Currently, a major trend is the development of less invasive, tissue-preserving approaches to selected skin cancers. There is increasing evidence for the curative role of ablative and fractional CO₂, Nd:YAG and other laser-based approaches in selected low-risk BCCs. Particularly interesting is the combination of laser treatment with reflectance confocal microscopy (RCM) and laser-assisted drug delivery (LADD).
This represents a potential transition from a destructive excisional approach to a tissue-sparing treatment , combined with a real-time imaging surveillance
This conservative, albeit curative approach, is accepted currently only for appropriately selected superficial/low-risk tumors, as superficial basal cell carcinoma, nodular basal cell carcinoma, in situ squamous cell carcinoma, multiple actinic keratosis and field of cancerization, where the objective becomes preservation of healthy tissue while maintaining oncologic control, an this should not be interpreted as lasers replacing excision or Mohs surgery.
The 2026 evidence still considers surgery the gold standard for many NMSC situations, and laser treatment remains particularly relevant to selected low-risk lesions.