Version July 2025
| Treatment modality | Advantages | Disadvantages |
| Surgical excision | Margins controlled. Usually performed under local anesthesia. Area of tissue removed (including important structures) precisely controlled. Resultant scar can be optimized both cosmetically and functionally. | Occasionally performed under conscious sedation or general anesthesia with their inherent risks. Random margin may result in lower cure rate compared with Mohs and unnecessary sacrifice of normal tissues. |
| Mohs surgery | 100% margin control. Offers highest cure rates for both primary and recurrent BCCs while maximizing preservation of normal tissue. No sedation or general anesthesia required. | More costly than simple excision, cryosurgery, or electrosurgery (not radiation). Invasive. Longer procedure compared with simple excision, cryosurgery, or electrosurgery (not radiation). Requires special training in the technique. |
| Cryosurgery | Cost effective, relatively quick. Requires a single visit. Potential excellent cosmesis and cure rate in appropriately selected tumors. No sedation or general anesthesia required. | Margins not controlled. Requires considerable experience on the part of the clinician and prolonged wound care. May result in pigmentary changes, possible permanent damage to underlying nerves or other critical structures. |
| Curettage and electrodessication | Cost effective, relatively quick, requires a single visit, well suited for multiple lesions. Relatively easy wound care. No sedation or general anesthesia required. Usually affords good to excellent cosmetic results. Low recurrence rates in small, primary BCCs that lack "high-risk" features. | Margins not controlled. Recurrence rate unacceptably high with larger (>5 mm) lesions located in high-risk sites. Requires special equipment and experience in its use to achieve higher cure rates. Poor choice in most BCCs of the head. Must be cautious in patients with pacemakers. |
| Radiation therapy | Noninvasive. High cure rate for selected lesions. Relative sparing of critical structures. Good for patients who are not otherwise candidates for surgery. Relatively painless. | Margins not controlled. Requires repeat office visits. Poorer long-term cosmetic results. Generally not suitable for younger patients, lesions located on the trunk or extremities, deeply invasive lesions, or previously irradiated sites. More expensive than simple excision, Mohs surgery, cryotherapy, and electrosurgery. |
| Topical fluorouracil or imiquimod | Noninvasive. Rarely causes scarring. Avoids operative risks. Valuable option for patients who are otherwise not candidates for surgery or prefer to avoid surgery. | Use limited to superficial BCCs located in low-risk areas. Brisk, inflammatory reaction that can be poorly tolerated. Requires prolonged application. |
