Abstract
BACKGROUND: Basal cell carcinoma (BCC) commonly affects facial skin, with surgical excision being the usual treatment. However, surgery often leads to complications and slow healing, impacting quality of life. Recently, ultra-pulsed CO₂ laser has emerged as a minimally invasive option with good cosmetic results, but its effectiveness and patient satisfaction compared to surgery are still uncertain. OBJECTIVE: This study aims to compare the clinical outcomes and patient satisfaction between ultra-pulsed CO₂ laser treatment and surgical excision for patients with facial BCC. METHODS: A retrospective analysis was conducted on 100 patients with facial BCC treated at our dermatology department from January 2021 to January 2024.Among them, 50 patients received ultra-pulsed CO₂ laser treatment, while 50 underwent traditional surgical excision. We compared the tumor excision rates, incidence of postoperative complications, healing times, and patient satisfaction (assessed through a questionnaire) between the two groups. RESULTS: The clinical effective rate in the ultra-pulsed CO₂ laser group was 94.0%, compared to 90.0% in the surgical excision group, with no statistically significant difference between the two groups (p > 0.05).Postoperative complications in the CO₂ laser group were primarily mild burns and inflammatory erythema, all of which resolved spontaneously within 1-2 days without treatment, with no serious adverse reactions reported. Recurrence rates were 4.00% (laser) vs. 16.00% (surgery), the difference between the two groups was statistically significant (p < 0.05). Regarding pain scores, there was no significant difference in preoperative pain scores between the groups; however, the CO₂ laser group reported significantly lower pain scores at 1, 3 days and 7days postoperatively (P < 0.001). Furthermore, patient satisfaction was significantly higher in the CO₂ laser group compared to the surgical group (96.0% vs. 76.0%, P < 0.001). CONCLUSION: In summary, both ultra-pulsed CO₂ laser treatment and surgical excision exhibit similar clinical efficacy in the management of facial basal cell carcinoma. Nonetheless, ultra-pulsed CO₂ laser treatment offers notable benefits regarding postoperative complication rates, pain scores, and patient satisfaction. Consequently, ultra-pulsed CO₂ laser treatment may be regarded as an effective and patient-friendly alternative for the treatment of facial basal cell carcinoma.