Basal cell carcinoma strikes the basal cells in our skin’s top layer — that’s how it gets its name. It’s the most common type of skin cancer. According to the American Cancer Society (ACS), it affects about 2.6 million people in the U.S. every year.
If basal cell carcinoma is detected early, odds are good that it’s easily treatable and it can be cured. “If it’s small, we can usually take care of it right there in the office,” said Dr. Amy McMichael, chair of the dermatology department at Wake Forest Baptist Health in North Carolina and a member of the American Academy of Dermatology.
The Skin Cancer Foundation (SCF) recommends an annual skin exam by a dermatologist, and you may need more frequent screening if you are at higher risk.
More advanced tumors can still be treated, but the procedures are more complex. The SCF reports that basal cell carcinoma is rarely deadly.
Symptoms of basal cell carcinoma
You need to watch for changes in your skin to spot basal cell carcinoma — tumors typically don’t show signs like pain, itching or bleeding until they’ve been progressing for a while.
This type of cancer is much more common in people who have light skin. “One of the things that’s tricky about basal cell carcinoma is that it can show up as skin-colored or pink,” said Dr. Ivy Lee, a board-certified dermatologist with Pasadena Premier Dermatology in California and a member of the American Academy of Dermatology. “A lot of patients mistake them as warts or witch’s moles.”
According to the ACS, you should watch for:
- Scar-like flat, firm areas
- Raised reddish patches
- Small, shiny bumps that could be pink or red
- Pink growths with a sunken center
- Open sores that don’t heal properly
Causes of basal cell carcinoma
The top cause of basal cell carcinoma is exposure to ultraviolet rays from indoor tanning or from the sun. According to the Skin Cancer Foundation (SCF), if you’ve ever tanned indoors you have a 69% increased risk of developing basal cell skin cancer before age 40.
And the more time you spend under the sun’s rays, the higher your risk. McMichael said, “I have patients tell me all the time, ‘I don’t lay outside.’ It doesn’t matter what you’re doing outside. If you’re playing golf or gardening you need a hat, sunscreen and sun-protective clothing.”
McMichael is concerned that with COVID-19, people are spending a lot more time outdoors without protecting their skin. “We’re going to come out of this pandemic with a whole lot more skin cancer,” she said.
Diagnosing basal cell carcinoma
To diagnose basal cell carcinoma your dermatologist will ask about your symptoms, risk factors, family history and other skin conditions and might also look at the suspect area with a dermatoscope — a lighted magnifying lens.
If it looks suspicious, your doctor might remove it and send it to a lab. For basal cell carcinoma, it’s likely that the whole tumor will be removed as part of this skin biopsy.
Treatment for basal cell carcinoma
With this type of skin cancer, if your dermatologist removes the tumor for biopsy, you probably won’t need any further basal cell carcinoma treatments.
If your tumor is large, or is on your face (like if you have a basal cell carcinoma on the nose), neck or ears, your doctor will probably recommend treating basal carcinoma with Mohs surgery, which is a procedure that’s designed to leave the smallest possible scar.
Either way, you’ll need to keep a close watch on your skin — McMichael said that once you’ve had this type of tumor, you’re at higher risk of getting another one in the next three years.
You can reduce your risk of basal cell carcinoma by avoiding indoor tanning and limiting your sun exposure.
The SCF recommends that you:
- Cover up with clothing
- Stay in the shade, especially between 10 a.m. and 4 p.m.
- Use a broad-spectrum sunscreen with SPF of 15 or higher every day
- Use a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher if you’re going to be out in the sun for a while