Skin cancer diagnosis is moving toward more accurate, non-invasive approaches with in vivo imaging techniques at the forefront (e.g. reflectance confocal microscopy [RCM], multiphoton tomography4 and optical coherence tomography). We have begun developing automated RCM analysis approaches that enable objective photoageing analysis. This effort has also lead to our developing novel approaches for identifying signs of precancerous lesions in clinical photographs. Ideally, skin cancer risk could be defined through non-invasive imaging. Practically, minimally invasive microneedle-based biopsies could hold the key for molecular detection of skin cancer. We have developed a stacked 3D microneedle device for instantaneously capturing small pieces of skin from suspicious lesions. We have also examined the effects this type of sampling my have on downstream histopathological assessment. This microbiobiopsy approach has the potential to enhance lesion diagnosis through minimally invasive molecular analysis. Topical treatment is an attractive approach to lesion management once a precancerous lesion is diagnosed. Unfortunately, many potentially therapeutic drugs have poor skin penetration profiles. We have developed and patented a novel platform for field-directed drug delivery, Foroderm™. This technology is based on unique microparitcles that were engineered to only penetrate the stratum corneum and viable epidermis. These microparticles are applied by massaging the material, with the active ingredient, into the skin in a manner similar to sunscreen. Our in vivo pig and volunteer data show attractive microparticle penetration profiles and enhanced drug delivery. Together, these technologies are the first step toward step change improvements in how skin cancer is detected and treated.