Definition

Basal cell carcinoma is the most common form of skin cancer. This cancer usually grows slowly and rarely spreads to other tissues in the body.

Basal cell carcinoma is rarely fatal but it can cause damage to the nearby tissue. If there is risk of damage, the cancer may need treatment or removal.

Causes

Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The growths invade and take over nearby tissue. It is not clear exactly what causes these problems in the cells but is probably a combination of genetics and environment.

Risk Factors

Areas of skin that are damaged have a higher risk of cancer. Skin that is regularly exposed to the sun is most likely to develop skin cancer. Basal cell carcinoma may also develop in skin that has scars, burns, or inflammatory skin diseases.

Factors that increase your risk of developing basal cell carcinoma include:

• History of radiation therapy
• A personal history of skin cancer
• Childhood sunburns, freckling, or long periods of sun exposure
• Frequent use of tanning beds
• Blonde or red hair
• Blue or green eyes
• Fair skin that rarely tans
• A family history of skin cancer
• Treatment that suppresses the immune system , such as having an organ transplant
• Certain rare genetic disorders, such as Gorlin’s syndrome

Symptoms

Symptoms of basal cell carcinoma include:

• A sore that may crust, bleed, or ooze for 3 weeks without healing
• A raised, red patch that may be itchy
• A shiny bump that can be pearl-like in appearance or, less often, dark in color, much like a mole
• A pink growth with a slightly raised border and dip in the middle
• A patch of skin that seems shiny and tight, much like a scar

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

The skin growth will be examined. A sample of the growth will be taken and examined for cancer cells. This will help determine the stage and type of the cancer. The information will be used to guide treatment and make a prognosis.

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

• Mohs micrographic surgery—microscopic surgery that offers the best cure rate for basal cell carcinoma
• Removal of the growth with simple surgery
• Plastic surgery to repair any cosmetic problems that occur after treatment
• Electrodesiccation and curettage—treatment to destroy the lesion

For people who are not able to have surgery, other treatment options include:

• Use of liquid nitrogen to freeze the growth
• Radiation therapy
• Photodynamic therapy—the cells absorb an acid that causes them to die when exposed to light
• Creams, especially fluorouracil or imiquimod

Prevention

To reduce your chances of getting basal cell carcinoma, take these steps:

• Avoid spending too much time in the sun.
• Avoid exposing your skin to the sun between 10:00 AM and 2:00 PM standard time, or 11:00 AM to 3:00 PM daylight saving time.
• Protect your skin from the sun with clothing. Wear a shirt, sunglasses, and a hat with a broad brim.
• Use broad-spectrum (UVA and UVB) sunscreens with a sun protection factor (SPF) of 30 or more on skin that will be exposed to the sun.
• Use a protective lip balm.
• Wear sunglasses with 99% to 100% UV absorption to protect your eyes.
• Don’t use sun lamps or tanning booths.
• Get regular full-body skin exams by a dermatologist. The doctor will check for moles, freckles, and other growths.

The Skin Cancer Foundation http://www.skincancer.org

Canadian Dermatology Association http://www.dermatology.ca

Basal cell carcinoma. American Academy of Dermatology website. Available at:
http://www.aad.org/skin-conditions/dermatology-a-to-z/basal-cell-carcinoma
Accessed February 24, 2015.

Basal cell carcinoma of the skin. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated December 18, 2014. Accessed February 24, 2015.

Saraiya M, et al. Preventing skin cancer. MMWR. 2003 Oct 17;52(RR15):1-12. Available at:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5215a1.htm
Updated October 2, 2003. Accessed February 24, 2015.

Sunscreen FAQs. American Academy of Dermatology website. Available at: https://www.aad.org/media-resources/stats-and-facts/prevention-and-care/sunscreens. Accessed February 24, 2015.

Wong C, Strange R, et al. Basal cell carcinoma. BMJ. 2003;327:794-798.