Sirtuin 3 (SIRT3) is a histone deacetylase protein capable of regulating multiple mitochondrial proteins. As a result, it plays a significant role in stabilizing metabolism and shifting cells toward oxidative phosphorylation. In cutaneous cancers, understanding cellular metabolism has become increasingly important. In cancers such as melanoma, treatment can often be hampered by metabolic plasticity, a phenomenon in which cells can shift between glycolytic and oxidative metabolic strategies to favor their survival based on their growth context (e.g., tumor microenvironment and stage of cancer development). Because cancers present in diverse ways, SIRT3 has been implicated as an oncogene in some malignancies (especially those where high oxidative phosphorylation activity helps meet bioenergetic demands), while it has tumor-suppressive properties in others. Thus, understanding the impact of SIRT3 in inducing a respiratory metabolism in cancers is vital. Even within the same type of cancer, induction of SIRT3 can have varying effects depending on certain mutations. For instance, melanoma cells with defective mitochondria that cannot reduce oxidative stress are susceptible to cell death via SIRT3 induction, while other melanoma cell lines display decreased proliferation with silencing of SIRT3. Furthermore, multiple studies have implicated SIRT3 in other diverse cancer-related roles, including regulation of apoptosis, immortalization, metastasis, and genomic stability. By exploring these various impacts of SIRT3, and later examining SIRT3 in the context of specific cutaneous cancers, we summarize the current knowledge regarding SIRT3 in the skin.