755-nm Alexandrite Laser for the Treatment of Non-Facial Superficial and Nodular Basal Cell Carcinoma

Background: There is emerging literature regarding laser therapy as a treatment for non-melanoma skin cancer, with reports of vascular selective lasers and ablative lasers showing promise in basal cell carcinoma (BCC). Objectives: To assess the efficacy of the 755-nm laser in the treatment of non-facial BCC of the superficial and nodular subtypes. To provide patients with a non-surgical option for the treatment of BCC. Methods: Nineteen veterans, each with at least one biopsy proven superficial or nodular BCC on the trunk or extremity, agreed to participate in our IRB-approved, prospective, non-randomized, open-label clinical trial. A total of 21 BCC were treated, after local anesthetization, using the 755-nm Alexandrite laser (Gentle-Lase, Candela Corporation) in a single session with a 4 mm margin. Treatment sites were re-biopsied approximately six weeks later. Results: Twenty-one of 21 treated BCC demonstrated complete histologic tumor resolution at 6-week follow-up. At six weeks, all patients had a scar, and some patients had associated crusting, scaling or ulceration. The high energy and absence of dynamic cooling in our study likely resulted in additional thermal damage to the tumors. Healing times and scar appearance were comparable to electrodesiccation and curettage sites. Limitations: Our study was limited by a small sample size, lack of a control group, and sampling of treatment sites with shave removal rather than complete excision. Conclusion: The 755-nm laser has vessel-selective properties and a greater depth of penetration compared to vascular selective lasers. Our study results suggest that the 755-nm Alexandrite laser may be an effective treatment for superficial and nodular BCC on the trunk and extremities. Further investigation is warranted.