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The surgical treatment of basal cell epithelioma proceeds in two stages: excision which must result in eradication and therefore complete cure of the lesion, and repair which, on the face, must not only cover the loss of substance but also take into account cosmetic considerations. Repair may consist of: simple suture after adjustment of the surrounding skin provided it has enough laxity; skin graft preferably using whole-thickness skin taken in the pre- or retro-auricular or supraclavicular regions; regional autoplasty with sometimes a skin island flap, and finally distant flap or free cutaneous or musculocutaneous transplant.

Basal-cell epitheliomas of the scalp are frequently observed on pre-existing chronic lesions: radiodermatitis or Jadassohn's sebaceous naevus. In cases where no irradiation has been given, basal-cell epitheliomas of the scalp should be treated by simple surgical excision. When irradiation has been applied, deep invasion must be recognized as an insufficient excision can often be fatal.