Basal cell carcinoma is the most common type of skin cancer and develops in basal cells located in the outer layer of the skin. It often appears on sun-exposed areas, such as the face, neck, ears, and hands. Symptoms may include a pearly bump, a flat scar-like patch, a sore that repeatedly heals and reopens.
Basal cell carcinoma (BCC) develops when basal cells grow uncontrollably, often because of damage caused by ultraviolet radiation from sunlight or tanning devices. Although it rarely spreads to distant organs, untreated tumors can grow into nearby tissues and cause damage. Recognizing suspicious skin changes and obtaining a professional evaluation are important steps in managing this condition.
Basal cell carcinoma can develop gradually, and its appearance varies depending on the type and location. It commonly occurs on areas that receive frequent sun exposure, although it can develop on other parts of the body.
Common symptoms and signs include:
Pearly or translucent bumps: Small raised growths that may have visible blood vessels.
Nonhealing sores: Open areas that heal and return or continue bleeding.
Pink or red patches: Flat or slightly raised areas that may be itchy, scaly, or irritated.
Scar-like lesions: White, yellowish, or waxy patches with poorly defined borders.
Bleeding and crusting: Growths that bleed after minor contact or repeatedly develop a crust.
Slow-growing skin changes: Lesions that gradually increase in size over weeks, months, or years.
Several factors can increase the likelihood of developing basal cell carcinoma. These include prolonged ultraviolet exposure, a history of sunburn, frequent use of tanning beds, fair skin, increasing age, previous skin cancer, and certain inherited conditions. People who take medicines that suppress the immune system may also have an increased risk.
A suspicious skin lesion should be assessed by a qualified healthcare professional, particularly if it changes in size, shape, or color, repeatedly bleeds, or fails to heal. Symptoms alone cannot confirm whether a growth is cancerous.
Diagnosis usually begins with a medical examination of the skin. A dermatologist may use a dermatoscope to examine the lesion more closely. A skin biopsy, in which a small tissue sample is removed for laboratory examination, is generally used to confirm the diagnosis.
Treatment depends on the tumor's location, size, depth, subtype, recurrence risk, and the person's overall health. The main options include:
Surgical excision: The tumor is removed along with a margin of surrounding tissue for examination.
Mohs surgery: Thin layers of tissue are removed and examined progressively. This technique helps preserve healthy tissue and is often considered for high-risk tumors or lesions in sensitive areas.
Curettage and electrodesiccation: Selected low-risk tumors are scraped away and the area is treated with an electric current to destroy remaining cancer cells.
Topical medicines: Prescription creams such as imiquimod may be used for certain superficial basal cell carcinomas when clinically appropriate.
Radiation therapy: Radiation may be considered when surgery is unsuitable or when other clinical circumstances support its use.
Targeted medicines: Drugs such as vismodegib or sonidegib may be considered for certain advanced cases when surgery or radiation is not appropriate. Immunotherapy may be an option for selected advanced cancers.
Regular follow-up is important because basal cell carcinoma can recur, and people who have had one skin cancer may develop another. Follow-up schedules depend on individual risk and medical advice. Sun protection, including protective clothing, shade, and broad-spectrum sunscreen, can help reduce further ultraviolet damage.
Anyone noticing a persistent or changing skin lesion should seek medical evaluation. Treatment decisions should be made with a qualified healthcare professional based on the confirmed diagnosis and individual circumstances.