Conventional radiation therapy treatment for skin cancers above the clavicle is electron beam therapy. An alternative treatment modality is high dose rate (HDR) brachytherapy with the use of surface applicators, such as a 3-dimensional topographic applicator (3-TAB). A dosimetric comparison of these two modalities is performed in this work. Electron treatment plans were created for 8 skin cancer patients previously treated with a course of HDR brachytherapy of 500 cGy per fraction, in 8 fractions, 2 fractions per week, using the 3-TAB surface applicator, constructed from thermoplastic material with catheters spaced apart by 5 mm in a H.A.M. or Freiburg flap material. The applicator conforms to the topography of the patient treatment site anatomy, immobilizes the treatment area and enhances reproducibility of treatment setup. The patients were randomly selected for dosimetric comparison with electron therapy included treatment sites: lip, ear, chin, cheek, orbit, nose and scalp. En face electron plans used the same target and normal structure contours as the original HDR plans, with 6 MeV electrons and either 0.5 or 1-cm bolus added to increase surface dose and reduce beam energy. The electron plans were prescribed to an isodose line such that the mean target doses were comparable for both techniques. Target dose coverage differed for the two treatment techniques, with the average minimum target dose for 3-TAB of 332 cGy versus 457 cGy for electrons. The average difference between V90 and V110 was 77% for the target dose volume histograms (DVH) in the electron plans, indicating that the gradient of the target DVH was sharper than that of the 3-TAB plans, for which the average difference between V90 and V110 was 40%. Normal tissues receiving 110% of prescription dose were reduced on average by 1 cc for electron plans. However, electron plans produced isodose curves with larger volumes such that the average V100, V75 and V50 were greater than 3-TAB plans by 3, 12 and 9 cm3 respectively. The volumes of the lower isodose lines were smaller for electrons due to the rapid distal dose falloff, with V10 being reduced on average by 154 cm3. Electron therapy and 3-TAB HDR are both suitable treatment options for skin cancers above the clavicle. Electrons provide more uniform dose coverage of the target volumes, high gradients from V90 to V110 and lower doses to normal structures, at the cost of more normal tissue volume receiving doses of 50-100% of the prescription. 3-TAB HDR dose distributions are not as uniform but with less normal tissue receiving doses of 50-100% of prescription due to inverse square falloff.