Small superficial tumors less than 1 cm in diameter can be treated by electrodesiccation and curettage. The base and edges must be smooth and clean after the procedure.
Lesions that are discovered to be deep during the procedure should be treated by excisional surgery. Most squamous cell carcinomas are treated with simple surgical excision with a margin of about 5 mm.
Mohs micrographic surgery is used for high risk lesions on the face years and lip area.
Radiation therapy is considered in older patients and especially for areas that are difficult to approach surgically.
Cryotherapy is the most common treatment for actinic keratoses. It is often difficult to determine the depth of the lesion on the vertex of the scalp. Lesions that appear to be superficial are often discovered to be quite deep during desiccation and curettage. When in doubt curet and desiccate or excise scalp lesions. Cryotherapy may not be sufficient.