Procedure

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.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026
A gloved clinician treating a small dark spot on a patient's shoulder with a fine handheld instrument

Start here

Electrodesiccation and curettage is one of the most useful things a dermatologist does, and one of the easiest to use in the wrong place. On a small superficial basal cell carcinoma on the back or the shoulder it is quick, inexpensive, done in one visit, and the cure rate is very good. On the nose, on an eyelid, on a tumor with fuzzy borders, or on anything that has already come back once, it is the wrong choice.

What I find myself repeating is about the healing, not the cancer. There are no stitches. You leave with an open, shallow, weeping round wound that takes three to six weeks to close, and the scar it leaves is a flat pale circle, usually a little wider than the spot you came in about. People are ready for the cancer part and are not ready for that.

The other thing worth saying plainly is that nobody looks at the edges under a microscope. The scraping tells the doctor a great deal by feel, and it is not a margin check. That is the real trade for the speed and the low cost, and it is why the tumor has to be a low-risk one to start with.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

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Also calledCurettage and electrodesiccation, C&E, ED&C, curettage and cautery, "scrape and burn"
DowntimeNo time off needed. The wound is left open and needs a daily dressing for 3 to 6 weeks
SessionsOne visit. The scrape-and-burn cycle is usually repeated two or three times within that visit
Typical costThe least expensive of the surgical options. When it is done to treat a diagnosed skin cancer it is generally covered by US health insurance; a deductible or copay still applies
Results timelineThe cancer is treated that day. The wound closes in 3 to 6 weeks, and the scar keeps fading and softening for about a year
PainThe numbing injection stings for under a minute. The procedure itself is not painful, and afterward the site is usually sore rather than painful
Cure rateCommonly quoted around 95 percent at 5 years for carefully selected low-risk tumors. Substantially lower when it is used on tumors it was not meant for
Skin tone safetyThe treatment works the same on every skin tone. The scar is what differs, and it is the main thing to plan around on deeper skin tones

What It Is

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Two instruments and one visit. After the area is numbed with a local anesthetic, the doctor uses a curette, a small instrument with a sharp spoon- or loop-shaped end, to scrape the tumor out. An electric needle or probe is then touched to the base, which chars a thin layer of tissue and stops the bleeding. That is the electrodesiccation. The pair is normally repeated two or three times in the same sitting. Nothing is stitched. The wound is left open and heals from the bottom up over several weeks. What it treats: Well-defined, low-risk skin cancers: superficial basal cell carcinoma, small nodular basal cell carcinoma on the trunk or limbs, and squamous cell carcinoma in situ, sometimes called Bowen's disease. It is also used for a number of harmless growths, including seborrheic keratoses, warts and pyogenic granulomas. It is not used for melanoma. It is also generally avoided for tumors on the central face, eyelids, ears, lips and nose, for aggressive microscopic subtypes such as infiltrative, micronodular and morpheaform basal cell carcinoma, for a cancer that has been treated once and returned, over hair-bearing skin, and anywhere the border cannot be seen clearly.

How It Works

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The method relies on a difference in texture. Basal cell and squamous cell tumor tissue is soft and crumbly compared with the firm collagen of the normal dermis around and beneath it. A sharp curette drags through the soft tumor and catches at the firm normal tissue, so the doctor feels the edge of the growth rather than sees it. Scraping continues until the base and walls feel uniformly firm in every direction.

The electric current that follows does two jobs. It seals small vessels so the base stops bleeding, and it destroys a thin rim of tissue beyond where the curette reached, which acts as a margin of sorts. The char is then scraped away and the cycle repeated, because the second and third passes catch small nests of tumor the first one missed.

The wound is left open because closing it would hide the treated base. New tissue fills the crater from the floor upward while skin grows across from the rim, which is why the healed result is a flat round disc rather than a line.

What the method cannot do is confirm the cancer is gone. There is no intact specimen with edges for a pathologist to read. The judgment is the operator's fingers. That judgment holds up well on tumors that are shallow and clearly bordered, and poorly on tumors that are not, which is the whole reason the list of suitable tumors is narrow.

Skin is about two millimetres thick on the face. How deep a treatment reaches is most of what decides what it can and cannot change.

How deep Electrodesiccation and Curettage goes
EPIDERMISDERMISFAT0.05 mm — pigment0.5 mm — texture + pores1.0 mm — collagen1.5 mm — deep dermisREACHES THE MID DERMIS

This works around one to one and a half millimetres down, in the middle of the dermis where collagen is made. That is the depth that changes scarring and firmness, and it is also why the downtime is longer and the result takes months to appear.

See how it compares
EPIDERMISDERMISFAT0.05 mm — pigment0.5 mm — texture + pores1.0 mm — collagen1.5 mm — deep dermisSTAYS IN THE TOP LAYERREACHES THE UPPER DERMISREACHES THE DEEP DERMISGOES BELOW THE SKINREACHES THE MID DERMIS

This works around one to one and a half millimetres down, in the middle of the dermis where collagen is made. That is the depth that changes scarring and firmness, and it is also why the downtime is longer and the result takes months to appear.

This works in the epidermis, the top layer, only about a tenth of a millimetre thick. That is the right depth for surface pigment, flaking and rough texture, and it is why nothing at this depth can change a scar or a wrinkle that is set in the layer below.

This reaches just past the epidermis into the top of the dermis, around half a millimetre down. That is where fine texture, pores and the shallowest scarring sit. Deep enough to remodel a little, shallow enough that healing is measured in days.

This goes through the full thickness of the skin, past the collagen and down to where hair bulbs, larger vessels and glands sit. At this depth a treatment can reach structures creams never touch, and it is also where scarring becomes a real risk if it is done badly.

This works below the skin altogether, in the fat or the muscle beneath it. Nothing applied to the surface reaches here, which is the whole reason the procedure exists — and why it is done by injection, by needle or with a blade rather than with a cream.

Lost? See skin basics
POREEPIDERMISMELANOCYTESDERMISOILGLANDBACTERIACOLLAGENEPIDERMISMELANOCYTESTHE POREOIL GLANDBACTERIACOLLAGENTHE DERMIS

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The cells that make pigment. They sit along the base of the epidermis and hand melanin to the cells around them, which is what gives skin its color. Dark marks, melasma and the patch left behind by a spot are all these cells making more than usual.

A narrow tube running from the surface down into the skin, with an oil gland at the bottom of it. Oil travels up and out. When the tube blocks, what is behind it has nowhere to go — which is where blackheads and spots start.

Makes sebum, the oil that keeps the surface soft and stops water escaping. How much it makes is set by hormones, not by how often you wash — which is why scrubbing does not fix oily skin.

Cutibacterium acnes lives in the pores of everyone with skin. It is not an infection and it is not a hygiene problem. It only causes trouble when a pore blocks and it multiplies in the oil trapped behind it.

The scaffolding in the dermis that keeps skin firm and springy. It is built by fibroblasts and broken down by age, sun and smoking. Lines and looseness are collagen lost faster than it is replaced.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

What It Treats

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Skin Tags
Skin Tags
Strong evidence
A fine electric tip burns through the stalk and seals it at the same time, so there is no bleeding. It suits several small tags in one session and very small ones on the eyelids. It destroys the growth, so it is not used on anything that needs examining first.
Seborrheic Keratosis
Strong evidence
The growth is scraped off with a small curette and the base sealed with a fine electric tip. It is controlled and shallow, which is why it is often preferred for small facial growths and for the dark facial growths common on deeper skin tones. Scraping first still gives tissue that can be examined if there is doubt.
Actinic Keratosis
Actinic Keratosis
Moderate evidence
The thicker, harder patches that freezing struggles with are scraped away under local anesthetic and the base sealed. It is useful when a patch has built up into a lump or a horn, and the scraped material can be sent for testing. It leaves a small scar, and like freezing it treats only the spot in front of you.
Squamous Cell Carcinoma
Squamous Cell Carcinoma
Moderate evidence
The tumor is scraped out with a small loop and the base is sealed with an electric current, repeated a few times in one sitting. It is quick and effective for small, thin, low-risk tumors on the trunk and limbs. It is not used on the face, on large or recurrent tumors, or anywhere depth matters, because nothing is sent for margin checking and it leaves a round pale scar.
Basal Cell Carcinoma
Basal Cell Carcinoma
Moderate evidence
The tumor is scraped away and the base burned, repeated a few times in one visit. It suits small, thin, superficial tumors on the trunk and limbs and is quick and cheap. Nothing is checked under a microscope afterwards, so it is not used on the face or for aggressive subtypes, and it leaves a permanent pale round mark.

Not the Best For

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Milia
Limited evidence
A fine heated needle used to destroy the sac, usually kept for milia that are numerous, very small, or sitting somewhere awkward for a blade. It works. It is also more likely than a simple nick to leave a small mark, so it is not the first choice for one or two bumps on an eyelid.
Warts
Warts
Limited evidence
The wart is numbed, burned with an electric current and scraped away in one visit. It is kept for a single stubborn wart that has failed everything gentler, because it leaves a scar, and a scar on the sole of a foot can hurt more than the wart did. Warts can still regrow at the edge of the scar.
Plantar Warts
Plantar Warts
Limited evidence
Burning and scraping the wart out under local anesthetic. It clears the visible wart in one go, which is why people ask for it. On the sole it leaves a wound that takes weeks to heal and can leave a scar you then walk on, and the wart can still return, so it is a late option rather than an early one.

Pros

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  • One visit, no stitches The cancer is treated on the day it is booked, and there is no return trip to have sutures removed.
  • Least expensive surgical option No laboratory processing, no repair, few instruments. It is the cheapest way to treat a skin cancer surgically.
  • Very good cure rate on the right tumor For a small, well-defined, low-risk basal cell carcinoma on the trunk or limbs, cure at 5 years is commonly quoted around 95 percent.
  • No activity restriction There are no stitches to burst, so there is no two-week lifting restriction the way there is after an excision.

Cons

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  • No margin check Nothing goes to a pathologist, so nobody can confirm the edges were clear. Recurrence is found later, by watching.
  • The scar is round and pale A flat, lighter disc, usually wider than the original spot, and permanent. On deeper skin tones the contrast is sharp.
  • Weeks of open wound care Three to six weeks of daily cleaning and dressing, with weeping and crusting through much of it. Wounds on the lower leg heal slowest.
  • A narrow list of suitable tumors Wrong for the high-risk zones of the face, for aggressive subtypes, for recurrent tumors, for hair-bearing skin, and for melanoma.

How to Prepare

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Before the dayOn the day
Ointment and dressings
Before the day
Buy plain petrolatum ointment and non-stick dressings before the appointment, not on the way home. The first dressing change is that evening.
What to wear and eat
On the day
Wear something you do not mind getting a spot of blood on, and expect to leave with a dressing in place. Eat normally and take your usual medicines.
Do not stop
Aspirin, clopidogrel, warfarin, apixaban, rivaroxaban and similar are usually continued. Extra oozing is easier to manage than a clot or a stroke. Only the doctor who prescribed it should say to stop.

What Happens

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ArrivingThe treatmentLeaving
Arriving
The lesion is identified against the biopsy report, usually photographed, and consent is signed. It is often marked while you sit up, since a small growth can be hard to find once you are lying down. Lidocaine, usually with epinephrine, is then injected around it. This is the only part that hurts. It stings and burns for under a minute, then the area is numb in a few minutes. Your provider will ask about these things.
The treatment
The skin is cleaned and the doctor scrapes with the curette, felt as 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. From injection to dressing, one lesion takes about 10 to 20 minutes. After the numbing nothing should feel sharp; say so if it does, since more anesthetic can be added.
Leaving
A round, shallow, raw crater slightly larger than the growth was, covered with ointment and a dressing. Numbness lasts an hour or two. Once it fades the site is usually sore rather than painful, and plain acetaminophen is enough for most people.

Recovery

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Day 1 to 7Weeks 2 to 6Month 2 to 12
Day 1 to 7
The wound weeps and the base looks yellow. That yellow film is new healing tissue and normal wound fluid, not pus. Wash gently with soap and water once a day, cover with thick plain petrolatum, and add a fresh non-stick dressing. Do not let it dry out or scab over.
Weeks 2 to 6
The crater shrinks and the base turns pink and slightly bumpy. Itching is common and normal. Keep it covered. New skin grows across from the rim inward. Face wounds close fastest and lower leg wounds slowest, sometimes taking two to three months in older adults or anyone with diabetes.
Month 2 to 12
The new scar starts pink or purple-red and firm, then flattens and pales over roughly a year. On deeper skin tones it often darkens first and lightens later.

Aftercare

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DailyFrom the next dayAt least a year
Dressing
Daily
Wash gently with soap and water, reapply plain petrolatum, cover with a non-stick pad. No hydrogen peroxide, no rubbing alcohol, and no antibiotic ointment unless your doctor asked for it — neomycin commonly causes allergic rashes.
Showering
From the next day
Let water run over the site rather than scrubbing it, and pat dry.
Sun
At least a year
Keep the site covered, or use SPF 30 or higher over it. Fresh scars pigment easily and that mark is slow to fade.
Exercise
No restriction from stitches, because there are none. Heavy sweating under a dressing softens the wound edges, so change it afterward.
Picking
Do not pick the crust or the yellow base. It is the main avoidable cause of a worse scar.
Watching
Look at the wound each time you change the dressing. It should get smaller every week, not larger.

Risks

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Most of what happens after this procedure is expected rather than a complication: weeping, a yellow wound base, itching, and a scar you can see. Real problems are uncommon and worth recognizing early.

Incomplete removal
The main risk of this method, and the price of not checking the margins. It shows up months to years later as a small pearly bump, a scab that keeps returning, or a rim of redness at the scar edge. It is treatable, usually with an excision or Mohs surgery, and it is easiest to treat when it is small.
A raised or thickened scar
A scar that is climbing rather than flattening after two months, or one that itches and spreads past the original border. Steroid injections and silicone work best before a scar is fully mature.
A wound that stalls
A wound on the lower leg that is no smaller after six weeks needs review. Swelling, circulation and diabetes are the usual reasons.
Numbness or a patch that stays firm
Uncommon, and worth raising at follow-up rather than living with.
Get care now
Redness spreading a centimeter or more beyond the wound, pain increasing after day three, thick green or foul discharge, red streaks running away from the site, or fever. These suggest infection, which is straightforward to treat and does worse when left.
Also get care now
Bleeding that has not stopped after 15 minutes of firm, continuous pressure without lifting to check.

In Deeper Skin Tones

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The procedure itself is not affected by skin tone. The tumor is scraped and the base is burned in exactly the same way, and the cure rate does not change. What differs is the mark it leaves.

The typical scar is a flat disc with less pigment than the skin around it, sometimes noticeably lighter. On deeper skin tones that contrast is much more visible, and it is usually permanent, because the pigment-producing cells in the treated base are destroyed along with the tumor. This is the most common regret after the procedure, and it is worth raising before booking rather than after.

Keloid and thickened raised scars are more common in people with deeper skin tones, and more likely again in anyone who has had one before. The highest-risk sites are the chest, shoulders, upper back and earlobes, which are also common places for these tumors. If you have ever had a keloid, say so. It can change which treatment is chosen, because an excision closed neatly under low tension sometimes scars better here, and it can mean treating the scar preventively with silicone or steroid injections rather than waiting to see.

Post-inflammatory hyperpigmentation, a brown or gray mark left where skin has been inflamed, is common in the first months and usually fades over six to twelve months. Daily sun protection over the site speeds that up. It is a different thing from the permanent pale scar and should not be mistaken for it.

One more point, and it is about diagnosis rather than treatment. Skin cancer is less common in people with deeper skin tones, and it is more often found at a later stage. It also turns up more often in places that see little sun: the palms, the soles, under a nail, and the mouth and genital skin. A new, changing, bleeding or non-healing spot in any of those places is worth showing to a doctor, whatever your skin tone. The gap in outcomes is about who gets examined, not about who can get skin cancer.

If You Stop

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There is nothing to stop. This is a one-time treatment rather than something you keep having, so it does not fade or wear off the way an injectable or a peel does. Once the wound has healed, the treated tumor is either gone or it is not, and the scar is permanent.

Stopping the follow-up: That is the risk worth naming here. Two things are being watched for. The first is recurrence at the treated site, which is the specific weakness of a method with no margin check, and which usually appears within the first few years as a bump, a pearly rim, or a scab that keeps coming back at the scar edge. The second is a new cancer somewhere else. Having had one keratinocyte skin cancer makes another substantially more likely, and it is the more common of the two outcomes.

Stopping sun protection: This matters as well. It does not reactivate the treated tumor, but it drives new ones, and it makes a fresh scar pigment.

Stopping wound care early: This has a smaller but real cost. A wound allowed to dry out and crust heals more slowly and leaves a worse mark.

None of this produces a sudden change. The cost of stopping is that the next thing gets found later, when the treatment for it is larger.

Combining Treatments

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Same day
Oral medicines
There is no interaction, so anything you take carries on unchanged.
Same day
Topical treatments
These carry on elsewhere on the skin, just not over the healing wound.
Same day
Cryotherapy
Scattered actinic keratoses are commonly frozen on separate spots at the same visit.
Same day
Nicotinamide
Some dermatologists use it to lower new skin cancers, but it does not treat one you have.
Until healed
Field creams and PDT
5-fluorouracil, imiquimod or photodynamic therapy follow once the wound has closed.
Wait 3–6 weeks
Lasers, peels, injectables
Nothing on the site, waxing included, until it closes in 3 to 6 weeks.
Until healed
Silicone gel
Gel or sheeting can start once the surface is fully closed.
Until healed
Steroid injection
Used later only if the scar starts to thicken.
Wait several months
Vascular laser
Considered for stubborn redness after several months.
Different visit
A second cancer nearby
Most doctors treat two nearby cancers one at a time when the wounds would touch.

Insurance Coverage

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In the US it is billed as a destruction procedure, priced by the size of the lesion and the body site, and it is generally covered by health insurance when it is done to treat a diagnosed skin cancer. Your share is whatever your plan's deductible, copay and coinsurance come to. Coverage almost never applies when the same procedure is used to remove a harmless growth such as a seborrheic keratosis for appearance alone, which is billed as cosmetic.

The biopsy that diagnosed the cancer is billed separately, as is the pathology on it. Dressings and petrolatum are out of pocket and cost very little.

Prices without insurance vary widely by region, and by whether the office is hospital-affiliated. If you are paying yourself, ask for the specific procedure codes and a written estimate in advance. Offices can usually provide one.

Ask Your Doctor

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If you take a blood thinner
Aspirin, clopidogrel, warfarin, apixaban, rivaroxaban and similar are usually continued through this procedure. Never stop one on your own; check with the doctor who prescribed it.
If you have a pacemaker or defibrillator
An implanted defibrillator counts too. The electric current used needs adjusting, or a different instrument. Say so before the appointment rather than on the day.
If you have ever had a thick raised scar
A keloid counts. This changes the conversation about which treatment to choose, and about whether the scar should be treated preventively.
If this is being done on your face
Especially the nose, eyelid, ear or lip. Ask whether Mohs surgery is more appropriate. Those areas have higher recurrence rates and less spare skin.
If this cancer has come back before
A tumor that was treated once and returned is generally not a candidate for this method.
If you have diabetes or leg swelling
Poor circulation counts too. A wound on the lower leg can take months to close. Ask whether a different approach would heal better.
If you take immune-suppressing medicine
Or have had an organ transplant. Skin cancers behave more aggressively, and the threshold for a margin-checked surgery is lower.
If your diagnosis is melanoma
This is not a treatment for melanoma. Melanoma is removed with surgery that produces a specimen for a pathologist.
If you are pregnant or breastfeeding
Local anesthetic is used for necessary small skin procedures in pregnancy, but the timing and the urgency are worth discussing with the doctor managing your pregnancy.
If your wound has not shrunk at all
After six weeks, have it looked at rather than continuing the dressings and waiting.

At-Home Versions

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There is no at-home version
Bad alternative
Treating a skin cancer requires a diagnosis from a biopsy and a trained operator who can feel the difference between tumor and normal tissue. Nothing sold for home use does either. This row exists to say that plainly rather than to offer a substitute.
Black salve and escharotic pastes
Bad alternative
There is no evidence of benefit and clear evidence of harm. Sold online as natural cancer removal, under names including black salve, Cansema, bloodroot, sanguinaria, and various drawing or escharotic pastes. They are corrosive. They destroy skin without any control over how deep or how wide they go, and reported outcomes include large disfiguring wounds and scars and destroyed cartilage on the nose and ear. The greater harm is quieter: the surface scabs and heals over while tumor continues to grow underneath, so the cancer is found again later and larger. The US Food and Drug Administration has warned about these products repeatedly. There is no safe brand, strength or protocol.
Home cautery pens and freeze-off kits
Bad alternative
Mole and skin tag removal devices count too. There is no evidence for any of them on skin cancer. They are sold for harmless growths. Used on a cancer, they destroy the surface, leave the deeper part behind, and remove the tissue a pathologist would have needed to make the diagnosis.
Wart removers and corn removers
Bad alternative
Acid preparations count too, used on a suspicious spot. Salicylic acid and similar products do nothing to a skin cancer except delay the diagnosis. A spot that is not healing is a reason to be seen, not a reason to try something stronger.
What is worth doing at home
Good alternative
Daily broad-spectrum SPF 30 or higher, sun-protective clothing and shade lower the rate of new skin cancers. Checking your own skin monthly, and keeping the professional checks, is how the next one gets found while it is small. Prevention and detection are the parts of skin cancer care that genuinely happen at home.

How It Compares

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Surgical excision
Surgical excision
The same
Cuts the tumor out with a measured margin of normal skin and sends the whole piece to a pathologist, so the edges are actually examined. Cure rates for the same low-risk tumors are similar or slightly better. The trade is stitches, a linear scar longer than the growth was, about two weeks of activity restriction, and a higher cost, in exchange for a documented answer.
Mohs surgery
Mohs surgery
Different job
The highest cure rate of any method. The entire margin is checked during the appointment and the least normal skin is removed, which is why it is used on the face. The trade is a four-to-eight-hour day and a much higher cost, and it is more than a small low-risk trunk tumor needs.
Topical imiquimod or 5-fluorouracil cream
Worse
For superficial basal cell carcinoma and squamous cell carcinoma in situ. No cutting, no scar, done at home over several weeks. The trade is a long, red, inflamed and uncomfortable course, lower cure rates than surgery, and no way to confirm the tumor is gone.
A rectangular LED panel in a white frame, angled on a white background, its face filled with a dense grid of several hundred small blue lights all lit, casting a blue glow onto the surface beneath it.
Photodynamic therapy
Different job
For superficial tumors and for sun damage spread across an area. Usually leaves the least visible mark afterward. Painful during treatment, needs specialist equipment and several visits, and cure rates sit below surgery.
Cryotherapy, freezing with liquid nitrogen
Cryotherapy, freezing with liquid nitrogen
Different job
For very superficial lesions and strong evidence for precancerous spots. Fast and needs no injection. Depth is harder to control, there is no margin check, and it leaves a pale mark of its own. It is used far more for actinic keratoses than for a diagnosed cancer.
Radiation therapy
Different job
Moderate to strong evidence. Reserved mainly for people who cannot have surgery, or for tumors where surgery would be disfiguring. No cutting, but many visits over weeks, a permanently altered patch of skin, and it is generally avoided in younger people.

Finding a Provider

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This is done by dermatologists, and also by some primary care physicians, plastic surgeons, physician assistants and nurse practitioners working in dermatology. The instrument is simple. The skill is in choosing which tumors are suitable, and in feeling the difference between tumor and normal tissue.

Reasonable questions: what exactly the biopsy showed including the microscopic subtype, why this method rather than an excision or Mohs surgery, roughly how large the scar will be, and what the plan is if the cancer comes back.

Ask to see the pathology report: The report from your biopsy should name the tumor and, for basal cell carcinoma, the subtype. Superficial and nodular are the low-risk ones. Infiltrative, micronodular and morpheaform are not, and generally should not be treated this way.

Red flags: a growth treated this way without a biopsy first, no mention that the scar will be round and pale, an offer to do it on an eyelid margin or the tip of the nose without discussing Mohs surgery, and no arrangement made for a follow-up skin check.

Myths

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  • "Burning it off means the cancer is definitely gone." Nobody can say that with certainty after this procedure, because nothing is examined under a microscope. Cure rates are very good for well-chosen tumors, but "very likely gone" is the honest phrase, and it is exactly why follow-up checks are part of the treatment.
  • "A yellow, weeping wound is infected." That yellow film is usually granulation tissue and normal wound fluid. Infection looks different: redness spreading outward, pain increasing after the first few days, thick or foul discharge, fever.
  • "It should be scabbed over and kept dry." Old advice. Wounds left to dry and crust heal more slowly and scar more. Keep it covered and moist with plain petrolatum.
  • "The scar will be smaller than the spot." It is usually a little larger, because the scrape extends past the visible edge and the burn extends past the scrape. It is round, flat, and lighter than the skin around it.
  • "Skin cancer only appears on skin that gets sun." Most keratinocyte cancers are on sun-exposed skin, and not all of them are. Melanoma in particular can appear on the palms, soles, under nails, and on skin that is always covered. Location alone never rules it out.
  • "People with deeper skin tones do not get skin cancer." Skin cancer is less common, not absent, and it is more often found at a later stage. That gap is about how often it is looked for.

Questions Patients Ask

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Does it hurt?

The numbing injection stings for under a minute. After that you feel pressure and tugging rather than pain. Afterward the site is usually sore rather than painful, and plain acetaminophen is enough for most people.

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

Because there is no intact specimen to check. The tumor is scraped away in fragments and the base is burned. The method relies on the operator feeling the difference between soft tumor and firm normal tissue, which is reliable for shallow, clearly bordered tumors and unreliable for others. That trade-off is the reason it is limited to low-risk cancers, and the reason follow-up matters.

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 and some a little raised. It is pink or red at first and pales over about a year. It is permanent.

How long until it heals?

The open wound closes in 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. It is generally not appropriate for the nose, eyelids, ears, lips, or the creases around them, where recurrence rates are higher and there is less spare skin. Ask specifically why one is being 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 figure falls when the method is used on tumors it was not meant for: aggressive subtypes, recurrent tumors, unclear borders, or high-risk facial sites.

References

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