I went to my dermatologist yesterday for some laser treatment, and he found a spot that he thinks might be basal cell carcinoma. He zapped it with the laser and told me to come back to him if the treatment didn't work -so he can do a biopsy, etc.

I've never had skin cancer or anything like that. What should I expect if it turns out to be basal carcinoma? can the doctor remove it in the office? Do I need major surgery? I assume other people on the board have been through this.

This sounds strange to me. I have had 28 Basal Cell Carcinomas removed but never without biopsy first. The spot is removed and sent to the lab to see if it's a BCC and if it is how wide and how deep the doctor has to remove it so all the cells are gone. It's odd your doctor just "zapped" it off.
The surgery for a BCC is done in the office. It's very quick and painless. BCC is not life threatening and doesn't spread to other organs. It gets removed and that's it. Once in a while a BCC will grow back but in the same spot and just needs to be removed again but in over 90% of cases the first removal is a cure. ;)

The doctor said "it may very well be vascular, although it is shiny." In other words, he wasn't sure. I have a lot of cherry angionoma (basically harmless red dots) on my face and chest. I thought this was just another one.

Now I'm totally paranoid that every spot on my face is skin cancer. I'm only 33 -is it common for people my age to end up with this? I do have very fair skin, and I was burned a whole lot as a kid.

I had my first BCC removed when I was about 27 years old. I'm fair skinned, freckled and have light eyes. We spent summers at the shore when I was a kid and I burned and blistered repeatedly which is why I had so many skin cancers in my life. Even one blistering sunburn increases the risk of skin cancer. I'm 58 years old so back in the Stone Age when I was a kid no one knew the the sun was bad for us. If you're fair and worried you can go for a skin exam once a year to check for skin cancers but don't worry too much about it. Basal Cell Carcinoma is a surface, non invasive, curable skin cancer.
Stay out of the sun and wear sun block when you go outside, even in cloudy weather.

I blistered several times as a kid, and got really badly burnt in 1991. Looks like it might be coming back to haunt me.

Now I'm freaking out because after the laser treatment, the thing looks horrible -all black and red.

I should have just gotten a biopsy on the spot.

I would seek a different dermatologist. It is extremely unorthodox to suspect BCC yet not take a biopsy—merely to "wait and see if it comes back."

I made an appointment to see him in 2 weeks. I will get him to do a biopsy then. He wasn't entirely convinced that it was BCC. He squeezed it and said it might be vascular.

I hope he's right.

How would you feel if you had a lump in your breast and the doctor gave a little squeeze and said he didn't think it was cancer? The lesion should have been removed for biopsy, IMO. In thirty years of seeing dermatologists I never had anything removed and told if it came back a biopsy would be done.

That sounds strange to me to. I have had dozens of basal cells and he always does a biopsy first. Most of the time it is BCC but there have been times when it wasn't. I scar bad and I don't want the full treatment until I am sure it's BCC. Don't worry about how it looks now. The dermatologist injects the scar with something and within a few weeks you never know it was there.