Basal Cell Carcinoma Symptoms, Causes & Treatment Options

Basal cell carcinoma is the most common skin cancer. There are many treatment options for this skin cancer and fortunately, it is almost never life-threatening.

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Basal Cell Carcinoma?

Summary

Basal cell carcinoma (or BCC) is the most common kind of skin cancer [4]. Basal cell carcinomas can occur nearly anywhere on the skin, and have a variety of appearances, from ruddy nodules to open ulcers. Tumors can grow to be large and disfiguring if neglected, and it is common for BCCs to grow back even after removal. Fortunately, this cancer almost never spreads (metastasizes) to other parts of the body, and is almost never life-threatening.

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Basal Cell Carcinoma Symptoms

Main symptoms

Basal cell carcinomas come in all shapes and sizes, and they can mimic many other skin cancers and skin conditions. Any new markings on the skin that don’t heal or resolve should be looked at by a doctor – this is often how skin cancers start out. The most common things to look for are listed below:

  • A shiny nodule: A new “nodule” or small bump on the skin, especially with a shiny “pearly” appearance, is the most classic appearance of a basal cell carcinoma. These may be the color of the surrounding flesh, pink, red, or another color.
  • A “rolled border”: Another classic feature of a basal cell carcinoma is a nodule with a heaped-up or rolled border surrounding a central depression
  • An open sore: If you have a sore or wound that refuses to heal, this may actually be a basal cell carcinoma or another type of skin cancer.
  • Irritated skin patch: A small patch of irritated, red, or flaky skin that always occurs in the same place may be a basal cell carcinoma. It may itch, hurt, or not feel like anything at all.
  • Vascularization: Basal cell carcinomas may have new, visible growth of small blood vessels beneath the surface of the skin.
  • “New” scar: If something resembling a new scar appears where there was no previous wound or scar, this may be a basal cell carcinoma or another type of skin cancer. [2]

Other symptoms

The most common presentations of basal cell carcinoma are listed above, but many varieties exist. Some less common symptoms include:

  • Easy bleeding: Due to the blood vessel growth common in BCCs, some may bleed with minimal trauma or spontaneously.
  • Neural involvement: In rare cases, a basal cell carcinoma may spread into the skin, causing changes to the nerves of the skin, leading to tingling or numb sensations around the cancer.
  • Scaling: Some basal cell carcinomas cause scaling of the skin that may resemble a new scab. In rare cases, these are basal cell carcinomas mixed with other (squamous) skin cancers.

Basal Cell Carcinoma Causes

Basal cell carcinomas are an overgrowth of the basal cell – a type of skin cell at the base of the skin. Basal cell carcinomas are more likely in skin that has been exposed to ultraviolet light, generally from the sun or tanning beds. Sunburns, sun exposure, and tanning bed exposure all make a person more likely to develop basal cell carcinomas.

Basal cell carcinomas are also more likely to develop in certain types of individuals, who have the following traits:

  • Fair skin
  • Fair eyes and hair
  • Exposure to other forms of ionizing radiation
  • Many moles
  • A family history of skin cancers
  • People with weakened immune systems, like those on medicines to suppress the immune system after an organ transplant
  • Cigarette smokers [5]
  • Men are more likely than women to develop BCC [3].

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Treatment Options, Relief, and Prevention for Basal Cell Carcinoma

Treatment

Treatment of basal cell carcinoma begins with a visit to the dermatologist’s office. The dermatologist will first conduct a skin check, where they will visually examine the spot in question, as well as the rest of the skin (to make sure they are not missing any other spots). If after looking at the spot, the dermatologist suspects skin cancer, they will likely take a biopsy, cutting off a small piece of the lesion for examination under the microscope to make a definitive diagnosis. This may take several days to process.

If basal cell carcinoma is confirmed by the biopsy, several types of treatment are available. Treatment will depend on the size and location of the tumor, and the patient’s preference. The major treatments are described below:

  • Curettage and electrodesiccation: Smaller lesions may be scraped off with a sharp scraping tool called a curette, and the residual skin beneath is burned with an electrical tool to minimize the chance of recurrence.
  • Excisional surgery: In excisional surgery, the dermatologist will remove the basal cell carcinoma as well as the surrounding skin (the margin) using a scalpel. Removal of a margin of skin minimizes the chance of recurrence. Often the skin is removed in an elliptical shape that can be quite a bit larger than the basal cell carcinoma, but this technique often allows for better healing.
  • Mohs surgery: For larger basal cell carcinomas, and those located in sensitive areas like the face, patients may be referred to a specialist called a Mohs surgeon, who will remove the tumor layer by layer, examining the surgical margins between each layer to check if the tumor has been cleared. This technique ensures that the absolute minimum amount of flesh is removed, while also minimizing the chance of recurrence.
  • Other techniques: Occasionally, basal cell carcinomas may be removed or destroyed by freezing them with liquid nitrogen, using lasers, radiation, or with topical medications that act as on-the-spot chemotherapies (like imiquimod, or 5-fluorouracil). Some patients with extensive or advanced basal cell carcinoma may even benefit from new immunologic agents like vismodegib, which inhibits BCC development. [2]

Prevention

The best way to prevent basal cell carcinoma and other skin cancers is to practice sun safety. Sun safety is a huge topic, but some of the basics are listed below:

  • Avoid peak sun hours: The sun is strongest between 10 AM and 4 PM. Exercise caution and try to avoid sunburns during these hours. Remember that sunburn causing UV radiation is present year-round, and on cloudy days too.
  • Sunscreen: Use sunscreen every day. Pick a sunscreen that blocks UVA and UVB rays, with an SPF value of 30 or more, and re-apply as directed.
  • Protective clothing: Specially-designed sun-protective clothing is a great addition to sunscreen and can be even more protective.
  • Avoid tanning beds: Tanning beds concentrate harmful radiation on the skin and should be avoided at all costs! [3]

When to Seek Further Consultation for Basal Cell Carcinoma

In addition to sun safety, self-screening is a great way to prevent skin cancers. Knowing your own skin will allow you to spot and track changes in your skin. If you see a new mark on your skin, it is never too soon to have it checked by a dermatologist or a primary care doctor. New nodules, non-healing ulcers, recurring or persistent rashes, new freckles or moles, or changes in old freckles or moles could all be signs of skin cancer.

Early diagnosis of basal cell carcinomas will prevent spread, invasion or disfigurement from large and advanced tumors. Early diagnosis is also essential to rule out more dangerous, potentially life-threatening skin cancers like squamous cell carcinoma and melanoma.