Basal cell carcinoma

Basal cell carcinoma is a type of skin cancer that develops in the basal cells. Basal cells are small cells located in the deepest part of the epidermis, the outer layer of your skin that you can see and touch. Their main function is to generate new skin cells, pushing the older cells to the surface, where they die and eventually flake off.

Basal cell carcinoma is the most common type of skin cancer. It usually looks like a shiny bump or a pinkish patch on your skin on places that get a lot of sun like your face, ears, neck, or shoulders. Basal cell carcinoma grows slowly and doesn’t usually spread to other parts of your body, but it can cause problems if not treated, like damage to surrounding tissues.

At Penn Medicine, our experienced specialists work together in diagnosing, treating, and researching all types of skin cancers. Our unique approach provides better outcomes and gives you access to the most advanced treatment, surgical techniques, and clinical trials available.

Basal cell cancer can develop in different forms depending on its location and characteristics.

• Nodular: The most common type, it appears as a flesh-colored or pinkish bump that can be shiny or pearly like a pimple, with visible blood vessels. 
• Superficial: Typically found on the trunk or limbs, it appears as a red, scaly patch that may be mistaken for eczema or psoriasis. It tends to grow slowly and is usually less aggressive. 
• Morpheaform (or sclerosing): A less common type, it appears as a flat, scar-like lesion that is usually skin-colored or whitish. It can invade deeper tissues, making it more challenging to treat. 
• Pigmented: This variant contains melanin, giving it a brown, blue, or black color, similar to melanoma. 
• Basosquamous: This is a rare and more aggressive form that shows features of both basal cell carcinoma and squamous cell carcinoma. It appears as a scaly, raised sore that doesn’t heal. 

Basal cell carcinoma signs and symptoms can vary but may include:

• Persistent, non-healing sores that bleed, ooze, or crust over 
• Sores that heal and then come back 
• Flat, scaly areas that may be red or brown and itchy or painful 
• Pearly or waxy bumps that are often flesh-colored, white, or pink 
• Pink or red growths with a slightly raised, rolled edge and a lower area in the center 
• Waxy, white, or yellowish areas that resemble a scar with poorly defined borders 
• A bump or nodule with small, visible blood vessels

It’s important to note that not all skin changes or sores are cancerous. However, any concerning or persistent symptoms should be evaluated by your doctor. Early detection and treatment of basal cell carcinoma cancer can lead to the best outcomes. 

Basal cell carcinoma is often caused by prolonged exposure to ultraviolet (UV) radiation from sunlight or tanning beds. UV radiation damages the DNA in skin cells. This damage can cause basal cells to make too many cells, leading to lumps or sores on the outer layer of your skin.

Some additional factors have been shown to increase the risk of basal cell carcinoma.

• A history of blistering sunburns in childhood  
• A history of melanoma or skin cancer 
• Arsenic exposure 
• Having fair skin 
• Having light-colored eyes 
• Having multiple moles—often in the hundreds 
• Increasing age 
• Previous radiation therapy to treat acne or other skin conditions 
• Taking immune-suppressing medications

Staging is the process of finding out how much cancer there is and where it’s located. This information is used to make sure you get the right treatment. For most cancers, the stage is based on three main factors:

• Size of the tumor 
• If the cancer has spread to nearby lymph nodes 
• If the cancer has spread to distant areas of the body

Basal cell carcinoma rarely spreads to other parts of the body, so staging is rarely needed. 

Reduce your risk of getting basal cell skin cancer by taking the following steps:

• Avoid peak sun exposure: Seek shade and wear protective clothing such as a wide-brimmed hat, long-sleeved shirt, and sunglasses with UV protection between 10 a.m. to 4 p.m.  
• Use sunscreen: Apply a broad-spectrum sunscreen with SPF 30 or higher to all exposed skin, including your face, neck, ears, and hands. Also use lip balm with SPF protection. Reapply sunscreen and lip balm every two hours or more frequently if swimming or sweating.  
• Don’t use tanning beds: Indoor tanning beds emit harmful UV radiation that increases the risk of skin cancer.  
• Perform regular skin examinations: Monitor your skin for new or changing moles, freckles, or other skin lesions, and schedule regular skin examinations with your dermatologist.  
• Manage chronic conditions: If you have a chronic skin condition such as actinic keratosis or a weakened immune system, work closely with your healthcare provider to manage the condition and minimize your risk of developing basal cell carcinoma.

Incorporating these preventive measures into your lifestyle can help reduce your risk of developing basal cell carcinoma and other types of skin cancer.