Excision is the most effective way to treat almost all skin cancers. For basal cell and squamous cell carcinomas, Mohs micrographic surgery is the gold standard because of its accuracy and because it spares tissue and leaves much less scarring - especially important if the lesion is on the face or neck.
Another option, surgically, is curettage - electrodessication of the area - which is basically scraping and burning the lesion off the skin. This is probably the most common procedure used to treat BCC and SCC that is not on the face or neck. First the area is numbed with lidocaine; then the doctor uses a curette to scrape off the skin deeply in the area of the lesion. The area is then burned with an electrical pen. This scraping and burning is repeated three times. The limitation of electrodessication and curettage is this: the doctor has no idea if he or she actually got all of the cancer, and now the patient will have a scar there that may mask any malignancy underneath it. Consequently, the chance of recurrence with this method is up to 50 percent (while Mohs has a 1 percent risk of relapse). In my opinion, Mohs surgery is always the best choice aesthetically and for accuracy, but it is very expensive and sometimes insurance companies won't cover it (unless the lesion is on the face, neck, hands and feet).
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