From the Guidelines
BBL (BroadBand Light) Moxi treatment should not be performed on patients with a history of basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) without careful dermatological clearance and consultation with both their dermatologist and the treating physician. Patients with a history of skin cancer are at increased risk of developing another BCC or SCC, with a 10-fold increase in risk compared to the general population 1. The intense pulsed light used in BBL therapy targets melanin and hemoglobin in the skin, but this light energy could potentially stimulate abnormal cells in someone with a history of skin cancer.
If a dermatologist approves the treatment, it should be performed with modified parameters (lower energy settings) and with more frequent skin checks before and after treatment 1. The treating physician should also avoid treating any suspicious areas or active lesions. Additionally, patients with a history of skin cancer should maintain vigilant sun protection practices before and after treatment, including daily broad-spectrum SPF 30+ sunscreen, as BBL treatments can temporarily increase photosensitivity.
Some key considerations for patients with a history of BCC include:
- Annual follow-up skin cancer screening 1
- Skin self-examination and sun protection after BCC 1
- Avoidance of topical and oral retinoids, such as tretinoin, acitretin, and isotretinoin 1
- Consideration of oral nicotinamide to reduce the risk for subsequent keratinocyte carcinoma 1
Regular skin cancer screenings should continue regardless of BBL treatments, and patients should be counseled regarding the need for sun protection, sun avoidance, and tanning booth avoidance 1.
From the Research
BBL Moxi Safety in Patients with History of Basal and Squamous Cell Carcinomas
- The safety of BBL (BroadBand Light) Moxi in patients with a history of basal cell carcinoma and squamous cell carcinoma is not directly addressed in the provided studies 2, 3, 4, 5, 6.
- However, it is known that patients with a history of basal or squamous cell carcinoma are at increased risk for new skin cancers as well as recurrences, and lifelong, regular, total cutaneous examinations are essential to detect potentially curable skin carcinomas and melanomas 2.
- The provided studies focus on the treatment and diagnosis of basal and squamous cell carcinomas, including topical imiquimod or fluorouracil therapy 3, Mohs micrographic surgery 5, and radiotherapy 6.
- There is no clear evidence to suggest that BBL Moxi is safe or unsafe for patients with a history of basal cell carcinoma and squamous cell carcinoma, as the studies do not specifically address this topic.
- It is essential to note that patients with a history of skin cancer require regular follow-up and monitoring for recurrence, as the risk of subsequent skin cancer is significant 4, 5.
Treatment Options for Basal and Squamous Cell Carcinomas
- Topical imiquimod or fluorouracil therapy may be used to treat basal and squamous cell carcinomas, but the evidence supporting their use is weak, and they are recommended for patients with small tumors in low-risk locations who will not or cannot undergo treatment with better-established therapies 3.
- Mohs micrographic surgery has the lowest recurrence rate among treatments, but is best considered for large, high-risk tumors 5.
- Radiotherapy may be used to treat recurrent basal and squamous cell skin carcinomas, with a five-year cure-rate of 83.62% and good cosmetic results in 92.62% of treated lesions 6.
Patient Monitoring and Follow-up
- Patients with a history of basal or squamous cell carcinoma require lifelong, regular, total cutaneous examinations to detect potentially curable skin carcinomas and melanomas 2.
- The frequency of follow-up depends on the number and types of previous skin cancers, as well as other risk factors, but as a rule, examinations should be performed at least yearly 2.
- Monitoring for recurrence is prudent, as the risk of subsequent skin cancer is 35 percent at three years and 50 percent at five years 5.