Basal cell carcinoma

Also known as: rodent ulcers

Basal cell carcinoma are the most common and the least serious form of skin cancer – as long as they are treated.

Basal cell carcinoma (BCC) occur when a mutation develops in one of the skin's basal cells. Basal cells are found at the bottom of the epidermis – the outermost layer of skinSun exposure is the main cause of damage leading to basal cell carcinoma. As a result, almost all basal cell carcinomas occur on parts of the body that receive the most exposure to the sun.

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Key points: 

  1. Basil cell carcinoma often appear as a pale, red or pearly, smooth lump, usually on the face or neck.
  2. Although more common among older people, they can develop in people in their early 40's or even younger.
  3. They tend to be slow growing and rarely spread to other parts of the body.

Causes

A combination of long-term, everyday sun exposure and the occasional intense exposure, usually leading to sunburn, is the main cause of damage leading to basal cell carcinoma. As a consequence, almost all BCCs occur on parts of the body that receive the most exposure to the sun, such as the face, ears, neck, scalp, shoulders, and back. 

On rare occasions, BCCs develop on sun-protected areas. In some cases, these are the result of damage caused by things such as burns, scars, infections, vaccinations or tattoos. In other cases, the cause is not so easily identified.

Who is most at risk of developing a BCC?

Those with the highest risk of developing a basal cell carcinoma are:

  • People with pale skin who burn easily and rarely tan (generally with light coloured or red hair, although some may have dark hair but still have fair skin).
  • People with outdoor hobbies or outdoor workers, and people who have lived in sunny climates.
  • People who use sun beds or sunbathe.
  • People who have previously had a basal cell carcinoma.

Treatment

A range of treatment options exist for basal cell carcinoma. These include:

  • removal of the cancer by biopsy or surgery
  • freezing it with liquid nitrogen
  • topical therapies (eg, creams)
  • photodynamic therapy
  • radiation treatment.

If you have a basal cell carcinoma, talk with your doctor about which treatment option is best for you.Treatment has a high success rate, provided the skin cancer is found at an early stage.

Self care 

Most basil cell carcinomas can be treated and cured. However, it is possible for these types of cancers to recur or for new skin cancers to appear.

To reduce the risk of new cancers occuring:

  • Keep all follow-up appointments with your GP or skin specialist.
  • Perform skin self-exams. Regularly check all your skin (from head to toe). If you see anything that is growing, bleeding, or in any way changing, go and see your doctor straight away.
  • Protect your skin from the sun and avoid indoor tanning. This is essential to prevent further damage, which can increase the risk of getting another skin cancer.

Ways to protect your skin:

  • Wear sunscreen and lip balm daily that offer SPF 30 or higher sun protection.
  • Use sun screen that is broad-spectrum (UVA/UVB) protection and water resistant. 
  • Apply the sunscreen and lip balm to dry skin 15 minutes before going outdoors. 
  • Apply the sunscreen to every part of your body that will not be covered by clothing. 
  • Whenever possible, wear a wide-brimmed hat, long sleeves, and pants. 
  • Wear sunglasses to protect the skin around your eyes. 
  • Avoid outdoor activities when the sun is strongest — between 10 a.m. and 4 p.m during Sept to April for NZ 
  • Avoid getting a tan and never use a tanning bed or sun lamp.

Learn more

Basal cell carcinoma staging, treatment information and image library DermNet NZ
Basal cell carcinoma patient information sheet British Association of Dermatologists

References

  1. Guidelines for the management of basal cell carcinoma Telfer NR, Colver GB, Morton CA. Br J Dermatol 2008; 159: 35-48.
  2. Basal cell carcinoma - tips for managing American Academy of Dermatology
  3. Basal cell carcinoma emedicine dermatology, the on-line medical reference textbook.
Credits: Collated by Health Navigator NZ, August 2014.