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Which Is Better for Skin Cancer: Mohs Surgery or Scrape and Burn (ED&C)?

Last Updated on October 20, 2025 by

Which Is Better for Skin Cancer: Mohs Surgery or Scrape and Burn (ED&C)?
Which Is Better for Skin Cancer: Mohs Surgery or Scrape and Burn (ED&C)? 2

Getting a skin cancer diagnosis can be scary, with treatment choices like Mohs surgery and scrape and burn (ED&C). At Liv Hospital, we focus on advanced, patient-focused care. We aim to help you find the best treatment for your health, comfort, and confidence.

Deciding between Mohs surgery and ED&C can be tough. Mohs is a detailed method that removes cancer bit by bit. It has a high success rate of 97%-99% for certain types of skin cancer. ED&C, on the other hand, is faster and less expensive. In this article, we’ll look at the good and bad of each to help you decide.

Key Takeaways

  • Mohs surgery offers a high cure rate for primary basal cell and squamous cell carcinomas.
  • ED&C is a quicker and cost-effective treatment option.
  • The choice between Mohs surgery and ED&C depends on individual patient needs.
  • Liv Hospital provides advanced, patient-centered care for skin cancer treatment.
  • Understanding the benefits and drawbacks of each treatment is key to making a good choice.

Understanding Skin Cancer Treatment Options

A well-lit clinical setting featuring various skin cancer treatment options, such as a Mohs surgery microscope, a cryosurgery unit, and a dermatological scraping tool, all arranged on a clean, sterile medical tray. The instruments are showcased in a clear, detailed manner, with a soft, clinical lighting that emphasizes their purpose and function. The background is a neutral, off-white color, creating a sense of professionalism and medical expertise. The overall composition conveys a sense of understanding and education about the available skin cancer treatment options.

The journey to treat skin cancer starts with knowing the different types and treatments. Skin cancer is complex, and treatment varies by type and severity.

Common Types of Skin Cancer

Skin cancer includes several types, with basal cell carcinoma and squamous cell carcinoma being the most common. Basal cell carcinoma grows slowly and rarely spreads. Squamous cell carcinoma, while less common, can spread more easily.

Knowing these types is key to choosing the right treatment.

Importance of Choosing the Right Treatment Method

Choosing the right treatment is vital for managing skin cancer. The treatment depends on the cancer type, location, size, and the patient’s health. The goal is to remove the cancer while keeping healthy tissue.

Each treatment has its benefits and drawbacks. Some may cure more cancers but cause more scarring. It’s important to understand these trade-offs.

Overview of Available Surgical Approaches

Surgical methods are a main treatment for many skin cancers. Two common techniques are Mohs surgery and electrodesiccation and curettage (ED&C). Mohs surgery removes tissue layer by layer, checking each under a microscope. ED&C uses a curette to remove tissue and an electric current to kill any remaining cancer.

Each method has its own use, benefits, and risks. The choice depends on the cancer’s characteristics and the patient’s preferences.

What Is Mohs Surgery?

A close-up view of a Mohs surgical procedure, capturing the intricate steps with scientific accuracy. In the foreground, a skilled dermatologist's hand carefully excises a section of skin, revealing the underlying tissue. The middle ground showcases the Mohs microscope, its lenses magnifying the sample for detailed examination. In the background, the sterile surgical suite is illuminated by bright, even lighting, creating a clinical atmosphere. The image conveys the precision and focus required in this delicate skin cancer treatment, allowing the viewer to understand the complexities of the Mohs technique.

Mohs surgery is a precise way to treat skin cancer. It removes cancerous tissue layer by layer. Each layer is checked under a microscope until no cancer is found. We’ll look at how it works, its history, and the technology behind it.

The Mohs Micrographic Surgery Procedure

The Mohs procedure is very detailed. It aims to remove all cancer while keeping healthy tissue. The surgeon takes off a layer of tissue, which is then checked under a microscope.

If cancer is seen, another layer is removed. This process is repeated until the tissue is clear of cancer.

Key steps in the Mohs surgery procedure include:

  • Removing a layer of tissue
  • Processing and examining the tissue under a microscope
  • Repeating the process until no cancer cells are detected

History and Development of Mohs Surgery

Mohs surgery was created by Dr. Frederic Mohs in the 1930s. At first, it used zinc chloride paste to fix the tissue. But over time, it has changed a lot.

Now, it’s much faster and more comfortable for patients. This is thanks to new methods that let doctors examine fresh tissue.

Advanced Technology in Modern Mohs Surgery

Today’s Mohs surgery uses new technology. This includes better ways to look at tissue under a microscope. It also maps the removed tissue precisely.

These improvements help doctors find cancer cells more accurately. They also help save more healthy tissue.

AspectTraditional ExcisionMohs Surgery
Tissue ExaminationLimited margin control100% margin control
Cure RateVariable, often lowerHigh, often above 99%
Tissue PreservationLess precise, more tissue removedPrecise, less tissue removed

Mohs surgery is a top choice for treating skin cancer. It removes cancer carefully while saving healthy tissue. Its success and the use of new technology make it popular among doctors and patients.

What Is Scrape and Burn (ED&C)?

The ED&C procedure, or curettage and electrodesiccation, is a common way to remove skin cancers. It’s often used for basal cell carcinoma and squamous cell carcinoma. This method has been a key part of dermatology for years.

The Curettage and Electrodesiccation Procedure

The ED&C procedure has two steps. First, a dermatologist uses a curette to scrape away the tumor. This is called curettage.

Next, the area is treated with electrodesiccation. An electric current is used to kill any leftover cancer cells. This step helps make sure the tumor is completely gone, lowering the risk of it coming back.

Key Steps in ED&C:

  • Curettage: Scraping away the tumor with a curette.
  • Electrodesiccation: Using an electric current to destroy remaining cancer cells.

When ED&C Is Typically Used

ED&C is often used for treating superficial skin cancers. This includes basal cell carcinoma and squamous cell carcinoma. It’s best for small tumors in certain body areas.

It’s also a good option for patients who can’t handle more complex surgeries. This might be due to health issues or if the cancer is in a sensitive spot.

Equipment and Techniques Used in ED&C

The tools for ED&C include a curette for scraping and an electrodesiccation unit for the electric current. The process involves careful scraping and precise electric current application. This ensures all cancer cells are removed.

We use local anesthesia to keep the patient comfortable during the procedure. This makes sure they feel little to no pain.

  1. Effective for superficial skin cancers.
  2. Less invasive compared to some other surgical options.
  3. Can be performed under local anesthesia.

Mohs Surgery vs Scrape and Burn: A Comparative Look

It’s important to know the differences between Mohs surgery and ED&C for treating skin cancer. Both methods aim to remove skin cancers but differ in approach, outcomes, and use.

Procedural Differences

Mohs surgery is a precise method. The surgeon removes tissue layer by layer, checking each under a microscope. This ensures only the needed tissue is taken.

ED&C, on the other hand, uses a curette to scrape away cancerous tissue. Then, an electric current is applied to destroy any remaining cancer cells. This process might be done several times in one session.

Key differences in procedure:

  • Mohs surgery is more precise and involves microscopic examination.
  • ED&C is less precise but can be effective for certain types of skin cancers.

Tissue Preservation Comparison

Mohs surgery is great at preserving healthy tissue. By examining each layer, surgeons remove all cancer cells while saving healthy tissue.

ED&C might not save as much healthy tissue. It involves scraping tissue without immediate microscopic check. Yet, it’s often used for small or superficial skin cancers where saving tissue isn’t as important.

“The precision of Mohs surgery allows for maximum preservation of healthy tissue, making it an ideal choice for sensitive or cosmetically sensitive areas.”

Duration and Complexity of Each Procedure

Mohs surgery takes longer because it involves examining multiple tissue layers. It can take several hours, depending on the tumor’s size and complexity.

ED&C, by contrast, is quicker and can be done in one visit. But, its simplicity might mean needing repeat treatments if cancer comes back.

Comparison of duration and complexity:

ProcedureTypical DurationComplexity
Mohs SurgerySeveral hoursHigh
ED&CSingle visit, typically under an hourModerate

In conclusion, both Mohs surgery and ED&C have their roles in treating skin cancer. The choice depends on the cancer’s type, the patient’s health, and the cosmetic outcome desired.

Effectiveness and Success Rates

It’s important to compare Mohs surgery and ED&C for treating skin cancer. Both methods are used, but their success rates differ. This depends on several factors.

Cure Rates for Mohs Surgery

Mohs surgery is known for its high success rate, mainly for certain skin cancers. It has a cure rate of up to 99% for primary basal cell carcinoma. For recurrent cases, it’s 94% effective.

Cure Rates for ED&C

ED&C’s success rates vary by skin cancer type and location. It can cure low-risk basal cell carcinoma 90% to 93% of the time. But, it’s less effective for complex or recurrent cases.

Recurrence Statistics and Long-term Outcomes

Knowing about recurrence rates is key for long-term care. Mohs surgery has a lower recurrence rate than ED&C, mainly for high-risk cancers.

Treatment MethodCure Rate for Primary BCCCure Rate for Recurrent BCCRecurrence Rate
Mohs Surgery99%94%1-2%
ED&C90-93%60-80%5-10%

Mohs surgery has higher cure and lower recurrence rates than ED&C, mainly for complex or recurrent basal cell carcinomas. Yet, ED&C is good for low-risk, primary basal cell carcinomas. It’s simpler and effective in some cases.

Choosing between Mohs surgery and ED&C depends on the patient’s situation. This includes the cancer type and stage, the patient’s health, and cosmetic concerns.

Potential Risks and Complications

When we talk about treating skin cancer, it’s key to look at the risks of Mohs surgery and ED&C. Both methods are effective but have possible complications. It’s important for patients to know about these risks.

Possible Side Effects of Mohs Surgery

Mohs surgery, like any surgery, has its risks. Side effects can include bleeding, infection, and scarring. Some patients might feel numbness or tingling where the surgery was done.

We do our best to avoid these issues. But, it’s vital for patients to follow the post-op instructions carefully.

There’s also a small chance the cancer might not be fully removed. This is rare but can happen if the cancer has spread. Our skilled surgeons use the latest techniques to increase the success rate.

Possible Side Effects of ED&C

ED&C, or Scrape and Burn, also has its side effects. These can include bleeding, infection, and scarring, similar to Mohs surgery. It might also change the skin’s color and not remove all cancerous tissue.

ED&C is often used for skin cancers that are close to the surface. It’s usually effective but might have a slightly higher chance of the cancer coming back. Our dermatologists carefully choose the best treatment for each patient.

Managing and Minimizing Complications

To reduce complications from both Mohs surgery and ED&C, we focus on proper wound care and follow-up visits. Patients get detailed instructions on wound care, including keeping it clean and dry. They also need to apply topical ointments as directed and attend all follow-up appointments.

If complications arise, we’re ready to handle them quickly. For example, if a patient shows signs of infection, we can start treatment with antibiotics.

ComplicationMohs SurgeryED&C
BleedingPossiblePossible
InfectionPossiblePossible
ScarringPossiblePossible
RecurrenceLow RateHigher Rate Compared to Mohs

Recovery and Healing Process

The journey to healing after skin cancer treatment is important. It involves careful post-procedure care, like for Mohs surgery and ED&C. Both need attention during recovery to get the best results.

Post-Procedure Care for Mohs Surgery

After Mohs surgery, patients get specific care instructions. They must keep the wound moist with antibiotic ointment, cover it with a bandage, and change the dressing every day. Following these steps is key to healing well and avoiding infection.

  • Keep the wound clean and dry
  • Avoid strenuous activities that may dislodge the scab
  • Monitor for signs of infection, such as redness, swelling, or increased pain

Post-Procedure Care for ED&C

For ED&C, care involves keeping the treated area moist and safe. Patients should apply antibiotic ointment and use a dressing. It’s important not to pick at scabs or scratch the area to avoid irritation or infection.

  • Apply antibiotic ointment as directed
  • Cover the area to protect it from dust and debris
  • Be gentle when washing the area to avoid irritation

Expected Healing Timeline for Both Procedures

The healing time varies based on the area’s size and location, and individual healing. Generally, it takes a few weeks for wounds from Mohs surgery and ED&C to fully heal. Patients should expect some scabbing and redness in the early stages.

It’s vital for patients to check in with their healthcare provider. This is to track healing and handle any issues that come up.

Cosmetic Outcomes and Scarring

Many patients worry about scarring and how they will look after skin cancer treatment. The way you look after treatment is very important. It affects how happy you are with the results and your overall well-being.

Aesthetic Results of Mohs Surgery

Mohs surgery is known for saving healthy tissue. This helps it look better after treatment. It’s great for areas like the face, where you want to keep things looking natural.

Aesthetic Results of ED&C

ED&C is another good option for some skin cancers. It’s less invasive than Mohs, but might leave more scars. The skill of the doctor is key to how well it looks.

Factors Affecting Cosmetic Outcomes

Many things can affect how you look after treatment. These include the size and where the tumor is, the type of cancer, and your skin. Knowing these helps you understand what to expect and choose the best treatment.

CharacteristicsMohs SurgeryED&C
Tissue PreservationExcellent, due to its micrographic techniqueVariable, depending on the extent of curettage
ScarringGenerally minimal, with optimal wound closureCan be more noticeable, for larger tumors
Cosmetic OutcomeTypically favorable, in sensitive areasVariable, depends on doctor skill and tumor size

Choosing between Mohs surgery and ED&C depends on many things. It’s about looking at your situation, the cancer, and what each treatment might do to your appearance.

Cost Considerations and Insurance Coverage

The cost of treating skin cancer can change a lot based on the treatment. It’s key to know the costs of Mohs surgery and ED&C. This helps with planning your finances.

Insurance Coverage and Financial Planning

Both Mohs surgery and ED&C are often covered by health insurance, including Medicare. But, how much is covered can differ. It depends on your insurance and policy. Always check with your insurance to know what you’ll pay out of pocket.

Financial planning tips:

  • Check your insurance coverage before treatment.
  • Know any deductibles or copays for the treatment.
  • Look into financing options if not fully covered.
  • Talk to your healthcare provider about payment plans.

Knowing the costs of Mohs surgery and ED&C helps patients make better choices. They can think about both the medical and financial sides of their treatment.

When Dermatologists Recommend Mohs Surgery vs Scrape and Burn

Dermatologists must understand the differences between Mohs surgery and ED&C to make the right treatment choices. We look at several factors when deciding between these treatments for skin cancer.

Best Applications for Mohs Surgery

Mohs surgery is best for skin cancers that are big, keep coming back, or are in places that matter a lot. It works well for basal cell carcinoma and squamous cell carcinoma, giving high cure rates and keeping tissue loss low.

We choose Mohs surgery for tumors that grow fast or are hard to define. It lets us check the tumor’s edges closely during the surgery.

Best Applications for ED&C

ED&C is good for small, early basal cell carcinomas or squamous cell carcinomas in situ. It’s faster and less invasive than Mohs surgery, perfect for small, simple tumors.

We suggest ED&C for patients who can’t handle big surgeries or prefer a less invasive option.

Location-Specific and Cancer Type Considerations

The skin cancer’s location is key in choosing between Mohs surgery and ED&C. Mohs surgery is best for cancers in areas where saving tissue is important, like the face, ears, or around the eyes.

For cancers on the trunk or limbs, where looks matter less, ED&C might be better if the tumor is small and shallow.

Patient-Specific Factors in Treatment Selection

Each patient’s health, skin type, and what they want also affects the choice. We think about how well the patient can heal, the risk of scarring, and follow-up care when making our recommendations.

In the end, the choice between Mohs surgery and ED&C depends on the patient’s skin cancer and their needs.

Conclusion: Making an Informed Decision About Skin Cancer Treatment

Understanding the differences between Mohs surgery and Scrape and Burn (ED&C) helps patients make better choices. We’ve looked at how each treatment works, how well they work, risks, and how they affect your skin’s look.

Choosing between Mohs surgery and ED&C depends on the skin cancer’s type and where it is. We found Mohs surgery is often better because it has high success rates and keeps more of your skin.

Talking to a dermatologist or healthcare professional is key. They can help you decide what’s best for you. We suggest asking lots of questions to get the right treatment for your needs.

Choosing the right treatment for skin cancer is very important. By looking at all the options and factors, you can help your own care and recovery.

FAQ

What is the main difference between Mohs surgery and ED&C?

Mohs surgery removes cancer layer by layer. It checks each layer under a microscope. This ensures all cancer cells are gone. ED&C, on the other hand, scrapes away the tumor and uses an electric current to kill any remaining cancer cells.

What types of skin cancer are typically treated with Mohs surgery and ED&C?

Both Mohs surgery and ED&C treat common skin cancers. These include basal cell carcinoma and squamous cell carcinoma.

How does Mohs surgery preserve healthy tissue?

Mohs surgery removes cancerous tissue layer by layer. It checks each layer under a microscope. This way, only cancerous tissue is removed, preserving healthy tissue.

What is the ED&C procedure, and how is it performed?

The ED&C procedure starts with curettage. This is where the tumor is scraped away. Then, an electric current is applied to destroy any remaining cancer cells.

When is ED&C typically used, and what are its advantages?

ED&C is used for small, superficial skin cancers. It’s quick and cost-effective, making it advantageous.

What are the cure rates for Mohs surgery and ED&C?

Mohs surgery has a high cure rate, often above 99% for certain skin cancers. ED&C cure rates vary, generally being lower than Mohs surgery.

What are the possible risks and complications of Mohs surgery and ED&C?

Both procedures can have risks like bleeding, infection, scarring, and recurrence. The risk level depends on individual factors and the procedure.

How do I care for the wound after Mohs surgery or ED&C?

After the procedure, keep the wound clean. Apply topical ointments as directed. Follow your dermatologist’s instructions for proper healing.

What are the aesthetic results of Mohs surgery compared to ED&C?

Mohs surgery often leads to better cosmetic results. It spares more tissue. ED&C may cause more noticeable scarring, depending on the area treated.

How much do Mohs surgery and ED&C cost, and are they covered by insurance?

Costs vary based on location, complexity, and other factors. Mohs surgery is generally more expensive. Insurance coverage also varies, so check with your provider.

How do dermatologists decide between recommending Mohs surgery or ED&C?

Dermatologists consider the cancer type, location, patient’s health, and scarring risk. They decide based on these factors.

What is the expected healing timeline for Mohs surgery and ED&C?

Healing times vary, but wounds from both procedures take a few weeks to heal. Complete recovery and final cosmetic results take several months.

Can Mohs surgery or ED&C be used for large or complex skin cancers?

Mohs surgery is preferred for larger or more complex cancers. It has a high cure rate and spares tissue. ED&C is used for smaller, superficial cancers.

References:

DESSNA. (n.d.). Understanding the Benefits and Risks of Mohs Surgery – DESSNA. https://dessna.com/understanding-the-benefits-and-risks-of-mohs-surgery/

Kaiser Permanente. (n.d.). Comparing Nonmelanoma Skin Cancer Treatment Options. https://mydoctor.kaiserpermanente.org/ncal/article/comparing-nonmelanoma-skin-cancer-treatment-options-1604352

Mayo Clinic Proceedings. (n.d.). Curettage and electrocoagulation versus surgical excision in the treatment of low-risk basal cell carcinoma: A prospective randomized trial. https://pmc.ncbi.nlm.nih.gov/articles/PMC9133236/

Westlake Dermatology. (n.d.). Mohs Surgery vs. Other Skin Cancer Treatments: Key Comparison. https://www.westlakedermatology.com/blog/mohs-surgery-vs-other-skin-cancer-treatment-options/

Aim at Skin Cancer. (n.d.). A dermatologist explains wide local excision and highlights differences from Mohs surgery. https://aimatskincancer.org/awareness/a-dermatologist-explains-wide-local-excision-and-highlights-differences-from-mohs-surgery/

Golden State Dermatology. (n.d.). Why Mohs Surgery is the Gold Standard for Skin Cancer Treatment. https://www.goldenstatedermatology.com/blog/why-mohs-surgery-is-the-gold-standard-for-skin-cancer-treatment/

Schlessinger MD. (n.d.). Why Mohs surgery is preferred for cancer treatment over SRT and IGRT. https://www.schlessingermd.com/mohs-vs-srt-and-ig-srt/

AMC. (n.d.). History of Mohs Surgery: A Step-by-Step Approach to Skin Cancer Treatment. https://www.mohssurgery.org/blog/mohs-surgery/a-comprehensive-comparison-of-mohs-micrographic-surgery-and-other-skin-cancer-treatments/

DESSNA. (n.d.). Skin Cancer Surgery in North Atlanta – DESSNA. https://dessna.com/surgery/skin-cancer-surgery/}}

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