Early Detection, Expert Treatment: Managing Basal Cell Carcinoma on the Forehead
Blog Article by Dr. Caroline Vaughn
At Village Dermatology Houston, we understand that skin cancer screenings can be anxiety-provoking—but early detection paired with precise treatment can make all the difference. In this article, I want to share the case of a 68-year-old patient we first saw in March 2025, whose story highlights the value of thorough skin exams, patient education, and personalized care.
Initial Visit: A Concern for Suspicious Lesions
Our patient, a vibrant 68-year-old woman, came to our clinic as a new patient seeking evaluation for suspicious skin lesions on her right upper back and chest, as well as overall surveillance for skin cancer. She also wanted counseling on sun protection and help monitoring existing moles.
During her full-body skin exam, which included the use of a dermatoscope, we identified two areas of concern:
A papule on her left dorsal forearm, which we suspected could be a seborrheic keratosis, squamous cell carcinoma, or a neoplasm of uncertain behavior.
A darkly pigmented macule on the left forehead, which had features raising concern for basal cell carcinoma (BCC).
To evaluate these lesions further, shave biopsies were performed on both. The forehead lesion was later confirmed to be a nodular basal cell carcinoma, the most common—and fortunately, one of the most treatable—types of skin cancer.
Learn more about BCC in our Village Dermatology skin cancer overview and basal cell carcinoma guide.
Why Basal Cell Carcinoma Needs Prompt Attention
Basal cell carcinoma (BCC) is a slow-growing skin cancer that often appears in sun-exposed areas like the forehead, nose, and ears. Although BCC rarely spreads to other parts of the body, it can grow deep into the skin and cause significant tissue damage if left untreated.
The forehead is considered a high-risk area (Area M) for cosmetic and functional reasons. Given the tumor’s location and size (1.1 x 1 cm), Mohs micrographic surgery was the recommended and most appropriate treatment.
April 2025: Mohs Surgery & Complex Repair
Mohs surgery was performed in April 2025, with excellent results. The cancer was fully removed in just one stage, and no residual tumor cells were detected on frozen section analysis. The final defect measured 1.4 x 1.7 cm, extending into the adipose (fat) layer.
Due to the location and lack of surrounding skin laxity, we performed a complex layered repair with a Burow’s graft to ensure the wound was closed properly and healed with minimal scarring.
What is a Burow’s graft?
A Burow’s graft uses nearby healthy skin, shaped and repositioned to fill in the surgical defect. In this case, tissue from the adjacent forehead was used to create a natural closure with good cosmetic outcomes.
What to Expect After Mohs Surgery
Mohs surgery is a meticulous technique that removes skin cancer while preserving as much healthy tissue as possible. It’s especially valuable in cosmetically sensitive areas like the face.
Our patient experienced no complications, and the wound was closed with both deep sutures and a running epidermal stitch. She returned for a suture removal and wound check one week later.
Skin Cancer Prevention Tips
Our patient came to us not only for treatment but also to learn how to prevent future skin cancers. Here's what we recommend for all our patients, especially those in sunny areas like Katy and Houston:
Apply broad-spectrum SPF 30+ sunscreen every day, even on cloudy days.
Wear a wide-brimmed hat and protective clothing when outdoors.
Schedule yearly full-body skin exams with a board-certified dermatologist.
Check your skin monthly at home for new or changing moles or growths.
Final Thoughts
This case is a great example of why early detection and personalized treatment planning matter so much. Because our patient came in early and we were able to act quickly, her basal cell carcinoma was treated successfully with minimal tissue loss and an excellent cosmetic result.
If you’re in Katy or Houston and concerned about a skin lesion—or just want peace of mind through regular skin checks—schedule a visit with Village Dermatology Houston today. Whether it’s a new mole, a non-healing spot, or a general skin concern, we’re here to help you protect your skin and your health.