Basal cell carcinoma treatment

What is basal cell carcinoma treatment?

Basal cell carcinoma (BCC), sometimes called a rodent ulcer, is the most common type of skin cancer. It usually grows slowly, is caused mainly by sun exposure over many years, and very rarely spreads to other parts of the body. It is almost never a danger to life, but if left untreated it can keep growing and damage nearby skin and tissue.

Treatment aims to remove or destroy the BCC completely. The most common treatment is minor surgery (excision) under local anaesthetic, where the lump and a margin of normal skin are cut out and sent to the laboratory to check it has all been removed. The wound is then stitched, left to heal, or sometimes closed with a skin graft or flap.

For BCCs in difficult areas — such as the nose, ear, lip or around the eye — or those with unclear edges or that have come back, a specialist technique called Mohs micrographic surgery may be used. This removes the cancer layer by layer, checking each layer under the microscope, to remove as little healthy skin as possible while achieving a very high cure rate.

Other options, suited to certain lower-risk BCCs, include curettage and cautery (scraping and sealing), freezing (cryotherapy), prescription creams, photodynamic therapy and, in selected cases, radiotherapy. The right choice depends on the type, size and site of the BCC.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Surgery vs Mohs surgery

Both have high cure rates. Your specialist will recommend the approach based on the BCC's type, size and site.

Preparing for your procedure

• See a GP about any scab that bleeds and will not heal, or a pearly or scaly patch or lump that is slowly growing.
• Tell the team about all your medicines, especially blood thinners, and any allergies to local anaesthetic or dressings.
• Mention any pacemaker or implanted device, as this affects the type of cautery that can be used.
• Ask which treatment is being recommended and why, and whether it will be done the same day.
• Arrange transport and time off if a larger excision, graft, flap or Mohs surgery is planned (Mohs can take most of a day).
• Plan for someone to help at home if the wound is on a hand, leg or prominent area.
• Bring a list of previous skin cancers or treatments if you have had any.

What happens

For most BCCs, the area is numbed with local anaesthetic and the lesion, plus a margin of normal skin, is removed. The wound is stitched, left to heal on its own, or closed with a skin graft or flap. The sample is sent to the laboratory to confirm the BCC has been fully removed, with results usually back in about two weeks.

With Mohs micrographic surgery, the visible cancer is removed and examined under the microscope while you wait. If any cancer remains at the edges, only that area is removed and checked again, layer by layer, until the edges are clear. The wound is then repaired, often the same day. This is why Mohs can take several hours.

Non-surgical treatments differ: curettage and cautery is done in one or more short sessions, cryotherapy is a brief freeze, creams are applied at home over weeks, and photodynamic therapy and radiotherapy involve attending for treatment sessions.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

BCCs are rarely dangerous, but the trade-offs are about cure rate and the scar. Treatments that check the edges (surgery and especially Mohs) have the lowest chance of the cancer returning; some non-surgical options are gentler but are only suitable for lower-risk lesions and may have higher recurrence. Ask why a particular treatment is being recommended, what the cure rate is for your BCC, and what the scar is likely to look like.

Published figures to discuss

Cure and recurrence rates depend on the BCC's type, size, site and the treatment used, so single figures can mislead. Edge-checking surgery, especially Mohs, has the highest cure rates; some non-surgical options trade a higher chance of recurrence for avoiding a cut. Reliable head-to-head numbers are limited for some treatments.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Recovery depends on the treatment and the site. A small excision heals quickly; a graft, flap or wound on the lower leg takes longer, and creams or photodynamic therapy cause a period of soreness and crusting as the skin heals.

• A tender, firm or red scar that softens and fades over months
• Bruising and swelling around the wound early on
• Crusting, redness and soreness with creams, cryotherapy or photodynamic therapy
• Slower healing on the lower leg
• Tightness or slight numbness near the scar

Aftercare

• Follow the wound-care and dressing instructions you are given, keeping the area clean and dry.
• Use any prescribed cream exactly as directed and expect a period of redness and crusting.
• Protect the healing skin from the sun and use high-factor sun protection long-term.
• Avoid knocking or stretching the wound, especially on a leg or near a joint.
• Watch the wound for signs of infection and take pain relief as advised.
• Attend follow-up for results and any skin checks.
• Learn to check your own skin and report any new or changing lesions.

• Clear written wound-care or cream instructions
• Date for results and any follow-up appointment
• Clinic contact number for problems
• High-factor sunscreen and sun-protection plan
• Help at home arranged if a graft, flap or leg wound is involved
• Dressings or supplies you have been told to get

Scars and how they heal

Treating a BCC leaves a mark or scar — this is expected, because the cancer has to be removed or destroyed. After surgical excision the scar is usually a thin line, but larger BCCs leave longer scars, and lesions on prominent areas such as the face can be more noticeable. Where a lot of skin is removed, the wound may be closed with a skin graft or flap, which looks and feels different from the surrounding skin. Curettage and cautery and cryotherapy can leave paler, sometimes less predictable scars, and lower-leg wounds heal more slowly. Mohs surgery aims to remove as little healthy skin as possible and to repair the wound so the scar is hidden as far as possible, but a scar still remains. All scars are red or firm at first and usually soften and fade over months.

⚠ Get urgent help if…

• Increasing redness, swelling, heat, throbbing or discharge from the wound (possible infection)
• Bleeding from the wound that does not stop with gentle pressure
• A graft or flap turning dark, very pale or coming away
• Severe or worsening pain after the first day or two
• Fever or feeling generally unwell after surgery
• The treated area not healing, or a lump or ulcer returning at the site
• Any new scaly patch, pearly lump or non-healing scab elsewhere on your skin
• A new or changing mole (which could be a different, more serious skin cancer)

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is complete removal of the BCC with the cancer cleared at the edges, a wound that heals well, and a scar that settles over time. BCCs can almost always be cured, especially when found early, and Mohs surgery in particular has a very high cure rate.

No treatment can promise the cancer will never return or that you will never get another skin cancer. Because people who have had one BCC are more likely to develop others, ongoing sun protection and skin awareness are an important part of a good outcome.

Most BCCs are cured by appropriate treatment, and Mohs surgery has one of the highest cure rates, with only a small chance of the cancer returning even for difficult, high-risk lesions. Standard excision with clear margins also has a high cure rate. Recurrence is more likely with incompletely removed or high-risk BCCs and with some non-surgical treatments, which is why edge-checking matters. Having had one BCC raises the chance of developing further skin cancers over the years, so lifelong sun protection and skin checks are advised.

Related tests, treatments or support

Treatment is sometimes combined with checking and treating other sun-damaged areas or skin cancers found at the same time. Surgery may be combined with reconstruction (a graft or flap). For people with many or recurrent skin cancers, a longer-term skin-surveillance plan is often put in place alongside treatment.

Follow-up & long-term care

Many people with a low-risk, fully removed BCC are discharged after treatment with advice on sun protection and self-examination. Follow-up is arranged for higher-risk or recurrent BCCs, incomplete removal, or for people prone to multiple skin cancers. Any non-healing area, recurrence at the site, or new suspicious lesion should be reported promptly.

• Use high-factor sun protection and avoid sunburn and sunbeds for life.
• Check your own skin regularly and report new or changing lesions.
• Attend any follow-up appointments arranged for higher-risk cases.
• Keep a record or photos of treated and new areas to spot changes.
• Seek prompt review of any non-healing scab, pearly lump or scaly patch.

Repeat, follow-on and what comes next

• If an excision does not fully clear the BCC, further surgery may be needed.
• Non-surgical treatments have a higher chance of the BCC returning and needing re-treatment.
• Reconstruction (graft or flap) may occasionally need revision.
• People prone to skin cancer often need treatment of new lesions over time.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Clear wound-care or cream instructions and a contact number for problems.
• A results process confirming the BCC was fully removed.
• Prompt review of any non-healing area, wound problem or recurrence.
• Teaching on skin self-examination and what to report.
• Lifelong sun-protection advice and a follow-up plan for higher-risk patients.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The treatment chosen (excision, Mohs surgery, curettage, cryotherapy, cream, photodynamic therapy or radiotherapy)
• The size and site of the BCC and how complex the removal is
• How the wound is closed (direct stitching, skin graft or flap)
• Whether Mohs micrographic surgery is needed (a longer, specialist procedure)
• Laboratory (histopathology) reporting to confirm clearance
• Anaesthetic type and any facility fees
• Follow-up appointments and treatment of any other lesions found

• The surgeon's or dermatologist's fee and which treatment is included
• Laboratory (histopathology) costs for checking the edges
• Whether reconstruction (graft or flap) is included if needed
• Anaesthetic and facility fees
• Whether Mohs surgery and its repair are covered, and the likely time involved
• Follow-up appointments and what happens if removal is incomplete
• How any complication or recurrence would be handled and charged

On the NHS? Basal cell carcinoma is diagnosed and treated on the NHS; private care may be used for speed or choice of provider, but the same range of treatments applies and treatment should be guided by the type and site of the lesion.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• What type and size of BCC do I have, and which treatment do you recommend and why?
• What is the likely cure rate with this treatment for my BCC?
• Will the edges be checked to confirm it is fully removed?
• What will the scar look like, and how will the wound be closed?
• Do I need Mohs surgery because of where the BCC is?
• Will I be followed up, and what should I watch for afterwards?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my procedure, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this procedure not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for basal cell carcinoma treatment

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: British Association of Dermatologists — Basal cell carcinoma (patient leaflet) Primary Care Dermatology Society — Basal cell carcinoma North Bristol NHS Trust — Mohs micrographic surgery (patient information) Curettage and cautery vs excision for low-risk BCC (randomised trial, PMC)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.