Usually, treating basal cell carcinoma (BCC) involves surgery to remove the cancerous cells. However, radiation and medication are also options.

BCC is the most common type of skin cancer. It begins in your basal cells at the bottom of the epidermis, the outermost layer of your skin.

BCC can often affect people who experience too much sun exposure, especially those with pale skin. Although rarely life threatening, untreated BCC can spread beyond your skin and cause complications.

Early diagnosis and treatment are essential to prevent the cancer from growing and spreading. This article provides an overview of the main treatment options for BCC.

Curettage and electrodesiccation (also known as “C&E,” “ED&C,” or “scrape and burn”) is a frequent treatment for small, superficial BCCs.

In this procedure, a doctor scrapes away the cancerous tissue with a surgical instrument called a curette. After this, they use an electric needle to destroy any remaining cancer cells. This method is relatively quick, and the doctor provides you with a local anesthetic to numb the area for the surgery.

C&E tends to be most effective for low risk BCCs, with the cure rate being close to 95% in these cases. But it may not be suitable for extensive, fast-growing tumors and lesions on sensitive areas like your face.

In a standard excision, a doctor removes the tumor and some healthy tissue, ensuring the removal of all cancer cells. They then send the tissue to a lab to confirm that the edges are cancer-free.

Doctors usually use this method for more advanced BCCs or those on less sensitive parts of your skin. The procedure’s cure rate is above 95% when performed on most body areas, but it can leave a scar because doctors typically close the wound with stitches.

Shave excision involves using a surgical blade to shave off the cancerous lesion at or slightly below the level of your surrounding skin. Doctors typically use it for superficial BCCs that haven’t spread deep into your skin. Once your doctor removes the tumor, they may send it to a lab for analysis.

This quick procedure often leaves minimal scarring but may be less effective for sizeable, fast-growing BCCs.

Mohs surgery is a precise surgical technique doctors use to treat BCCs, especially those on your face or other sensitive areas. This method involves removing the cancerous tissue layer by layer and examining each layer under a microscope until no cancer cells remain.

Mohs surgery has one of the highest cure rates of all BCC treatments. It’s as high as 99% for skin cancer that hasn’t undergone treatment before and 94% for cancer that has returned after a previous treatment.

The surgery ensures complete cancer removal while sparing as much healthy tissue as possible and leaving the least scarring. The procedure can be time consuming, with doctors typically performing it in stages during a single visit.

Other surgeries for basal cell carcinoma

In some cases, you may require additional surgeries following the removal of a BCC.

For example, if your cancer has spread to your lymph nodes, surgery to remove lymph nodes may be necessary.

Doctors can also recommend reconstructive surgery to restore your skin’s appearance and function, especially for larger tumors. An example of this procedure is skin grafting, which uses healthy skin from another part of your body to heal the wound from cancer removal.

Radiation therapy is an option for people who can’t or don’t want to have skin surgery for various reasons, such as if the tumor is:

  • too large
  • difficult to reach
  • located on a sensitive area, such as your face

Radiation therapy uses high energy rays to kill cancer cells. People usually have several radiation sessions to remove the tumor.

Radiation may be effective but can cause side effects such as:

Doctors don’t recommend it as often as surgery because of the side effects.

Your doctor can prescribe chemotherapy creams to treat superficial BCCs. These creams stimulate your immune system to attack cancer cells or interfere with their DNA, causing them to die. Examples include imiquimod (Aldara, Zyclara) and fluorouracil (Carac, Efudex).

For advanced or metastatic BCC (when cancer spreads beyond your skin), doctors can also prescribe targeted therapies to prevent the growth of cancer cells. These are oral medications, meaning you take them by mouth. Examples include vismodegib (Erivedge) and sonidegib (Odomzo).

What’s the best treatment for basal cell carcinoma?

There’s no single “best” treatment for BCC. The most effective treatment for your specific condition depends on:

  • tumor size and location
  • the cancer’s growth speed
  • your overall health
  • treatment preferences

Can I treat basal cell carcinoma with a cream?

Certain creams, like imiquimod and fluorouracil, can treat superficial BCCs. However, they’re typically ineffective for deeper or fast-growing BCCs.

How quickly should a basal cell carcinoma be removed?

It’s essential to receive a BCC diagnosis and start treatment as soon as possible to prevent tumor growth and potential complications.

What happens if you don’t remove basal cell carcinoma?

Untreated BCCs can grow larger and deeper, causing injury to your skin and nearby tissues. Over time, they can spread into your bones and nervous system.

BCC is a common and typically treatable form of skin cancer, especially when detected early. Surgery is often the most effective treatment option, but other methods can also be highly effective. If you think you have a BCC, consult a healthcare professional promptly to discuss the most appropriate treatment plan.