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Your dermatologic surgeon will select the most appropriate treatment for a particular skin cancer, or precancerous condition, from among the following procedures and techniques:
Curettage and electrodesiccation
This technique may be used to treat small basal cell and squamous cell tumors by scraping the tumor with a curette (a surgical instrument shaped like a long spoon) and then using an electric needle to gently burn or “cauterize” the remaining cancer cells and a margin of normal-looking tissue.
Cryosurgery may be used to treat some small primary basal cell and squamous cell tumors as well as a few recurrent lesions. Cryosurgery involves freezing the tumor. The frozen cancer cells are destroyed by the freezing and slough off, allowing the underlying normal skin to heal.
Excision may be used to treat both primary and recurrent tumors by surgically removing the tumor and an area of healthy looking skin (margin) around the tumor. In some cases, the wound does not require treatment and is allowed to heal on its own. When closure is necessary, the wound may be closed with stitches, skin from another area of the body (skin graft), or healthy skin moved from a nearby area (skin flap). After surgery, the excised tissue is examined under a microscope to see if any cancer cells were present in the skin that appeared cancer free.
Laser surgery may be used in certain cases to vaporize superficial and multiple basal cell carcinomas and to excise or destroy squamous cell carcinoma. Laser surgery does not destroy cancer cells found deeper in the skin so close follow-up with a dermatologist is important.
Mohs micrographic surgery
Mohs involves first removing the visible tumor and then successive layers of skin one at a time until no more cancer cells are shown on microscopic examination. Once skin cancer is no longer visible, the surgical wound is treated as needed. Methods include allowing the wound to heal naturally, closing the wound with stitches, covering the surgical site with skin from another area of the body (skin graft), and moving healthy skin from a nearby area to cover the surgical wound (skin flap).