The use of polarized light imaging can facilitate the determination of skin cancer borders before a Mohs surgery procedure. Linearly polarized light that illuminates the skin is backscattered by superficial layers where cancer often arises and is randomized by the collagen fibers. The superficially backscattered Iight can be distinguished from the diffused reflected light using a detector analyzer that is sequentially oriented parallel and perpendicular to the source polarization. A polarized image pol = parallel-perpendicular I parallel+perpendicular is generated. This image has a higher contrast to the superficial skin layer than simple total reflectance images. Pilot clinical trials were conducted with a small hand-held device for the accumulation of a library of lesions to establish the efficacy of polarized light imaging in vivo.