Curettage and Electrodesiccation (C&E): A Simple Office Treatment for Skin Cancer

What Is Curettage and Electrodesiccation?

C&E is one of the oldest and most practical treatments in dermatology. It uses two straightforward tools working together:

• Curettage — a curette is a sharp, spoon-shaped instrument used to scrape the tumor. Cancer cells are softer and more fragile than normal skin, so they scrape away more easily. The curette literally scoops out the cancerous tissue, leaving normal skin behind
• Electrodesiccation — after curettage, an electrosurgical device delivers a small electric current to the wound. This simultaneously destroys any remaining cancer cells at the wound edges and cauterizes tiny blood vessels to stop bleeding

Most dermatologists perform 2–3 cycles of curettage and electrodesiccation in sequence on the same wound. Each cycle scrapes away another thin layer and then destroys any remaining cells. This repetition improves cure rates without adding significant tissue removal or complexity.

Who Is a Good Candidate?

C&E is a reliable treatment when the cancer and location are right for it. The best candidates include:

• Small (under 2 cm) primary basal cell carcinomas or squamous cell carcinomas on the trunk, arms, or legs
• Tumors on areas where scarring from C&E is less visible — upper back, shoulders, and extremities
• Superficial or nodular basal cell carcinoma (not morpheaform or infiltrative subtypes, which have indistinct borders and are harder to scrape cleanly)
• Patients who want a fast, simple procedure without sutures or stitches
• Well-defined tumors with clear clinical borders

C&E is generally not recommended for:

• Tumors on the face, especially the nose, eyelids, ears, and lips — where cosmetic results from C&E are less predictable and where recurrence would be difficult to manage
• Recurrent skin cancers or aggressive tumor subtypes
• Large tumors (over 2 cm)
• Areas of the scalp or where hair follicles are deep — cancer cells can track along follicles, making them harder to eradicate with scraping alone
• Patients with pacemakers or implanted electronic devices (the electrical current can interfere with some devices)

What to Expect During the Procedure

C&E is performed entirely in the office. No sedation is needed. Here is what happens:

1. Anesthesia: The skin over and around the tumor is injected with local anesthetic — typically 1% lidocaine with epinephrine. The injection stings briefly; within a few minutes the area is completely numb
2. First curettage pass: Using the curette, the surgeon scrapes firmly across the tumor surface. You will feel pressure and movement but no pain. The cancerous tissue — which is softer and less cohesive than normal skin — gives way first, letting the surgeon feel when they reach firmer, normal tissue beneath
3. First electrodesiccation pass: The electrosurgical device is passed over the scraped wound, delivering a brief electrical current. You may hear a slight buzzing sound and smell the odor of burning tissue — this is normal and expected
4. Repeat cycles: Steps 2 and 3 are repeated 2–3 times total to ensure thorough removal. The entire treatment takes 10–20 minutes
5. Wound care: The wound is covered with a simple bandage. No stitches are needed — the wound heals on its own over the next 3–6 weeks

How the Wound Heals

After C&E, you are left with a round, raw wound that heals by second intention — meaning the body heals it from the inside out without stitches pulling the edges together. This produces a round, flat scar that is typically lighter in color than your surrounding skin (hypopigmented). The scar does not shrink to a line the way a sutured wound does.

Healing timeline:

• Week 1: A dry, brownish-black scab (eschar) forms over the wound — this is protective and should not be picked off
• Weeks 2–3: The scab gradually loosens; new skin grows underneath
• Weeks 4–6: The wound is fully closed; the area appears pink and flat
• Months 3–12: The scar fades to a lighter, flat circle — often difficult to notice under clothing

Wound care instructions are simple: apply a thin layer of petroleum jelly (Vaseline) to the wound daily and cover with a bandage until healed. Keep the wound clean with mild soap and water. Avoid soaking (no pools or hot tubs) until fully healed. Your dermatologist will schedule a follow-up to confirm healing and check for signs of recurrence.

Cure Rates and When Recurrence Happens

For small, well-defined, primary basal cell carcinomas on low-risk body sites, C&E achieves 5-year cure rates of 90–95%. For squamous cell carcinoma on similar sites, rates are comparable. These numbers are lower than Mohs surgery (98–99%), but for the right tumor in the right location, C&E is a clinically appropriate choice that avoids more complex surgery.

Recurrence, when it happens, usually occurs within 3 years. This is why regular follow-up skin exams after C&E are important. Recurrent tumors are harder to treat because the scar tissue from prior surgery can mask deeper tumor extension. If a skin cancer does come back after C&E, Mohs surgery is often recommended for the recurrence.

C&E Compared to Other Treatment Options

Understanding how C&E stacks up against other choices helps you have an informed conversation with your dermatologist:

• Mohs surgery: Higher cure rate (98–99%), tissue-sparing, confirms complete removal in real time. Preferred for face and recurrent tumors. More time-intensive and requires suture repair
• Standard excision: Removes the tumor with a margin and closes with stitches. Good cure rates; pathology confirms margins but results take days
• Topical treatments (imiquimod, 5-fluorouracil): Non-surgical options for superficial basal cell carcinoma only. Take weeks of daily application; lower cure rates than C&E for thicker tumors
• Radiation therapy: Alternative for patients who cannot undergo surgery; requires multiple visits over weeks
• C&E: Fastest and simplest for appropriate tumors. No stitches, done in one visit, effective cure rates on trunk and extremities

When to See a Dermatologist

• You have been told you have a basal cell or squamous cell carcinoma and want to understand your treatment options
• You have a spot that has not healed for more than 4 weeks, is bleeding, or is growing
• You had C&E previously and notice a new growth or change at or near the treated site
• You want a quick, no-stitches option for a skin cancer on your back, arms, or legs
• You are due for a full skin check — especially if you have had skin cancer before

Frequently Asked Questions

Will the scar look bad?

The scar from C&E is round (or oval), flat, and usually lighter in color than your surrounding skin. On the back, shoulders, and limbs — where C&E is most commonly used — these scars are generally well tolerated and less visible under clothing. The scar does not look like a surgical incision scar; it is more like a flat, pale circle. Over 12 months, it continues to fade and flatten significantly.

Does it hurt?

The only uncomfortable part is the anesthetic injection, which stings for 10–30 seconds. Once the area is numb, you will feel pressure and movement during the scraping but no sharp pain. If you feel pain during the procedure, tell your doctor immediately — more anesthetic can be given. After the anesthetic wears off (a few hours later), the wound may be mildly sore for 1–3 days. Acetaminophen is usually enough for pain relief.

How do I know the cancer was completely removed?

Unlike Mohs surgery or standard excision, C&E does not send tissue to a lab for microscopic margin analysis. The surgeon's assessment during the procedure — feeling the change in tissue consistency as normal skin is reached — is the primary confirmation. This is why C&E is reserved for tumors with clear clinical borders on low-risk sites where the margin of normal tissue around the tumor is more predictable. Regular follow-up after treatment is essential to catch any recurrence early.

Can C&E be used on my face?

Generally, Mohs surgery is preferred for skin cancers on the face, particularly around the eyes, nose, lips, and ears. C&E on the face can leave round, pale scars in visible areas and has lower cure rates for aggressive tumor types that are more common on sun-exposed facial skin. There are some selected situations where C&E may be appropriate on the face, but your dermatologist will evaluate your specific tumor characteristics before recommending it.

Trusted Resources

• American Academy of Dermatology — aad.org
• Skin Cancer Foundation — skincancer.org
• National Comprehensive Cancer Network — nccn.org
• Mayo Clinic — mayoclinic.org

Always consult a board-certified dermatologist for personalized advice about your skin cancer diagnosis and treatment options.