Basal and Squamous Cell Skin Cancer: Treatment Options

This page is for people who have been diagnosed with basal cell or squamous cell skin cancer, and their families. It walks through the main treatment options, recovery, and follow-up care.

Basal cell and squamous cell carcinoma are the two most common types of skin cancer. For most people, treatment removes or destroys the cancer. NCI says treatment options depend on the type of cancer, its stage, and other factors.

Simple excision removes the tumor along with a margin of normal-looking skin around it. This margin helps make sure no cancer cells are left behind.

Mohs micrographic surgery removes the tumor in thin layers. Each layer is checked under a microscope before the next one is taken. This lets your surgeon remove all the cancer while sparing as much healthy tissue as possible. It is often used on the face.

In this approach, your doctor scrapes away the tumor with a small tool called a curette. An electric current then seals the area and destroys any remaining cancer cells. NCI says this may be repeated one to three times during the surgery.

External radiation uses high-energy x-rays delivered by a machine outside your body. NCI lists it as a treatment for both basal cell and squamous cell carcinoma.

Fluorouracil cream, also called 5-FU, is a topical chemotherapy applied directly to the skin. It is used for some basal cell carcinomas.

Imiquimod cream works differently. It stimulates your immune system to attack the cancer. It is also used for certain basal cell cases.

For advanced or spreading basal cell carcinoma, hedgehog pathway inhibitor drugs are an option. These include vismodegib and sonidegib. They block a specific signal these cancer cells rely on to grow.

Advanced or spreading squamous cell carcinoma can be treated with immunotherapy. Drugs called PD-1 inhibitors, including cemiplimab and pembrolizumab, help your immune system recognize and attack cancer cells. These are generally reserved for cases that cannot be treated with surgery or radiation alone.

Healing time depends on the size and location of the treated area. A small area on an arm heals differently than a larger area on the face. Ask your team what your specific healing timeline looks like. Also ask what wound care you will need at home.

Chemotherapy sets the fever line. Anyone who has had a dose in the past few weeks should treat a temperature of 100.4°F (38°C) or higher as a medical emergency, which is how the CDC describes it: phone the oncology team straight away at any hour, and use an emergency department if nobody can be reached.

If you are not on chemotherapy, call your care team right away for a fever of 100.4°F (38°C) or higher. Also call right away for signs of infection at a treated site, such as growing redness, warmth, swelling, or pus. For emergencies call 911 or go to the ER.

Bleeding is the exception. If a treated site keeps bleeding after 15 minutes of firm, unbroken pressure, or soaks through dressings, call 911 or go to an emergency department instead of waiting for a callback.

ACS says people who have had basal cell skin cancer are at high risk of other skin cancers in different places. Regular skin checks with your dermatologist after treatment are how new cancers get caught early, when they are easiest to treat. Ask how often you should be checked going forward.

• Which treatment do you recommend for my specific tumor, and why this one over the others?
• What will my scar or healing look like, and how long will recovery take?
• Am I a candidate for a less invasive option, like topical treatment or curettage?
• How often should I have skin checks after this treatment?

• National Cancer Institute — Skin Cancer Treatment (PDQ)
• American Cancer Society — Living as a Basal or Squamous Cell Skin Cancer Survivor
• CDC — Fever and Cancer Treatment