Basal Cell Carcinoma

What is Basal Cell Carcinoma?

Basal cell carcinoma (BCC) is the most common type of skin cancer, which develops in the top layer of the skin (epidermis). They usually grow slowly, and they rarely spread to other parts of the body.

Basal cell carcinomas can occur anywhere on the body but are most common in areas that are exposed to the sun such as your face, head, neck, and ears.

If left untreated, Basal cell carcinomas will continue to grow and can eventually cause an ulcer; hence they can have the name ‘rodent ulcer’. They can start to destroy surrounding skin if they are left to continue to enlarge over time.

Most Basal cell carcinomas are painless, although sometimes they can be itchy or bleed.

What does Basal cell carcinoma look like?

Basal cell carcinomas can vary in their appearance.

  • They are often first noticed as a scab that bleeds and does not heal completely or a new lump on the skin. Basal cell carcinomas can develop as a nodule that progressively and slowly enlarges.
  • Some Basal cell carcinomas are superficial and look like a scaly red flat mark on the skin.
  • Others form a lump and have a pearl-like rim surrounding a central crater and there may be small red blood vessels present across the surface.
  • Any new lesions need to be shown to a doctor.

What causes Basal Cell Carcinoma?

Although the cause is not fully understood, those with the highest risk of developing a Basal cell carcinoma are:

  • People with pale skin who burn easily and rarely tan (generally with light coloured or red hair, although some may have dark hair but still have fair skin).
  • Those that have had a lot of exposure to the sun, such as people with outdoor hobbies or outdoor workers, and people who have lived in sunny climates.
  • People who have used sunbeds or have regularly sunbathed.

What types of treatment are used?

Most Basal cell carcinomas are removed surgically, and the lesion is sent to the lab, to be examined under the microscope. It may take two to three weeks for the results of the biopsy to be sent back to the consultant.

Occasionally it is necessary to repair the area with a skin graft or other types of plastic surgery.

Some very superficial lesions can be treated with topical creams.

If all the cancer has been completely removed or treated, you should view yourself as ‘cured’. If no further treatment is required, you may be informed by letter, without the need to return to the hospital.

Looking ahead

If you have had one Basal cell carcinoma, new Basal cell carcinomas may sometimes develop over the years.

  • Check your skin monthly for any existing or new skin lumps or moles that enlarge, change colour, bleed, or itch. Most changes are harmless, but they may indicate the start of a new skin cancer. See your General Practitioner if in doubt.
  • Take care whilst in the sun by wearing protective clothing and using high factor sunscreens (SPF 30+).
  • Wearing a hat with a large brim is recommended.
  • Avoid strong sunshine from 11 am to 3 pm. n Avoid using sunbeds.
  • Pass on the message to friends and family about protecting themselves and checking their moles and skin.

© North Bristol NHS Trust. This edition published May 2022. Review due May 2024. NBT002426

Basal Cell Carcinoma