At Cumberland Skin, our dermatologists are very familiar with all skin cancers and how to…
Did you know that basal cell carcinoma (BCC) is the most common type of skin cancer, with over 4 million new cases diagnosed in the United States each year? Luckily, BCCs usually grow slowly and, with early treatment, they’re often curable. This month, we’re taking an in-depth look at basal cell carcinoma to learn the signs and symptoms, treatments, and easy ways to prevent it.
What is basal cell carcinoma?
There are three layers in the skin, the epidermis, dermis, and subcutis. Basal cells are one part of the epidermis, which is the topmost layer of skin. They’re below the squamous cells and, in fact, they naturally reproduce at a high rate to replace squamous cells that shed from the skin’s surface. As basal cells move up in the epidermis, they flatten to become squamous cells.
Basal cell carcinoma is a condition where the basal cells begin to replicate out of control, which causes a tumor. Usually, BCC develops on skin that’s been exposed to UV radiation from the sun or tanning beds, such as the face, ears, forearms, hands, and lips.
It’s rare for basal cell carcinoma to spread to other parts of the body, but if left untreated, it can grow deep into the bone and nearby tissue. With enough time, tumors can be disfiguring and deadly.
Basal cell carcinoma risk factors
A risk factor is something that increases a person’s chances of developing a certain kind of cancer. Having several risk factors does not guarantee that a person will get BCC, nor does a complete absence of risk factors mean that a person cannot get skin cancer. Some BCC risk factors are:
- Total lifetime exposure to UV rays – The more time you spend in the sun or tanning beds, the greater your chances of experiencing cellular damage that can lead to cancer.
- Fair skin that freckles and burns easily – Though people with fair skin are at a greater risk, people of all skin tones can develop skin cancer.
- Previous skin cancer – After developing basal or squamous cell carcinoma, your chances of developing it again are higher. Also, BCCs on the nose, ears, and lips are more likely to recur within two years of treatment.
- Having a weakened immune system – Your immune system helps fight off cancers of all kinds, so having other illnesses that compromise your immune system raises the chances of developing BCC.
Warning signs of basal cell carcinoma
BCCs are common on the neck, face, shoulders, back, and ears, but they can occur anywhere on the body. Be on the lookout for the following warning signs and symptoms:
- An open sore that won’t heal, and that crusts or bleeds. It may heal and then return.
- Red, scaly patch of skin that may crust, itch, and hurt. In some people, though, these patches may not cause any discomfort.
- A shiny bump or node on the skin.
- A small raised growth with an indentation in the center.
- Scar-like skin that isn’t from a known injury. The skin is often pulled taut with irregular edges.
One of the biggest challenges with BCC tumors is that they can take many different forms. They may even mimic chronic skin disorders like psoriasis and eczema. Other times, a person may have no visible symptoms until they cut themselves shaving and it doesn’t heal.
The best thing that you can do is schedule an appointment with a dermatologist as soon as you notice a change in your skin that you can’t explain.
If you’ve had a previous BCC, keep an eye on the area where it occurred, as another BCC can recur there or nearby. Performing a monthly skin cancer self-exam is a great way to find changes in your skin. You should also schedule an annual skin cancer checkup with your dermatologist, who is highly trained in finding changes that the average person can overlook.
Treatments for basal cell carcinoma
With early detection and treatment, BCCs are highly curable through a variety of excellent treatments. Some of the most common ways to treat basal cell carcinomas are:
Many basal and squamous cell cancers begin as a scaly, red precancer called actinic keratosis (AK). Not all AKs develop into skin cancer, but many people like to treat them before they have a chance to become cancer. During a chemical peel, a dermatologist will apply a thin layer of acid over the affected area. In the days following the treatment, the top layer of skin will slough off, removing the precancerous AK.
Topical chemotherapy creams
For BCCs that have not spread beyond the surface of the skin, a chemotherapy ointment may be a great option. When applied to the skin, the topical medication will destroy a tumor on the surface. It’s a great option for widespread AKs or very superficial cancers, but it does not penetrate into the skin to heal deeper cancers.
Another effective treatment for superficial BCCs is cryosurgery. During the procedure, a dermatologist will apply liquid nitrogen to the lesion, freezing and destroying any remaining cancer to reveal healthy skin. It’s a suitable treatment for AKs and superficial, small BCCs. It is not the ideal treatment for skin cancers in cosmetically sensitive locations, like the face, because it can leave a scar as it heals.
Curettage and electrodessication
In this treatment, a dermatologist uses a spoon-like instrument called a curette to remove the tumor. Then, they will use heat to stop the bleeding and destroy any remaining cancer cells. It’s an effective treatment with cure rates up to 95%. However, it will leave a scar, so it’s not usually used on places like the face.
During an excision procedure, the dermatologist will numb the treatment area and remove the basal cell tumor, plus a safety margin of healthy-looking skin around the tumor. They will send the tissue to an off-site lab for testing to be sure that they removed all of the cancer. If the lab results come back showing that some cancer cells remain, then the patient will need another round of excision surgery at a later date.
Mohs surgery is the gold standard in skin cancer treatment. It’s similar to excision, but the Mohs surgeon is trained in both skin cancer removal and lab analysis, so the treatment occurs in one visit with multiple stages.
During the treatment, the physician will remove the tumor and bandage the wound. While the patient waits in the office, the surgeon will test the tissue in an on-site lab and will create a precise map of where cancer cells remain. The surgeon will return to the patient and remove tissue only in the areas specified on the map, retest, and remove more tissue as necessary until all of the cancer is gone.
Mohs is an outstanding option for cosmetically sensitive areas because it preserves more healthy tissue than any other treatment. It also has the highest cure rate of any skin cancer treatment.
Preventing basal cell carcinoma
The best way to prevent basal cell carcinoma is to protect your skin from UV damage. Whether it’s cloudy or not, you should wear sunscreen daily with an SPF of 30 or more. Wear clothing that covers your skin when you’ll be outdoors for a long time and try to avoid being out between 10 a.m. and 4 p.m. when the sun’s rays are the strongest.
Early detection and treatment are the keys to a great prognosis after a basal cell carcinoma diagnosis. If you notice anything suspicious on your body, schedule an appointment with the skin cancer experts at Cumberland Skin right away.