Basal Cell Carcinoma (BCC) is the most common and most treatable form of skin cancer. If diagnosed early, it can be managed effectively with minimal risk. In this blog, we’ll walk you through the key symptoms to watch for, possible causes, and the range of safe and effective treatment options available today. Whether you’re looking to understand your diagnosis or simply want to stay informed, you’re in the right place.
Overview
What is Basal Cell Carcinoma?
It is a type of non-melanoma skin cancer that starts from the basal cells that are located deep in the epidermis. (outermost layer of skin) Basal cells help create the new skin cells. When they form cells the older cells are pushed to the surface of the epidermis where they die and are removed from the body.
Types of Basal Cell Carcinoma
There are several distinct types of Basal Cell Carcinoma(BCC), with ~20 histological growth patterns these includes:-
Nodular BCC- It is the most common facial skin cancer. It appears as a shiny, pearly nodule with a smooth surface, often with a central dip or rolled edges. Tiny blood vessels may be visible. The cystic type feels soft with jelly-like content. Micronodular, microcystic, and infiltrative types are more aggressive. A mixed form is called nodulocystic carcinoma.
Superficial BCC- This type of Basal Cell Carcinoma is more common in younger adults and typically appears on the upper trunk and shoulders. It presents as a slightly scaly, irregular plaque with a thin, translucent rolled border and may show multiple small erosions on the surface.
Morphoeic(Sclerosing)- Sclerosing Basal Cell Carcinoma, also known as morpheic or morphoeiform BCC, is usually found in mid-facial areas. It appears as a waxy, scar-like plaque with poorly defined borders and tends to extend widely and deeply beneath the skin. It may also infiltrate cutaneous nerves, leading to perineural spread.
Basosquamous- Mixed Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC), also known as basosquamous carcinoma, shows an infiltrative growth pattern and is considered more aggressive than typical BCC. It carries a higher risk of recurrence and deeper tissue invasion.
Pigmented- In this type, melanocytes and melanin are found within the tumor cells, causing hyperpigmentation, leading to a darker appearance.
Symptoms and Causes
What are the signs and symptoms of Basal Cell Carcinoma?
Some of the Clinical Signs Include:-
- Presence of lumps, bumps, or scaly patches on the skin
- Lesions may be translucent and similar to your natural skin tone, or range in color from white, pink, and brown to black or blue
- Appear shinier than the surrounding skin, with fine visible blood vessels.
- Tend to grow slowly over time.
- May cause itching or discomfort
- Can ulcerate, leading to clear fluid discharge or bleeding when touched
What Causes Basal Cell Carcinoma?
Basal Cell Carcinoma (BCC) is primarily caused by long-term exposure to UV radiation, either from the sun or tanning beds. The UV rays damage the DNA in skin cells that may cause mutation in the patched (PTCH) tumor suppressor gene, part of hedgehog signalling pathway. leading to uncontrolled growth. Risk increases with:
Fair or light skin that burns easily
History of sunburns
Living in sunny or high-altitude areas
Weakened immune system (e.g, transplant patients)
Radiation therapy in the past
Exposure to certain chemicals (like arsenic)
Genetic conditions like Gorlin syndrome (which appear in childhood)
Diagnosis and Treatment
Diagnosis- It starts with the physical examination of the lesion skin, Depending on the appearance, your healthcare provider may suspect a basal cell carcinoma and after the complete examination, they may ask you few questions like
- When did you first notice the lump or spot on your skin?
- Has it changed in size over time?
- Does it look different now compared to when you first saw it?
- Have you experienced any pain, itching, or discomfort in the area?
- Have you been diagnosed with skin cancer in the past?
What are the treatment options for Basal Cell Carcinoma?
The Treatment for the BCC depends on the size,type and location and preferences of the doctor here are some of the treatment methods mentioned below:-
Biopsy(Excision)- in this, the lesion is cut out and skin stitched up, the most appropriate treatment for nodular, infiltrative and morphoeic. Surgery may be recommended if the lesion is improperly excised.
Mohs Surgery- Advanced surgical technique in which marked excised tissue is carefully examined layer by layer to ensure complete excision, mainly used in the area of eyes, lips and nose.
Electrodessication- Cancerous lump is scraped with a curette and then burned with a special needle.
Cryotherapy- Cancerous lumps are frozen with liquid nitrogen that result in a blister that heals within several weeks.
Photodynamic Therapy- In this the Superficial BCC are treating with photosensitizing chemical and exposed to light, effective for tumor with high risk of recurrence.
Laser Therapy- Utilises a high-energy beam to remove the Cancerous lump.
Radiotherapy– It utilises High Radiation doses to target and kill Cancerous cells in their advanced metastatic stage may cause radiation burns and other side effects
Immunotherapy- Immunotherapy is an emerging treatment for advanced or recurrent BCC, especially when surgery radiation isn’t possible or effective. It works by boosting your immune system to recognize and destroy cancer cells.Ex include Checkpoint inhibitors like Cemiplimab targets and specifically kills Cancerous cell with Minimal side effects.
Prevention
How to Prevent this Condition?
- Stay out of direct sunlight between 10 a.m. and 4 p.m., when UV rays are strongest.
- Skip tanning beds—they increase your risk of skin cancer significantly.
- Apply a broad-spectrum sunscreen (SPF 30 or higher) daily, and reapply every two hours if you’re outdoors, swimming, or sweating.
- Wear sun-protective clothing with UPF, along with wide-brimmed hats and UV-blocking sunglasses.
- Check your skin monthly for any new or changing spots, lumps, or unusual lesions.
- Schedule an annual skin check with a dermatologist for any symptoms or detection.
- Go for a doctor if you having skin concerns or noticeable changes.
- Consider taking nicotinamide (vitamin B3), 500 mg twice daily, which has been shown to lower the risk of developing new BCC and SCC in high-risk individuals.
A Key Note
Basal Cell Carcinoma may be the most common type of skin cancer, but it’s also one of the most treatable, especially when detected early. By staying mindful of the warning signs and understanding the causes, you can take proactive steps to protect your skin and your health. If you notice any unusual spots, sores that don’t heal, or changes in your skin, don’t ignore them. Early diagnosis can make all the difference. Consult a dermatologist or a trusted cancer clinic for a thorough evaluation and peace of mind.
FAQs
What if Basal Cell Carcinoma left Untreated?
If left untreated it can spread to the nearby tissue in later stages it can become painful and ulcerated which can cause bleeding and infection.
Is Basal Cell Carcinoma a serious Cancer?
Basal Cell Carcinoma (BCC) spreads slowly, but if not detected early, it can reach lymph nodes and deeper tissues. Timely screening is the only way to treat it effectively and prevent it from becoming serious.
Is Basal Cell Carcinoma Curable?
Yes it is curable in early stages when the lump is small, it can be treated for this regular self skin examination and annuals skin test are recommended.
