Basal Cell Carcinoma

What is Basal Cell Carcinoma?

Basal cell carcinoma is a form of skin cancer that begins in the basal cells. It often appears as a somewhat transparent bump on the skin. This form of skin cancer often appears in areas of the skin that are often exposed to the sun, such as the head and neck.

Basal cell carcinoma takes place when one of the skin’s basal cells develops a mutation. This mutation causes the basal cells to multiply quickly and continue growing. This accumulation of abnormal cells may cause a cancerous tumor to form.

Common signs of basal cell carcinoma include:

• A skin-colored, pearly white, or pink bump. This lesion may rupture, bleed, and scab over.
• A brown, black, or blue lesion with a translucent border.
• A scaly, flat, red patch that may grow quite large.
• A waxy, white, scar-like lesion.

Certain individuals may have an increased risk of basal cell carcinoma, including those:

• With regular sun exposure.
• With fair skin.
• Who are older in age.
• Who take immune-suppressing drugs.
• Who have inherited syndromes that cause skin cancer.

Basal Cell Carcinoma FAQs

Causes and Risk Factors

Basal cell carcinoma develops when the DNA of basal cells, found in the skin’s outermost layer, undergoes changes that cause uncontrolled growth. The leading cause of this type of skin cancer is exposure to ultraviolet (UV) radiation, whether from the sun or artificial sources like tanning beds. Over time, repeated UV exposure damages the DNA in skin cells, increasing the risk of cell carcinoma.

Certain risk factors make some individuals more susceptible to basal cell carcinoma. People with fair skin, light hair, and light eyes are at higher risk because they have less melanin to protect against UV rays. A history of frequent sunburns, especially in childhood, further raises the likelihood of developing basal cell cancer. Other contributing factors include a weakened immune system, either from medical conditions or medications, and exposure to harmful substances such as arsenic.

Family history also plays a role. Those with close relatives who have had skin cancer, particularly basal cell carcinoma, are more likely to develop it themselves. Professionals recommend regular skin examinations and protective measures, such as using sunscreen and wearing protective clothing, to help reduce these risks. By understanding and addressing these risk factors, you can take important steps toward skin cancer prevention and early detection.

Types and Classification

Basal cell carcinoma is the most common type of non-melanoma skin cancer, but it isn’t a one-size-fits-all diagnosis. There are several clinical and histological subtypes, each with unique characteristics and appearances.

• Nodular Basal Cell Carcinoma: This is the most frequent subtype, often presenting as a shiny, pink, or flesh-colored bump that may bleed or develop a central depression.
• Superficial Basal Cell Carcinoma: Appearing as a flat, scaly patch, this form is more likely to develop on the trunk or limbs and may be mistaken for eczema or psoriasis.
• Morpheaform (Sclerosing) Basal Cell Carcinoma: This rare subtype looks like a firm, flat, or slightly depressed area, often with ill-defined borders, and can be more aggressive in invading surrounding tissues.

Basal cell carcinomas are also classified as low-risk or high-risk based on factors such as tumor size, location, and histological subtype. Tumors on the face or other sensitive areas, or those with aggressive growth patterns, are considered high-risk and may require more specialized treatment. Recognizing the type and classification of basal cell carcinoma helps guide the most effective treatment plan for each individual.

Symptoms and Diagnosis

Basal cell carcinoma can present in a variety of ways, depending on its subtype and where it appears on the body. Common symptoms include the appearance of a new growth or bump, a persistent sore that doesn’t heal, or a change in the size, color, or shape of an existing spot. Sometimes, basal cell carcinoma may look like a scaly patch, a pearly or waxy bump, or a flat, flesh-colored or brown scar-like area.

These tumors most often develop on sun-exposed areas such as the face, ears, neck, scalp, and hands, but they can occur anywhere on the body. Because basal cell carcinoma can mimic other skin conditions, it’s important to have any suspicious changes evaluated by a dermatologist.

Diagnosis typically involves a skin biopsy, where a small sample of the affected skin is removed and examined under a microscope. This allows doctors to confirm the presence of cancer cells and determine the specific type of cell carcinoma, ensuring the most appropriate treatment plan is chosen.

Basal Cell Carcinoma Treatment

The main goal of basal cell carcinoma treatment is to completely remove all cancer cells. The treatment that is right for you will be dependent on the type, location, and size of the cancer, as well as your preference. Common treatment options include:

Surgery

Surgical Excision

During this technique, known as standard surgical excision, the doctor will cut out the cancerous lesion and a surrounding area of healthy skin. While effective, standard surgical excision generally has higher recurrence rates compared to Mohs micrographic surgery, especially for basal cell carcinoma on facial areas. This is examined under a microscope to ensure that all cancer cells have been removed.

Mohs Surgery

During Mohs micrographic surgery, the cancer is removed layer by layer, and each layer is examined under a microscope. Mohs micrographic surgery offers high cure rates for basal cell carcinoma by allowing examination of 100% of the surgical margins in real-time, which helps minimize tissue removal and improve cosmetic outcomes. This process is continued until no abnormal cells remain.

Other Treatments

Cryosurgery

Liquid nitrogen is used to freeze cancer cells. This is often an option for treating more superficial skin lesions.

Curettage and Electrodesiccation

This treatment involves removing the surface of the skin cancer using a special instrument called a curet. The base of the cancer is then seared with an electric needle. This technique is used for treating small basal cell carcinomas that are less likely to return.

Topical Treatments

Sometimes prescription creams are considered for treating small and thin basal cell carcinomas.

Superficial Radiation Therapy

This treatment uses superficial radiation that only goes skin deep to kill and effectively remove the targeted cancer cells.  It is a good choice for patients who are older, on blood thinners, suffer from other medical issues, or have lesions on areas of the body that would be difficult to repair. SRT has a cure rate of 95%. Dr. Erwin offers this treatment in her office in partnership with SkinCure. 

Candidates for Basal Cell Carcinoma Treatment

Anyone who has the signs or symptoms of basal cell carcinoma or those who have been diagnosed with basal cell carcinoma can benefit from treatment. It is important that you be seen by a dermatologist if you have seen changes in the appearance of your skin, such as a change in a previous growth or a new growth.

The best way to determine which treatment option is best for you is through a consultation appointment with our skilled dermatologist, Dr. Erwin. During this appointment, she will examine your skin and may take a skin biopsy in order to reveal whether or not skin cancer is present, and if so, what type of skin cancer.

Contact Us Today

To learn more about basal cell skin cancer and possible treatment options, contact our office today by calling 979-543-9933! We will be happy to answer any questions that you may have, as well as assist you in scheduling your initial consultation appointment.