Basal Cell Carcinoma: Causes, Symptoms, and Treatment

Basal cell carcinoma (BCC) is the most common form of skin cancer, developing from basal keratinocytes located in the epidermis. BCC rarely spreads but can cause significant tissue damage if untreated. It accounts for about 75% of all non-melanoma skin cancers and primarily affects areas exposed to the sun, such as the face, neck, and arms.

How Does Basal Cell Carcinoma Differ From Other Keratinocyte Cancers?

Keratinocyte cancers include both BCC and SCC; actinic keratosis is a common precancerous condition that can progress to SCC.

What Are the Main Causes of Basal Cell Carcinoma?

The primary cause of basal cell skin cancer is chronic ultraviolet (UV) radiation exposure from sunlight or tanning beds. Other risk factors include:

• Fair skin, light eyes, or red/blond hair
• Age over 50
• Personal or family history of skin cancer
• Immune suppression (e.g., organ transplant recipients)
• Exposure to radiation or arsenic

UV rays damage DNA in skin cells, leading to abnormal growth of basal cells.

What Are the Symptoms of Basal Cell Carcinoma?

Typical symptoms include:

• Pearly or waxy bumps, often pink or flesh-colored
• Open sores that don’t heal or bleed easily
• Reddish, irritated patches or shiny scar-like areas
• Rolled, raised borders on skin lesions

BCCs may appear anywhere but are most common on sun-exposed regions. Subtypes, such as nodular, superficial, or morphoeic BCC, can slightly alter presentation.

How Is Basal Cell Carcinoma Diagnosed?

Diagnosis involves:

1. Visual skin exam by a doctor or dermatologist
2. Skin biopsy to confirm cell type and BCC subtype

A biopsy is essential to rule out other types of skin cancer and decide the best treatment approach.

What Are the Treatment Options for Basal Cell Carcinoma?

Treatment is highly effective, with most BCCs curable if found early:

1. Surgical excision: Removal of tumor with clear margins (including Mohs micrographic surgery for high-risk or facial sites)
2. Electrodesiccation and curettage: Scraping and cauterizing the tumor
3. Topical therapies: Creams or gels for superficial BCCs (e.g., imiquimod)
4. Radiation therapy: For patients unsuitable for surgery
5. Targeted therapy/Immunotherapy: For advanced or recurrent BCC

What Are Keratinocyte Cancers and Why Are They Important?

Keratinocyte cancer is a term for BCC and SCC, the most common skin cancers worldwide. They outnumber melanoma cases and, left untreated, can cause significant health problems, even death (notably from SCC).

Are There Ways to Prevent Basal Cell and Other Keratinocyte Skin Cancers?

• Use broad-spectrum sunscreen (SPF 30+)
• Wear protective clothing and hats outside
• Limit sun exposure, especially midday
• Avoid tanning beds
• Perform regular skin self-exams
• Schedule annual skin checks if high risk

What Should I Do If I Notice a Suspicious Skin Spot?

1. Monitor: Note changes in size, shape, or color.
2. Photograph: Take clear photos to track progression.
3. Schedule Dermatologist Visit: Early medical evaluation is key.
4. Follow Recommendations: If a biopsy is advised, get it done promptly.
5. Adhere to Treatment Plan: Follow through with prescribed therapy.