Home > Diseases and Conditions > Basal cell carcinoma
  • We are sorry, but NCBI web applications do not support your browser and may not function properly. More information

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Basal cell carcinoma

Basal cell skin cancer; Rodent ulcer; Skin cancer - basal cell; Cancer - skin - basal cell; Nonmelanoma skin cancer; Basal cell NMSC

Last reviewed: July 26, 2011.

Basal cell carcinoma is a slow-growing form of skin cancer.

Skin cancer falls into two major groups: Nonmelanoma and melanoma. Basal cell carcinoma is a type of nonmelanoma skin cancer.

Causes, incidence, and risk factors

Basal cell carcinoma, or basal cell skin cancer, is the most common form of cancer in the United States. Most skin cancers are basal cell cancer.

Squamous cell cancer

Basal cell carcinoma starts in the top layer of the skin called the epidermis. Most basal cell cancers occur on skin that is regularly exposed to sunlight or other ultraviolet radiation. This includes the top of your head, or scalp.

Basal cell skin cancer is most common in people over age 40. However, it occurs in younger people, too.

You are more likely to get basal cell skin cancer if you have:

  • Light-colored or freckled skin
  • Blue, green, or grey eyes
  • Blond or red hair
  • Overexposure to x-rays or other forms of radiation
  • Many moles
  • Close relatives who have or had skin cancer
  • Many severe sunburns early in life
  • Long-term daily sun exposure (such as the sun exposure people who work outside receive)

Symptoms

Basal cell skin cancer grows slowly and is usually painless. It may not look that different from your normal skin. You may have a skin bump or growth that is:

  • Pearly or waxy
  • White or light pink
  • Flesh-colored or brown

In some cases the skin may be just slightly raised or even flat.

You may have:

  • A skin sore that bleeds easily
  • A sore that does not heal
  • Oozing or crusting spots in a sore
  • A scar-like sore without having injured the area
  • Irregular blood vessels in or around the spot
  • A sore with a depressed (sunken) area in the middle
Skin cancer, basal cell carcinoma - nose

Signs and tests

Your doctor will check your skin and look at the size, shape, color, and texture of any suspicious areas.

If your doctor thinks you might have skin cancer, a piece of skin will be removed and sent to a lab for examination under a microscope. This is called a skin biopsy. There are different types of skin biopsies.

A skin biopsy must be done to confirm basal cell skin cancer or other skin cancers.

Treatment

Treatment depends on the size, depth, and location of the skin cancer, and your overall health.

Treatment may involve:

  • Excision: Cutting out the skin cancer and stitching the skin together
  • Curettage and electrodesiccation: Scraping away cancer cells and using electricity to kill any that remain
  • Cryosurgery: Freezing the cancer cells, which kills them
  • Medication: Skin creams containing imiquimod or 5-fluorouracil for superficial (not very deep) basal cell cancer
  • Mohs surgery: Removing a layer of skin and looking at it immediately under a microscope, then removing many layers of skin until there are no signs of the cancer; usually used for skin cancers on the nose, ears, and other areas of the face.
  • Photodynamic therapy: Treatment using light

Radiation may be used if a basal cell cancer cannot be treated with surgery.

Expectations (prognosis)

How well a patient does depends on many things, including how quickly the cancer was diagnosed. Most of these cancers are cured when treated early.

Some basal cell cancers may return. Smaller ones are less likely to come back. Basal cell carcinoma almost never spreads to other parts of the body.

If you have had skin cancer, you should have regular check-ups so that a doctor can examine your skin. You should also examine your skin once a month. Use a hand mirror to check hard-to-see places. Call your doctor if you notice anything unusual.

Complications

Basal cell skin cancer almost never spreads. But, if left untreated, it may grow into surrounding areas and nearby tissues and bone. This is most worrisome around the nose, eyes, and ears.

Calling your health care provider

Call your health care provider if you notice any changes in your skin. You should also call if an existing spot becomes painful or swollen, or if it starts to bleed or itch.

Prevention

The best way to prevent skin cancer is to reduce your exposure to sunlight. Ultraviolet light is most intense between 10 a.m. and 4 p.m., so try to avoid sun exposure during these hours. Protect the skin by wearing hats, long-sleeved shirts, long skirts, or pants.

Always use sunscreen:

  • Apply high-quality sunscreens with sun protection factor (SPF) ratings of at least 15, even when you are only going outdoors for a short time.
  • Apply a large amount of sunscreen on all exposed areas, including ears and feet.
  • Look for sunscreens that block both UVA and UVB light.
  • Use a waterproof formula.
  • Apply sunscreen at least 30 minutes before going outside, and reapply it frequently, especially after swimming.
  • Use sunscreen in winter, too. Protect yourself even on cloudy days.

Other important facts to help you avoid too much sun exposure:

  • Avoid surfaces that reflect light more, such as water, sand, concrete, and white-painted areas.
  • The dangers are greater closer to the start of summer.
  • Skin burns faster at higher altitudes.
  • Avoid sun lamps, tanning beds, and tanning salons.

Examine the skin regularly for unusual growths or skin changes.

References

  1. Basal cell and squamous cell cancers. NCCN Medical Practice Guidelines and Oncology. V.1.2009. Accessed July 15, 2009.
  2. Neville JA, Welch E, Leffell DJ. Management of nonmelanoma skin cancer in 2007. Nat Clin Pract Oncol. 2007;4:462-469. [PubMed: 17657251]
  3. Eigentler TK, Kamin A, Weide BM, et al. A phase III, randomized, open label study to evaluate the safety and efficacy of imiquimod 5% cream applied thrice weekly for 8 and 12 weeks in the treatment of low-risk nodular basal cell carcinoma. J Am Acad Dermatol. 2007;57:616-621. [PubMed: 17610993]
  4. Hexsel CL, Bangert SD, Hebert AA, et al. Current sunscreen issues. 2007 Food and Drug Administration sunscreen labelling recommendations and combination sunscreen/insect repellant products. J Am Acad Dermatol. 2008;59:316-323. [PubMed: 18485529]
  5. Lautenschlager S, Wulf HC, Pittelkow MR. Photoprotection. Lancet. 2007;370:528-537. [PubMed: 17693182]
  6. Ridky TW. Nonmelanoma skin cancer. J Am Acad Dermatol. 2007;57:484-501. [PubMed: 17512631]
  7. Wood GS, Gunkel J, Stewart D, et al. Nonmelanoma skin cancers: basal and squamous cell carcinomas. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKenna WG, eds. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa: Churchill Livingstone; 2008:chap 74.

Review Date: 7/26/2011.

Reviewed by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Mohs micrographic surgery versus surgical excision for periocular basal cell carcinomaMohs micrographic surgery versus surgical excision for periocular basal cell carcinoma
    A basal cell carcinoma (BCC) is the commonest skin cancer and the most common cancer in people of white origin. It is usually seen on the sun exposed parts of the body like the face, neck, head and ears. Untreated lesions can slowly eat away the surrounding skin and hence they are also called "rodent ulcers". The commonest treatment for BCC is surgery. This is traditionally achieved by surgical excision (SE) which involves cutting away the BCC, along with a margin of normal appearing skin around it to ensure complete removal of the cancer and to reduce the risk of recurrence. Another type of surgery is Mohs micrographic surgery (MMS). This involves the removal of the skin tumour after colour coding the edges. This is then examined under the microscope to see if all the BCC has been removed. If any residual BCC is left at the edge of the excision further skin is excised from only that localised area by using the colour coding, and examined under the microscope. This process is continued until all the BCC is removed. This ensures complete tumour removal and spares normal tissue in the other directions. The latter is considered the better alternative for treatment of certain types of BCC arising in the eyelids because it has the highest chance of curing the disease and minimises the size of the defect that needs to be repaired. Unfortunately, this modality of therapy is a limited resource and not always employed because of practical limitations in the service delivery. Surgical excision is perceived to be a cheaper option as it does not require the special training, multiple procedures, and money involved in setting up and running a MMS service. Extended follow up, greater surgical morbidity and the cost of dealing with recurrences may over time significantly increase the cost of SE. We searched for studies where people with BCC had been randomised to receive either method of treatment. The aim was to establish which treatment method is associated with lower recurrence rate. We also looked at the cost difference, complications and acceptability of the two procedures. This review could not find enough evidence to answer these questions. There is a clear need for further randomised studies to provide more reliable evidence for the management of this condition.
See all (12) ...

Figures

  • Basal cell nevus syndrome - close-up of palm.
    Skin cancer, basal cell carcinoma - nose.
    Skin cancer, basal cell carcinoma - pigmented.
    Skin cancer, basal cell carcinoma - behind ear.
    Skin cancer, basal cell carcinoma - spreading.
    Basal cell nevus syndrome - plantar pits.
    Basal cell nevus syndrome - face and hand.
    Multiple basal cell cancer due to x-ray therapy for acne.
    Basal Cell Carcinoma - face.
    Basal cell carcinoma - close-up.
    Basal cell cancer.

PubMed Health Blog...

read all...

MedlinePlus.gov links to free, reliable, up-to-date health information from the National Institutes of Health (NIH) and other trusted health organizations.

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...