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Non-surgical Local Treatments for Basal Cell Carcinomas
Local treatments only affect the area being treated. Topical medicines, cryotherapy, photodynamic therapy, or other local treatments might be options to treat some basal cell carcinomas (BCCs), also known as basal cell skin cancers. They might help treat BCCs that are at low risk for coming back, especially in people who can’t have or don’t want surgery.
Radiation therapy, another type of local treatment, is described separately.
Topical medicines
Some drugs can be applied to the skin to boost the body’s immune response against the cancer, causing it to shrink and go away.
Imiquimod (Zyclara) is a cream that can be applied to some very early basal cell cancers. It causes the immune system to react to the skin lesion and destroy it. It’s typically applied a few times a week for several weeks, although schedules can vary.
Possible side effects
This drug irritates the skin, which might lead to itching, burning, redness, swelling, scabbing, crusting, or pain in the area. It can also make the skin more sensitive to sunlight, so treated areas should be protected from the sun to prevent sunburn for a few weeks after treatment.
This drug can also cause flu-like symptoms in some people. The skin in the area being treated might also lose its pigment and become lighter in color.
5-FU is a topical chemotherapy (chemo) drug used to treat some basal cell skin cancers, with brand names such as Efudex, Carac, and Fluoroplex. It is usually in a cream or ointment and typically applied to the skin once or twice a day for several weeks.
Sometimes 5-FU might be used along with calcipotriene, a drug related to vitamin D, which could shorten the length of treatment to days instead of weeks.
Possible side effects
5-FU makes the treated skin red and very sensitive for a few weeks. Other topical medicines can be used to help relieve this, if needed. 5-FU can also make the skin more sensitive to sunlight, so treated areas should be protected from the sun to prevent sunburn for a few weeks after treatment.
A very small number of people have a condition called DPD deficiency, which makes it hard for their bodies to break down and get rid of 5-FU. This can result in serious or even life-threatening side effects. If you are applying 5-FU and have any reactions beyond those you were told to expect on your skin, call your doctor or nurse right away.
Photodynamic therapy (PDT)
PDT might be an option to treat some small, low-risk BCCs.
For this treatment, a drug is applied to the skin as a gel or liquid. The drug collects in the tumor cells over several hours, where it is converted to a different chemical that makes the cells very sensitive to certain types of light. A special light source is then focused on the tumor, which kills the cells.
When large areas need to be treated, daylight PDT, where the person goes out into the sunlight for a specific amount of time, might be an option.
Possible side effects
PDT can cause redness and swelling on the skin where it is used. PDT might also make a person’s skin very sensitive to sunlight for some time, so sun protection might be needed to avoid severe burns.
Cryotherapy (cryosurgery)
Cryotherapy is the use of extreme cold to destroy tumors. It might be an option for some small, low-risk BCCs.
For this treatment, the doctor applies liquid nitrogen to the tumor to freeze and kill the cells. This is often repeated a couple of times in the same office visit.
Possible side effects
After the dead area of skin thaws, it will swell, blister and crust over. The treated area might have fluid draining from it for a while, and it might take a month or two to heal. It will leave a scar, and the area might have less color after treatment.
Laser therapy (laser resurfacing)
This approach uses a beam of laser light to destroy the top layers of the skin. It might be an option for very superficial BCCs (those only on the surface of the skin). It’s not yet known whether this type of treatment is as effective as standard methods of treatment, and it’s not widely used.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Aasi SZ. Treatment and prognosis of basal cell carcinoma at low risk of recurrence. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/treatment-and-prognosis-of-basal-cell-carcinoma-at-low-risk-of-recurrence on June 5, 2026.
Maytin EV, Warren CB. Photodynamic therapy. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/photodynamic-therapy on June 5, 2026.
National Cancer Institute. Skin Cancer Treatment (PDQ®)–Health Professional Version. 2025. Accessed at https://www.cancer.gov/types/skin/hp/skin-treatment-pdq on June 5, 2026.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Basal Cell Skin Cancer. Version 2.2026. Accessed at https://www.nccn.org on June 5, 2026.
Xu YG, Aylward JL, Swanson AM, et al. Chapter 67: Nonmelanoma Skin Cancers. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.
Last Revised: August 11, 2026
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