The goal of treatment is to remove the lesion completely while preserving as much normal tissue as possible. There are a variety of techniques available. Desiccation and curettage is adequate for nodular lesions less than 6 mm in diameter. The cure rate is high and normal tissue is preserved. Larger lesions are treated by surgical excision.
Mohs micrographic surgery is a highly specialized technique performed by specialists. Tissue is removed and examined immediately with histologic techniques using frozen sections. Tumor extensions are mapped and methodically pursued until the entire tumor is removed and histologically confirmed. This technique is especially useful for treating complicated areas such as the nose and about the eyes and ears. It is also the treatment of choice for recurrent tumors and sclerotic basal cell carcinoma.
Radiation therapy is reserved for older patients who cannot tolerate surgery. It is also useful for difficult to treat areas such as lesions about the lip.
Superficial basal cell carcinoma can be treated with imiquimod cream. The medication is applied each day for at least 6-8 weeks.
5-Fluorouracil (Efudex) has also been approved for treating superficial basal cell carcinoma.
Cryotherapy can be used for very small nodular or superficial lesions.