Comparative Study of CO₂ Laser and Curettage-Electrodesiccation for Superficial Basal Cell Carcinoma Treatment: A Focus on Cosmetic Results

Basal cell carcinoma (BCC) is the most common type of skin cancer worldwide, and the incidence is rising. While surgical excision remains the gold standard, it can be time-consuming and resource-intensive. Therefore, there is a growing need for simpler and more cost-effective treatment options for low-risk tumors. This study compared the scar quality and the recurrence rate from continuous wave CO2 laser and curettage and electrodesiccation treatments. Scar quality and the recurrence rate from the treatments were assessed. A single-blind randomized prospective interventional trial was conducted at Odense University Hospital, Denmark, from 2017 to 2023. Patients with histologically confirmed superficial BCC were randomized 1:1 to Curettage-Electrodesiccation (CE) or continuous wave CO2 (CW CO2) laser treatment. Scar quality was assessed using the Patient and Observer Scar Assessment Scale (POSAS) and a modified visual-only scale (VSAS). Recurrence within one year was a secondary outcome. Thirty-two patients were treated for 32 tumors: 17 with CE and 15 with CO2 laser. There was no significant difference in scar quality or recurrence rate between the CE and CO2 laser groups (PSAS: P = 0.422; OSAS: P = 0.747; VSAS: P = 0.522). After one year, neither group showed tumor recurrence. CO2 laser used in continuous wave setting offers a treatment for superficial BCCs with cosmetic outcomes and recurrence rates comparable to CE. However, a larger patient sample and longer follow-up are needed for definitive conclusions.