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What Is Basal Cell Carcinoma Of The Skin

Diagnosing Basal Cell Carcinoma

Basal Cell Carcinoma (BCC) Skin Cancer

The most common way dermatologists diagnose basal cell carcinoma is with a full body skin check.

Stevenson says during the diagnosis process dermatologists are looking for papules with skin cancer characteristics. Sometimes dermatologists will use a tool called a dermatoscope, which uses a polarized light to look for other signs of skin cancer. With their training, dermatologists should be able to tell patients if the lesion is benign or something that should be removed because of a skin cancer concern.

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Skin Cancer Types: Basal Cell Carcinoma Overview

All content solely developed by the American Academy of Dermatology

The American Academy of Dermatology gratefully acknowledges the support from Sanofi Genzyme and Regeneron.

Basal cell carcinoma

What is basal cell carcinoma?The most common type of skin cancer, basal cell carcinoma can show up on the skin in many ways.

Is it contagious? No

Treatment Of Basal Cell Carcinoma

  • Removal of the tumor

Doctors may remove the cancer in the office by scraping and burning it with an electric needle or by cutting it out. Doctors may destroy the cancer by using extreme cold .

Certain chemotherapy drugs may be applied to the skin. Photodynamic therapy , in which chemicals and a laser are applied to the skin, also may be used. Occasionally, radiation therapy is used.

A technique called Mohs microscopically controlled surgery may be required for some basal cell carcinomas that are large or regrow or occur in certain areas, such as around the nose and eyes.

People whose cancer has spread to nearby tissues or spread to other parts of the body and who are not candidates for surgery or radiation therapy may be given the drug vismodegib or sonidegib taken by mouth.

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Symptoms And Signs Of Basal Cell Carcinoma

The clinical manifestations and biologic behavior of basal cell carcinomas are highly variable. The most common types are

  • Nodular : These types are small, shiny, firm, almost translucent to pink nodules with telangiectases, usually on the face. Ulceration and crusting are common.

  • Superficial : These types are red or pink, marginated, thin papules or plaques, commonly on the trunk, that are difficult to differentiate from psoriasis or localized dermatitis.

  • Morpheaform : These types are flat, scarlike, indurated plaques that can be flesh-colored or light red and have vague borders.

  • Other: Other types are possible. Nodular and superficial basal cell carcinomas can produce pigment .

    This basal cell carcinoma appears as a flat, waxy, poorly demarcated plaque with prominent telangiectasia.

    Pigmented basal cell carcinoma is rare. These lesions are sometimes misdiagnosed as pigmented nevi or malignant melanomas.

Most commonly, the carcinoma begins as a shiny papule, enlarges slowly, and, after a few months or years, shows a shiny, pearly border with prominent engorged vessels on the surface and a central dell or ulcer. Recurrent crusting or bleeding is not unusual. Commonly, the carcinomas may alternately crust and heal, which may unjustifiably decrease patients’ and physicians’ concern about the importance of the lesion.

More Pictures Of Basal Cell Carcinoma

What Is Basal Cell Carcinoma Skin Cancer?

While the above pictures show you some common ways that BCC can appear on the skin, this skin cancer can show up in other ways, as the following pictures illustrate.

Scaly patch with a spot of normal-looking skin in the center

On the trunk, BCC may look like a scaly patch with a spot of normal-looking skin in the center and a slightly raised border, as shown here.

Basal cell carcinoma can be lighter in some areas and darker in others

While BCC tends to be one color, it can be lighter in some areas and darker in others, as shown here.

Basal cell carcinoma can be brown in color

Most BCCs are red or pink however, this skin cancer can be brown, as shown here.

Basal cell carcinoma can look like a group of shiny bumps

BCC can look like a group of small, shiny bumps that feel smooth to the touch.

Basal cell carcinoma can look like a wart or a sore

The BCC on this patients lower eyelid looks like a wart* in one area and a sore** in another area.

If you see a spot or growth on your skin that looks like any of the above or one that is growing or changing in any way, see a board-certified dermatologist.

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The Most Common Skin Cancer

Basal cell carcinoma is the most common form of skin cancer and the most frequently occurring form of all cancers. In the U.S. alone, an estimated 3.6 million cases are diagnosed each year. BCCs arise from abnormal, uncontrolled growth of basal cells.

Because BCCs grow slowly, most are curable and cause minimal damage when caught and treated early. Understanding BCC causes, risk factors and warning signs can help you detect them early, when they are easiest to treat and cure.

Is It Time For Your Annual Skin Check

One of the best ways to prevent basal cell carcinoma is to take steps to protect your skin from the sun, including daily sunscreen, protective clothing, and seeking shade whenever possible. If you have a high risk of developing skin cancer, then make sure that you dont miss your yearly skin check-up with your dermatologist.

Are you experiencing any symptoms that concern you? Schedule an appointment with the dermatologists at the Center for Surgical Dermatology. Were now accepting patients for telemedical appointments!

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Untreated Basal Cell Carcinoma

Any irregular marks or sores that refuse to heal should be checked by your dermatologist for a specific diagnostic and treatment plan. Non-melanoma skin cancer has a high success rate for treatment, but only when caught within a reasonable time frame.

While rare, untreated basal cell carcinoma can spread to other parts of the body, affecting surrounding tissues. The cancerous area can become quite large and in some cases cause disfigurement, especially when on the face. Small bumps can grow into massive protrusions that destroy healthy tissues and create permanent damage.

In extreme cases, untreated basal cell carcinoma can be fatal, so it is crucial to seek treatment as early as possible.

What Do I Need To Know

Skin Cancer What is a Nodular Basal Cell Carcinoma BBC)?
  • AKs are evidence of sustained sun damage. Having them raises your lifetime risk for skin cancer. Since having one AK means that its likely you have already developed more, this may translate into an especially elevated risk for developing an SCC.
  • An untreated SCC can become invasive and even life-threatening.

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The Dangers Of Untreated Skin Cancer

Skin cancer is the most common form of cancer in the world. Brought on typically by overexposure of UV rays , skin cancer can be prevented and oftentimes easily treated. However, if left untreated, no matter which type of skin cancer you have, it will undoubtedly cause severe health complications and may even lead to death. Lets break it down a bit and walk you through what would happen if skin cancer were left untreated.

Protect Yourself From Melanoma


Reducing your exposure to the suns UV rays is the only action you can take to lower your risk of skin cancer.

If you spend time in the sun, even in the winter, use a sunscreen with a sun protection factor of 30 or higher that is labeled broad-spectrum this means that it protects against both UVA and UVB light. Use sunscreen even on cloudy daysabout 80 percent of the suns rays can filter through clouds.

Apply sunscreen 15 to 30 minutes prior to sun exposure. Cover any exposed skin, including your ears, lips, back of your neck, and your scalp if your hair is thinning. For added protection, stay out of direct sunlight between 10 a.m. and 4 p.m.


Follow the ABCDE rule as a guide when examining moles and other spots on your skin. Look for:

  • Asymmetry, in which one half of the mole is shaped differently than the other half.
  • Borders that are irregular, ragged, or blurred.
  • Color that varies from one area to another, with shades of tan, brown, black, white, pink, red, or blue.
  • Diameter larger than 6 millimeters .
  • Evolving, such as growing larger and/or changing color or shape.


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What Are The Treatments For Basal Cell Carcinoma

BCC is treated by removing it. The choice of treatment depends on many things, including patient health and age, the location of the tumor, and the extent and type of the cancer. Treatment may occur in many ways:

  • Scratching off with a curette, an instrument that may end in a ring or a spoon, and then burning with a special electric needle. This method is called electrodessication and curettage.
  • Surgical removal
  • Mohs surgery: This is a specialized technique. The doctor first removes the visible cancer and then begins cutting around the edges. The tissues are examined during the surgery until no more cancer cells are found in tissues around the wound. If necessary, a skin graft or flap might be applied to help the wound heal.
  • Excisional surgery: The growth and a bit of surrounding skin is removed with a scalpel.
  • Freezing
  • Applying chemotherapy medication to the skin
  • Using lasers
  • Using blue light and a light-sensitive agent applied to the skin
  • Using radiation
  • If the BCC has advanced locally or spread to another location, which is very rare for BCC, the FDA has approved two medicines: vismodegib and sonidegib . These drugs are of a class called hedgehog inhibitors.

    Types Of Basal Cell Carcinoma

    Basal cell skin cancer on the face

    Basal cell carcinomas are divided into different types to help physicians evaluate the progression of the disease and determine which course of treatment is best. Understanding the different ways that basal cell carcinomas grow in the skin helps determine the most optimal treatment approach.

    Physicians also assess whether the basal cell carcinoma has any of the following high-risk features:

    • Aggressive microscopic growth pattern
    • Spread to lower dermis or subcutis layers of the skin
    • Spread to the small nerves in the skin

    Additionally, the health of the individual must be taken into consideration. Patients who are immunosuppressed due to certain medical conditions or medications may have basal cell carcinomas that behave more aggressively.

    The classification of basal cell carcinomas is based on how they appear at a microscopic level and includes the following types most commonly:

    Superficial basal cell carcinoma = the cancer originates at the basal layer of the epidermis and has spread only slightly deeper than this. These cancers are well less than 1 mm in depth

    Nodular basal cell carcinoma = the cancer grows as a ball of cancer cells, spreading into the dermis, or collagen layer, of the skin. These nodular basal cell carcinomas often extend 1 mm or more into the skin

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    Basal Cell Carcinoma: The Most Common Skin Cancer

    Basal cell carcinoma, which is also called basal cell skin cancer, is the most common form of skin cancer, accounting for about 80 percent of all cases.

    Rates of basal cell carcinoma have been increasing. Experts believe this is due to more sun exposure, longer lives, and better skin cancer detection methods.

    This type of cancer begins in the skins basal cells, which are found in the outermost layer, the epidermis. They usually develop on areas that are exposed to the sun, like the face, head, and neck.

    Basal cell carcinomas may look like:

    • A flesh-colored, round growth
    • A pinkish patch of skin
    • A bleeding or scabbing sore that heals and then comes back

    They typically grow slowly and dont spread to other areas of the body. But, if these cancers arent treated, they can expand deeper and penetrate into nerves and bones.

    Though its rare, basal cell carcinoma can be life-threatening. Experts believe that about 2,000 people in the United States die each year from basal cell carcinoma or squamous cell carcinoma.

    Some risk factors that increase your chances of having a basal cell carcinoma include:

    • Being exposed to the sun or indoor tanning
    • Having a history of skin cancer
    • Being over age 50
    • Having chronic infections, skin inflammation, or a weakened immune system
    • Being exposed to industrial compounds, radiation, coal tar, or arsenic
    • Having an inherited disorder, such as nevoid basal cell carcinoma syndrome or xeroderma pigmentosum

    Where Do Skin Cancers Start

    Most skin cancers start in the top layer of skin, called the epidermis. There are 3 main types of cells in this layer:

    • Squamous cells: These are flat cells in the upper part of the epidermis, which are constantly shed as new ones form. When these cells grow out of control, they can develop into squamous cell skin cancer .
    • Basal cells: These cells are in the lower part of the epidermis, called the basal cell layer. These cells constantly divide to form new cells to replace the squamous cells that wear off the skins surface. As these cells move up in the epidermis, they get flatter, eventually becoming squamous cells. Skin cancers that start in the basal cell layer are called basal cell skin cancers or basal cell carcinomas.
    • Melanocytes: These cells make the brown pigment called melanin, which gives the skin its tan or brown color. Melanin acts as the bodys natural sunscreen, protecting the deeper layers of the skin from some of the harmful effects of the sun. Melanoma skin cancer starts in these cells.

    The epidermis is separated from the deeper layers of skin by the basement membrane. When a skin cancer becomes more advanced, it generally grows through this barrier and into the deeper layers.

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    Basal Cell Carcinoma Overview

    Basal cell carcinoma, also called epithelioma, is the uncontrolled growth of the skin’s basal cells. These are the cells that line the deepest layer of the epidermis, the skin’s outermost layer. This type of cancer rarely spreads to other parts of the body.

    It is mainly caused by repeated long-term exposure to sunlight. Light-skinned people who spent a lot of time in the sun as children, or who spend time in tanning booths, are especially susceptible. X-ray treatments for acne and exposure to industrial pollutants such as arsenic and hydrocarbons also increase the risk of developing basal cell carcinoma.

    Basal cell carcinoma is the most common skin cancer in the United States, with nearly 3 million cases diagnosed each year.

    What Is A Basal Carcinoma

    Basal Cell Carcinoma (BCC) | Skin Cancer | Dermatology for Patients


    Accordingly, how serious is basal cell skin cancer?

    The Most Common Skin CancerBCCs arise from abnormal, uncontrolled growth of basal cells. Because BCCs grow slowly, most are curable and cause minimal damage when caught and treated early. Understanding BCC causes, risk factors and warning signs can help you detect them early, when they are easiest to treat and cure.

    Also, can you die from basal cell skin cancer? Basal cell carcinoma is a very slow growing type of non-melanoma skin cancer. This type of skin cancer needs to be treated and has a high cure rate. If left untreated, basal cell carcinomas can become quite large, cause disfigurement, and in rare cases, spread to other parts of the body and cause death.

    Consequently, can a basal cell carcinoma turn into melanoma?

    Basal cell carcinoma does not progress into melanoma. The cancerous cells originate in the lower layers of the epidermis, grow slowly and rarely spread to other parts of the body. Melanoma is a rare but aggressive type of skin cancer that originates in the melanocytes.

    What is the best treatment for basal cell carcinoma?

    Effective Options for Early and Advanced BCC

    • Curettage and electrodesiccation

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    Rarer Types Of Non Melanoma Skin Cancer

    There are other less common types of skin cancer. These include:

    • Merkel cell carcinoma
    • T cell lymphoma of the skin
    • Sebaceous gland cancer

    These are all treated differently from basal cell and squamous cell skin cancers.

    Merkel cell carcinoma

    Merkel cell carcinoma is very rare. Treatment is with surgery or radiotherapy, or both. This usually works well, but sometimes the cancer can come back in the same place. And sometimes it spreads to nearby lymph nodes or to other parts of the body.

    Sebaceous gland cancer

    Sebaceous gland cancer is another rare type of skin cancer affecting the glands that produce the skin’s natural oils. Treatment is usually surgery for this type of cancer.

    Kaposi’s sarcoma

    Kaposis sarcoma is a rare condition. It’s often associated with HIV but also occurs in people who don’t have HIV. It’s a cancer that starts in the cells that form the lining of lymph nodes and the lining of blood vessels in the skin. Treatment is surgery or radiotherapy, and sometimes chemotherapy.

    T cell lymphoma of the skin

    T cell lymphoma of the skin can also be called primary cutaneous lymphoma. It’s a type of non Hodgkin lymphoma. There are a number of different types of treatment for this type of cancer.

    How Can You Prevent Basal Cell Carcinoma

    Being safe in the sun is the best way to prevent BCC and other skin cancers. Here are some tips:

    • Avoid being in the sun from 10 am to 4 pm.
    • Avoid tanning beds.
    • Use a broad spectrum sunscreen with an SPF of 15 or higher each day. If you will be outside for longer periods of time, use a broad spectrum sunscreen that is water-resistant and has an SPF of 30 or higher. Put the sunscreen on 30 minutes before going outside. Put sunscreen on again every two hours, or more frequently if you have been swimming or sweating a lot.
    • Use protective clothing that has built-in sun protection, which is measured in UPF. Also, use broad-brimmed hats and sunglasses.
    • Do your own skin self-exam about once per month and see a dermatologist about one time per year for a professional skin exam.
    • Have any skin changes examined as soon as possible by a healthcare provider.

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