Basal cell carcinoma is a type of skin cancer that originates in the basal cells of the skin. Each year, millions of people in the United States are diagnosed with the disease, which is the most common type of skin cancer.
In fact, according to the Skin Cancer Foundation, malignant basal cell carcinoma (BCC) is actually the most commonly occurring form of any cancer. Basal cells are located in the lower part of the epidermis, which is the top layer of skin. BCC skin cancer develops when the skin is damaged, and basal cells begin to grow out of control.
There are four main types of basal cell carcinoma:
- Nodular, which looks like a round pimple surrounded by visible blood vessels, is the most common type of basal cell carcinoma.
- Pigmented is a rare type of BCC skin cancer that causes hyperpigmentation in the skin.
- Sclerosing causes scars that gradually expand over time or a small red dot on the skin.
- Superficial spreading causes lesions that look like small, shallow marks on the skin that are lighter than surrounding skin.
Basal cell carcinoma typically develops on parts of the skin that are frequently exposed to the sun’s ultraviolet (UV) rays. The forms of BCC differ in where they most commonly occur on the body—sclerosing basal cell carcinoma, for example, is most common on the face, while superficial spreading basal cell carcinoma is more likely on the torso, arms, or legs.
This type of skin cancer is slow-growing and rarely spreads beyond the original site. Early detection and treatment are important, though, to ensure the BCC doesn’t grow deeper into the skin, becoming locally invasive.
What causes basal cell carcinoma?
Basal cell carcinoma is caused by DNA changes in the skin resulting from exposure to UV radiation. The damaged DNA causes basal cells to continually produce new cells, flooding the skin with an overabundance of basal cells that causes lesions or tumors on the skin’s surface.
Certain factors can increase a person’s risk of developing basal cell carcinoma. Risk factors include:
- Advanced age
- Blond or red hair
- Blue or green eyes
- Exposure to certain chemicals, such as arsenic
- Male sex
- Pale skin
- Personal history of skin cancer
- Radiation treatment for cancer
A rare congenital disease called basal cell nevus syndrome can cause the development of basal cell cancers throughout life, including in childhood. The condition is inherited, and exposure to UV rays increases the risk of BCCs developing in those with the disease.
What are the signs and symptoms of basal cell carcinoma?
Recognizing the signs of a BCC skin cancer can help identify it early, when it’s most treatable. Basal cell carcinoma symptoms can include:
- A persistent open sore that doesn’t heal and may bleed or ooze
- A reddish or irritated patch of skin that may itch or be painful
- A scar-like area that is shiny and white, yellow, or waxy
- A shiny bump that is pearly, clear, pink, red, or white
- A small pink growth with a slightly raised edge and a crusted indentation in the middle
It’s important to know that basal cell carcinoma may appear differently on darker skin tones. People of color who develop a BCC may have a shiny bump on the skin that’s tan, black, or brown, resembling a normal mole.
How is basal cell carcinoma diagnosed?
If a dermatologist or other medical provider suspects you may have a basal cell carcinoma, he or she will carefully examine your skin, using a dermatoscope, a handheld device that works like a microscope. Other tests may also be used to confirm a diagnosis:
- Biopsy to examine a tissue sample, looking for abnormalities in the basal cells
- Imaging, such as CT scans, ultrasound, or PET scans, to determine if cancer has spread
In many cases, early-stage basal carcinoma may be detected and removed during a single visit without the need for further treatment.
Basal cell carcinoma treatment at NGMC
BCC cancer treatment typically includes the removal of the lesion or skin spot, either surgically or using freezing or light therapy. In some cases, other treatment may be used along with surgery or in place of it.
Surgery for basal cell carcinoma
Surgical removal is the standard of care for early-stage basal cell carcinoma. There are three forms of surgery for basal cell carcinoma:
- Curettage and electrodesiccation combines two forms of treatment by first scraping basal carcinoma from the skin and then applying heat to destroy any remaining cancer cells. This type of surgery is used on the torso, arms, and legs.
- Excision involves cutting out the skin cancer and a section of normal-looking skin around it. The normal skin is analyzed under a microscope, and if no additional cancer cells are detected, the cancer is considered removed.
- Mohs surgery removes only a thin layer of skin, then analyzes the skin to determine if cancerous cells are present. Additional layers of skin will be removed until no malignant cells are detected.
If excision is recommended but cancerous cells are detected in the normal skin, Mohs surgery may be recommended as follow-up treatment.
Other removal methods for basal cell carcinoma
Less commonly, basal cell carcinoma may be removed using either freezing or light therapy. Freezing, which is also called cryosurgery, applies liquid nitrogen to the BCC to destroy it. Light therapy uses a red or blue light to kill cancerous cells.
Topical medications for basal cell carcinoma
Topical medications may also be used to remove malignant basal cells. These medications are applied to the skin and are designed to reduce the size of a basal cell carcinoma prior to surgery. In some cases, topical medications may be the only treatment for BCC cancer.
Radiation therapy for basal cell carcinoma
Radiotherapy for basal cell carcinoma is used to kill cancer cells and stop them from growing. It involves the targeted application of radiation to the affected area of the skin. While radiation therapy may be used as a standalone treatment, it’s more commonly used along with surgery, especially for aggressive basal cell carcinoma or a BCC that has metastasized.
Basal Cell Carcinoma Research
Clinical trials help advance our knowledge about how to effectively diagnose and treat cancer. Patients at NGMC have access to clinical trials that can expand and innovate their care. Learn more about the current clinical trials we are participating in.
Cancer rehabilitation
BCC cancer treatment can have a number of side effects, including skin irritation, redness, swelling, and tingling. Those who undergo radiotherapy may have additional effects, such as fatigue and nausea. Our cancer rehabilitation services are specifically designed to help cancer patients overcome the challenges of cancer and cancer treatment.
Patient navigation
Need help determining your next steps after a basal cell carcinoma diagnosis? Our team of cancer care navigators is here to help guide you through the process. Reach out to our patient navigation program today to connect with a navigator.
Schedule an Appointment with a Dermatologist
In Georgia, with our beautiful landscape and frequently sunny days, we are often exposed to the sun’s UV rays. That means an increased risk of basal cell carcinoma and other types of skin cancer. Our board-certified dermatologists provide expert services for a variety of skin cancer conditions. From diagnostic procedures to specialized skin cancer treatment, our dedicated team can help guide you through your skin cancer journey. Choose your dermatologist below to get started.