Basic Facts about Basal Cell Carcinoma

Basal cell carcinoma (BCC) is the most common type of skin cancer. It typically arises on sun-exposed body parts and is most likely to occur in fair-skinned individuals with blue, green, or gray eyes and blonde or red hair. It is rare in African Americans and people of darker complexions. While skin cancer had typically been a disease of older adults, an increasing number of cases are being diagnosed in people in their twenties, thirties, and even teens. Among the many reasons for this is tanning bed use, increased sun exposure, the body’s inability to repair damage caused by ultraviolet radiation, smoking, and the depletion of the ozone layer.

Appearance

BCC can take on many forms. It may look like a shiny persistent pimple, white, light pink, flesh-colored, or even red or brown. It may be raised, flat, scaly, or indented. Be suspicious if an unusual spot develops a scab or bleeds. Seek consultation with a board-certified dermatologist if a spot like this lasts longer than a month.

You can find photos and more information at the American Society for Dermatologic Surgery skin cancer page.

Diagnosis and Treatment

Diagnosis and treatment of BCC is done at your dermatologist’s office. Your dermatologist will typically perform a biopsy to take a sample of the skin. Once this sample is evaluated by a dermatopathology specialist, it will be determined whether it is BCC, and if it is, what type. Then appropriate treatment will be recommended.

The good news is that the prognosis for BCC is usually excellent. Treatment for BCC is typically successful and cure rates are high. It is a slow growing skin cancer that rarely spreads to other organs or lymph nodes (metastasizes). However, if BCC is left untreated, it can cause significant damage to the skin in that area. The sooner it is treated, the better the outcome.

Options for treatment include topical creams, excisional surgery, cryosurgery, curettage and electrodessication, and radiation therapy. Large or deep tumors may require more extensive treatment or Mohs surgery, a specialized procedure in which serial skin samples are taken and evaluated under the microscope until a cancer-free sample is obtained.

Prevention

People who have had one BCC are at increased risk for another. It is recommended that routine skin cancer screenings be performed by a dermatologist. Initially, these may be recommended every six months and then annually. The American Academy of Dermatology (AAD) advises preventative measures including:

• Never use tanning beds or sun lamps

• Wear sunscreen every day on all exposed areas

• Wear hats and clothing to protect your skin

• Wear sunglasses with UV protection

• Avoid sun exposure during midday hours (10am-4pm)

• Use a broad spectrum sunscreen that covers UVA and UVB rays with a minimum SPF30

Please see your board-certified dermatologist with any concerns.

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