Laser-based therapies in the management of non-melanoma skin cancers: a narrative review

Sep 22, 2026

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Rising global incidence of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) drives demand for tissue-sparing alternatives to surgical excision, still the gold standard. This narrative review synthesizes clinical evidence on laser-based strategies for non-melanoma skin cancers, emphasizing treatment parameters, patient and lesion selection, oncologic clearance and recurrence, and safety. A targeted search of PubMed, Embase, and Scopus up to May 2026 is narratively integrated. For low-risk BCC, Nd:YAG shows 3.1% recurrence with 7.9-year follow-up, while CO2 reports 9.4% with 2.1-year follow-up and PDL monotherapy shows 38% recurrence. Evidence for cSCC remains limited, with focus on in situ disease and combined regimens; RCM and LADD may improve efficacy and depth. Overall, Nd:YAG and CO2 are viable for low-risk BCC, but cSCC requires cautious selection.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Introduction

Laser modalities and rationale

Treatment outcomes and safety

Lasers in Medical Science (2026) 41:107 [https://doi.org/10.1007/s10103-026-04899-0](https://doi.org/10.1007/s10103-026-04899-0) REVIEW Laser-based therapies in the management of non-melanoma skin cancers: a narrative review Francesco Russano1 · Davide Brugnolo1 · Luigi Dall’Olmo1,3 · Francesco Callegarin3 · Paolo Del Fiore1 · Marcodomenico Mazza1 · Alberto Camuccio4 · Daniele Scafuri2 · Davide Furlan2 · Marco Rastrelli1,2 · Simone Mocellin1,2 Received: 10 April 2026 / Accepted: 20 May 2026 © The Author(s) 2026 Abstract The rising global incidence of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) necessitates the exploration of tissue-sparing alternatives to surgical excision, which remains the gold standard. Laser systems (CO₂, Nd: YAG, PDL) offer a less invasive approach using selective photothermolysis, addressing functional and aesthetic concerns in anatomically sensitive areas. This narrative review summarizes the current clinical data on laser-based strategies for non-melanoma skin cancers (NMSC), focusing on treatment parameters, patient/lesion selection, oncologic outcomes (clearance and recurrence), and safety. A targeted search of PubMed, Embase, and Scopus up to May 2026 was synthesized narratively. For low-risk BCC, Nd: YAG lasers showed a 3.1% recurrence rate (7.9-year follow-up), while CO₂ lasers reported 9.4%(2.1-year follow-up) . Pulsed dye laser (PDL) monotherapy was less reliable, with 38% recurrence. Evidence for cSCC remains limited, focusing on in situ disease and combined regimens. Integrating Reflectance Confocal Microscopy (RCM) and Laser-Assisted Drug Delivery (LADD) significantly improves oncologic efficacy and treatment depth. Laser therapy, particularly Nd: YAG and CO₂ systems, represents a viable tissue-sparing option primarily for low-risk BCC. However, evidence for cSCC remains limited and suggests higher recurrence rates, necessitating cautious patient selection. Keywords Non-melanona skin cancers · Laser · Basal cell carcinoma · Cutaneous squamous cell carcinoma Davide Brugnolo and Marco Rastrelli contributed equally to this work. 􀀍 Luigi Dall’Olmo [luigi.dallolmo@unipd.it](luigi.dallolmo@unipd.it) Francesco Russano [francesco.russano@iov.veneto.it](francesco.russano@iov.veneto.it)[ ](francesco.russano@iov.veneto.it)Davide Brugnolo [davide.brugnolo@iov.veneto.it](davide.brugnolo@iov.veneto.it)[ ](davide.brugnolo@iov.veneto.it)Francesco Callegarin [francesco.callegarin@iov.veneto.it](francesco.callegarin@iov.veneto.it)[ ](francesco.callegarin@iov.veneto.it)Paolo Del Fiore [paolo.delfiore@iov.veneto.it](paolo.delfiore@iov.veneto.it)[ ](paolo.delfiore@iov.veneto.it)Marcodomenico Mazza [marcodomenico.mazza@iov.veneto.it](marcodomenico.mazza@iov.veneto.it)[ ](marcodomenico.mazza@iov.veneto.it)Alberto Camuccio [alberto.camuccio@iov.veneto.it](alberto.camuccio@iov.veneto.it)[ ](alberto.camuccio@iov.veneto.it)Daniele Scafuri [daniele.scafuri@studenti.unipd.it](daniele.scafuri@studenti.unipd.it) Davide Furlan [davide.furlan@studenti.unipd.it](davide.furlan@studenti.unipd.it) Marco Rastrelli [marco.rastrelli@unipd.it](marco.rastrelli@unipd.it) Simone Mocellin [simone.mocellin@unipd.it](simone.mocellin@unipd.it) 1 Soft-Tissue, Peritoneum and Melanoma Surgical Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy 2 Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Padua, Italy 3 Clinical Research Unit, Veneto Institute of Oncology IOVIRCCS, Padua, Italy 4 Immunology and Molecular Oncology Diagnostics Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy Introduction Non-melanoma skin cancers (NMSCs), predominantly basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), rank among the most frequently diagnosed malignancies worldwide [1] . Their incidence is steadily increasing in fair-skinned populations, particularly in regions with high cumulative ultraviolet exposure,

FAQs

Why is surgery not always the preferred option for non-melanoma skin cancers?

Surgical excision remains the gold standard, but it may be unsuitable due to patient comorbidities, difficult anatomic locations, and concerns about cosmetic or functional outcomes. Less invasive options can be especially relevant for medically fragile or elderly patients.

Which laser systems are discussed for basal cell carcinoma and cutaneous squamous cell carcinoma?

The review discusses CO₂, Nd:YAG, erbium:YAG, and pulsed dye lasers (PDL). CO₂ and erbium:YAG are ablative systems targeting tissue water, while PDL targets tumor microvasculature.

What are the reported recurrence rates for low-risk basal cell carcinoma in the review?

For low-risk BCC, Nd:YAG shows a 3.1% recurrence rate with a 7.9-year follow-up, CO₂ reports 9.4% recurrence with a 2.1-year follow-up, and PDL monotherapy reports 38% recurrence.

What evidence exists for laser therapy in cutaneous squamous cell carcinoma?

Evidence for cSCC is described as limited, largely involving in situ disease and combined regimens. The review notes that recurrence rates may be higher, so patient selection should be cautious.

Sep 22, 2026

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