Skin cancer is the most common malignancy in the UK, and up to a third of lesions are ulcerated at the time of excision. Ulceration has been shown to increase the risk of developing surgical site infection post-excision, with some studies finding infection rates of 33%. However, no specific guidelines for the use of antibiotic prophylaxis in such cases exist. We surveyed 129 clinicians from dermatology, plastic surgery, ear, nose and throat surgery and oral and maxillofacial surgery, who all excise skin lesions on a regular basis. There was significant variability in their practice with regards to antibiotic prophylaxis, with 9% always prescribing them and 19% never prescribing them. Variation exists both inter- and intra-speciality. This variation increases the risk of antimicrobial resistance and shows a paucity of good clinical evidence, which mandates a well-designed clinical trial to guide future practice.