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Published on: May 23, 2025
Prospective Outcomes After 1064 nm Nd:YAG Laser Treatment of Basal Cell Carcinoma
Jusleen Ahluwalia1, Amanda F Marsch2, Kayla Zafar3
1Private Practice, San Diego, California, USA.
Background:
Existing data on basal cell carcinoma (BCC) clearance rates are predominantly derived from histological sampling or retrospective analyses. Prospective evaluations of clinical clearance remain limited. This study prospectively assessed long-term clinical clearance and scar outcomes following treatment of BCC with a 1064 nm Nd:YAG laser.
Methods:
A total of 34 BCC lesions were treated using a 1064 nm Nd:YAG laser and evaluated at approximately 6 and 12 months post-treatment. Each follow-up included assessment for clinical evidence of recurrence and scar evaluation using the Patient and Observer Scar Assessment Scale (POSAS; range 6 = normal skin to 60 = severe scarring) which is a standardized scale.
Results:
Twenty-two patients with 34 BCC tumors completed the study. Patients selected laser therapy primarily due to concerns regarding surgical downtime, cosmetic considerations, prior surgical burden, or poor surgical candidacy. Clinical recurrence was identified in one tumor at 6 months, with no additional recurrences observed at 12 months.
Conclusions:
At 6 months, 97% of tumors (33/34) demonstrated clinical clearance, and all 33 tumors remained free of recurrence at 12 months. Scar outcomes were favorable, with mean POSAS patient and observer scores of 2.96 and 3.8 (on a 10-point scale), respectively. The 1064 nm Nd:YAG laser represents a promising, cosmetically favorable, and minimally invasive therapeutic option for BCC, particularly in patients who are suboptimal surgical candidates or who prefer non-surgical interventions.
