and effectively target abnormal skin cells.

## Contribution

The paper introduces HIFU as a novel non-invasive alternative for treating skin cancers and precancerous lesions with high clearance rates.

## Key findings

- HIFU achieves 70–97% clearance rates for actinic keratoses and basal cell carcinomas.
- HIFU offers reduced pain and faster healing compared to traditional skin cancer treatments.
- HIFU can treat multiple lesions in a single session while preserving healthy skin.

## Abstract

Skin cancers are becoming increasingly common, and many patients need treatments that are both effective and minimally invasive. High-intensity focused ultrasound (HIFU) is a new technique that uses concentrated sound waves to precisely destroy abnormal skin cells without cutting the skin. This review explains how HIFU works and summarizes the current evidence for its use in skin conditions such as actinic keratosis and basal cell carcinoma. Early studies suggest that HIFU can remove precancerous and cancerous lesions with acceptable safety and promising clinical results. Because it can target only the affected area while leaving healthy skin intact, HIFU may become an important alternative or addition to surgery and other established methods. The findings presented here may help guide future research and clinical practice in non-invasive skin cancer management.

High-intensity focused ultrasound (HIFU) has recently emerged as a novel non-invasive treatment modality in dermatology, offering precise ablation of cutaneous lesions with minimal damage to surrounding tissue. Originally developed for deep-seated tumors, dermatological HIFU platforms operating at ~20 MHz enable submillimeter-scale treatment of thermal or mechanical injuries localized to the epidermis and superficial dermis, making them suitable for managing benign, premalignant, and malignant skin conditions. This review outlines the mechanistic basis of HIFU—including thermal coagulation, acoustic cavitation, and immunomodulatory effects—and presents the current evidence for its efficacy in treating actinic keratoses and basal cell carcinomas (BCCs), where early studies report clearance rates of 70–97% and excellent cosmetic outcomes. Compared to conventional therapies such as surgery, photodynamic therapy, or cryotherapy, HIFU offers reduced procedural pain, faster healing, and the ability to treat multiple lesions in a single session. Its role in field cancerization and potential utility in prophylaxis for high-risk skin areas are also explored. While promising, long-term oncologic outcomes and standardized treatment protocols remain under investigation. HIFU represents a significant advancement in non-invasive skin cancer management, aligning oncologic efficacy with patient-centered care.