I would like to know if I am just prolonging having MOHS surgery by using zyclara for 6 weeks? (photo)
Doctor Answers 3
Basal Cell Carcinoma
I would suggest going to the doctor who did the original biopsy and getting clarification on your diagnosis. Basal Cell IS skin cancer, it is NOT precancerous. As you stated the nose is very sensitive. I normally have my patients take something for pain and/or an antianxiety medication by mouth prior to my injections them to numb them up on the nose. Ice can also be applied to the area prior to injections. After the injections, patients normally only feel a little pressure or pulling, but nothing painful. I would also suggest that you see a facial plastic surgeon to close the site if further surgery is required. They have specialized training that will help give you the best scarring possible. From the picture you included the site appears to have gotten rather large, Please don't let this go any longer than absolutely necessary. Best of Luck
Do I need Mohs?
It is somewhat difficult to answer exactly without knowing the precise biopsy result. You mentioned "basal cell precancerous" - this is not an accurate term, although I assume that this implies actinic keratosis, which is indeed a precancerous lesion. Zyclara is useful for actinic keratosis and for superficial basal cell carcinomas; however, as you suggest, it does sound like if has not healed yet that there may be more to it. Mohs surgery and radiation therapy are the two primary methods to treat this. Each has its pros and cons and there are factors that push us to recommend one over the other. A repeat biopsy will provide the most information and allow the best decision to be made. It may mean Mohs surgery but it could also mean that you don't need surgery. As for the pain of the injection, there are methods to help but I suggest you discuss this with the individual performing the biopsy. It may be possible to take an oral medication prior to the biopsy to help so long as your physician is aware and you have someone else driving you. There are also tricks to helping it hurt less such as holding an ice cube on the site for 10-20 seconds.
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