Electrodesiccation and Curettage vs Photodynamic Therapy

Electrodesiccation and Curettage: A small, low-risk skin cancer is scraped out with a sharp loop, and the base is then burned. It takes one visit and needs no stitches. It leaves a round pale scar, and the edges are never checked under a microscope.

Photodynamic Therapy: A light-activated drug applied in the office, then switched on with a lamp or laser. It is the strongest non-drug option for inflammatory acne, and the downtime is a real week.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Last updated: 10/22/2026

Editorial illustration for Electrodesiccation and Curettage, based on the entry’s treatment or equipment reference.

Editorial illustration for Photodynamic Therapy, based on the entry’s treatment or equipment reference.

Choose if Key differences What is it?What it treats Treatment areas Skin tones How it works Before your treatment Day of treatment After your treatment Risks Cost Questions Related

Choose Electrodesiccation and Curettage if…

Choose for a small, low-risk skin cancer on the body when one quick visit with no stitches matters more than margin checking.

A small, low-risk basal cell cancer
On the trunk or limbs, not the face
You accept a round pale scar

Choose Photodynamic Therapy if…

Choose to treat a whole area of sun damage at once — or as a strong non-drug option for stubborn acne — with a real week of downtime.

Many precancerous patches on the face or scalp
You can stay out of light for 48 hours
You can take a week of redness

Alternatives, not combined

Can you have both?

Both can treat superficial skin cancers and precancers. One is chosen for each spot.

Key differences

● Electrodesiccation and Curettage

● Photodynamic Therapy

DowntimeNone → 2+ weeks

2+ weeks

3–7 days

PainMinimal → Needs anesthesia or sedation

Mild

Moderate

Results showImmediately → 3+ months

Immediately

1–4 weeks

How long it lastsWeeks → Years or permanent

Years or permanent

1–2 years

Visits neededOne → Every few months

One

A short series (2–3)

Cost per visit$ → $$$$$

ReversibleYes, can be undone → No, permanent

No, permanent

What is it?

Electrodesiccation and Curettage

Photodynamic Therapy

What is it?

It combines scraping and heat.

A lesion is scraped with a curette and treated electrically.

It suits superficial lesions.

It can treat carefully selected low-risk skin cancers.

It does not check margins.

It lacks the margin assessment of excision or Mohs surgery.

Not every cancer qualifies.

Type, site, size and depth determine suitability.

It pairs medicine with light.

A photosensitizing medicine is activated by a set light exposure.

It treats precancers.

It is used for actinic keratoses and some superficial lesions.

It differs from LED therapy.

It is not ordinary LED or UV treatment.

Light avoidance is needed after.

Sunscreen alone may not prevent activation.

What it treats

Evidence level

Electrodesiccation and Curettage

Photodynamic Therapy

Strong evidenceMost established uses

Basal Cell Carcinoma

High cure rates for small tumors.

Two growths on the upper back on fair skin. One is a flat light tan patch and the other is a raised mid-brown growth with a rough waxy surface and a sharply defined edge.

Seborrheic Keratosis

Removes growths quickly.

Actinic Keratosis

Clears 75–90% of spots.

Moderate evidenceSome supportive research

AI-generated educational illustration: Crusted red raised lesion on a light-skinned sun-exposed hand.

Squamous Cell Carcinoma

For small, low-risk tumors.

Basal Cell Carcinoma

Treats superficial types.

Limited evidenceEarly or small studies

—

Acne

Used for stubborn acne.

Not effective

Melanoma

Needs excision with margins.

Melanoma

Needs excision.

Can make it worse

A raised, smooth, firm scar on the upper chest on light skin. It is shiny pink-red and hairless, and its edges spread well past the small mark it grew from.

Keloids

Can trigger new keloids.

Flat tan patches with soft irregular edges across the forehead and upper cheek of an adult with light skin, the surface completely smooth.

Melasma

Light can darken patches.

Treatment areas

The specific lesion, scar or affected patch determines the treatment site; there is no fixed body distribution.

Face; the selected area depends on the concern and treatment plan.

Skin tones

Skin tone

● Electrodesiccation and Curettage

● Photodynamic Therapy

Lighter skin

Some risk

A round pale scar.

Low risk

Redness and peeling.

Medium skin

Some risk

Pale scar is more visible.

Some risk

Temporary darkening possible.

Deeper skin

Higher risk

Pale or raised scars are more noticeable; discuss excision.

Some risk

Dark marks are more likely; strict light avoidance helps.

How it works

Electrodesiccation and Curettage

Photodynamic Therapy

How it works

Curettage & Electrodesiccation mechanism diagram. A curette removes tissue: A clinician scrapes away the selected lesion. Electrical treatment treats the base: Energy dries or coagulates tissue in the treatment bed. The wound heals: The open area repairs with scar tissue; follow-up remains important.

Photodynamic Therapy mechanism diagram. A photosensitizer is applied: The selected medicine accumulates in the prepared treatment area. Light activates the medicine: A matched light regimen produces reactive molecules. Selected cells are damaged: Inflammation and healing follow; treatment response varies.

Diagram explanation

A curette removes tissue: A clinician scrapes away the selected lesion. Electrical treatment treats the base: Energy dries or coagulates tissue in the treatment bed. The wound heals: The open area repairs with scar tissue; follow-up remains important.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

A photosensitizer is applied: The selected medicine accumulates in the prepared treatment area. Light activates the medicine: A matched light regimen produces reactive molecules. Selected cells are damaged: Inflammation and healing follow; treatment response varies.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

Before your treatment

Electrodesiccation and Curettage

Photodynamic Therapy

2–4 weeks before

Not specified

2 weeks before: Sun and tanning: Avoid sun and tanning for 2 weeks.

Before you book: Time off: Clear several days, especially the 48 hours after, when you must stay out of sunlight and bright indoor light.

The week before

Do not stop: Blood thinners: Aspirin, clopidogrel, warfarin, apixaban, rivaroxaban and similar are usually continued — extra oozing is easier to manage than a clot or a stroke.

Ointment and dressings: Buy plain petrolatum ointment and non-stick dressings beforehand, not on the way home.

5 to 7 days before: Actives: Stop retinoids and exfoliating acids.

Day of treatment

Electrodesiccation and Curettage

Photodynamic Therapy

Before you arrive

What to wear and eat: Wear something you do not mind getting blood on.

Not specified

Arrival & prep

The lesion is matched against the biopsy report, photographed, and consent signed.

Photos, consent covering the off-label use and the downtime, and a medication review.

Treatment

The doctor scrapes with the curette, which feels like pressure and tugging, not pain.

The electric probe follows, with a faint buzz and a smell of burning. The pair is repeated two or three times; one lesion takes about 10 to 20 minutes. Nothing should feel sharp once you are numb, so say so if it does.

Skin is cleaned and degreased, sometimes with microdermabrasion or an acetone wipe, so the drug soaks in evenly.

The solution goes on and you wait 20 minutes to 3 hours in a dim room. Then eye shields go on and you sit under a blue or red light for 8 to 20 minutes, or a laser or IPL is passed over. Stinging builds and peaks at the end; cold air helps.

Before you leave

A round, shallow, raw crater slightly larger than the growth, under ointment and a dressing.

The least comfortable procedure on this list.

After your treatment

Electrodesiccation and Curettage

Photodynamic Therapy

First 24 hours

Day 1 to 7: The wound weeps and the base looks yellow.

First 48 hours: Stay strictly out of sunlight and bright indoor light; daylight through a window can trigger a severe reaction.

Days 2–7

Not specified

Days 4 to 10: Peeling and flaking, sometimes in sheets.

Weeks 2–4

Weeks 2 to 6: The crater shrinks and the base turns pink.

Weeks 1 to 2: An acne flare is common in the first week or two, before improvement starts.

Beyond 1 month

Month 2 to 12: The scar starts pink and firm, then flattens and pales over roughly a year.

Not specified

Time to results

Immediately

2–4 weeks

How long results last

90–95% cure for suitable cancers

Treated spots clear; new ones may form

Risks

Most of what happens after this procedure is expected rather than a complication
Incomplete removal
A raised or thickened scar
A wound that stalls
Numbness or a patch that stays firm
When to contact your provider

Dark patches
Prolonged redness
A cold sore outbreak

Cost

Per session

This is the least expensive way to treat a skin cancer surgically.

In the US, PDT for acne generally costs about $400 to $1,500 per session, so a course commonly lands between $800 and $4,000.

Insurance

In the US it is billed as a destruction procedure, priced by lesion size and body site, and generally covered when it treats a diagnosed skin cancer.

Insurance does not cover PDT for acne, because the approved indication is precancerous sun damage.

Questions

Electrodesiccation and Curettage

Photodynamic Therapy

Individual Questions

Does it hurt?

The numbing injection stings for under a minute. After that you feel pressure and tugging, not pain. Afterward the site is sore rather than painful, and acetaminophen is enough.

Why don't they check the edges under a microscope?

There is no intact specimen to check — the tumor is scraped away in fragments and the base burned. The method relies on the operator feeling soft tumor against firm normal tissue, which is reliable for shallow, clearly bordered tumors and unreliable for others.

What will the scar look like?

A round, flat disc, usually slightly wider than the original spot and lighter than the skin around it. Some are a little sunken, some raised. Pink at first, paling over about a year. It is permanent.

How long until it heals?

About 3 to 6 weeks on the face, trunk and arms. On the lower leg it is slower, sometimes two to three months, particularly in older adults or with diabetes or poor circulation.

Can I have this instead of Mohs surgery on my face?

Sometimes, for a small superficial tumor on the cheek or forehead. Generally not for the nose, eyelids, ears, lips or the creases around them, where recurrence is higher and there is less spare skin. Ask why one is recommended over the other for your tumor.

What are the chances it comes back?

For a well-selected, small, low-risk tumor, cure at 5 years is commonly quoted around 95 percent. That falls when the method is used on tumors it was not meant for — aggressive subtypes, recurrent tumors, unclear borders, high-risk facial sites.

Is photodynamic therapy approved for acne?

Not in the US. It is FDA-approved for precancerous sun spots; using it for acne is off-label. That is legal and common, but it means no standard protocol and results that vary between clinics.

How bad is the downtime really?

Plan for 5 to 7 days of a visibly red, then swollen, then peeling face, with the worst in the first 48 hours. It is closer to a medium-depth peel than a laser facial.

Why do I have to stay out of the sun for 48 hours?

The drug is still in your skin, and sunlight — including through a car or office window — activates it and can cause a severe burn. This is the most important instruction of the treatment.

Does it cure acne?

No. Improvement typically lasts 6 to 12 months and repeat courses are often needed. It does not treat scars or existing brown marks.

Is it safe on deeper skin tones?

It can be done, but the risk of lasting dark patches is meaningfully higher, because the treatment works by causing strong inflammation. A shorter incubation, a lower light dose and an experienced provider make a large difference.

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