Basal cell skin cancer begins in the basal cell layer of the skin. It usually occurs in places that have been in the sun.
For example, the face is the most common place to find basal cell skin cancer. In people with fair skin, basal cell skin cancer is the most common type of skin cancer.
You are more likely to get basal cell cancer if you have:
- Light-colored or freckled skin
- Blue, green, or grey eyes
- Blond or red hair
- Overexposure to x-rays or other forms of radiation
- Many moles
- Close relatives who have or had skin cancer
- Many severe sunburns early in life
- Long-term daily sun exposure (such as the sun exposure received by people who work outside)
The top layer of the skin is called the epidermis. The bottom layer of the epidermis is the basal cell layer. With basal cancer, cells in this layer are the ones that become cancerous. Most basal cell cancers occur on skin that is regularly exposed to sunlight or other ultraviolet radiation.
This type of skin cancer is most common in people over age 40. But it can also occur in younger people who have had extensive sun exposure.
Basal cell cancer grows slowly and is usually painless. It may not look that different from your normal skin.
You may have a skin bump or growth that is:
- Pearly or waxy
- White or light pink
- Flesh-colored or brown
- A red, scaly patch of skin
In some cases, the skin is just slightly raised, or even flat.
You may have:
- A skin sore that bleeds easily
- A sore that does not heal
- Oozing or crusting spots in a sore
- A scar-like sore without having injured the area
- Irregular blood vessels in or around the spot
- A sore with a depressed (sunken) area in the middle
Your doctor will check your skin and look at the size, shape, color, and texture of any suspicious areas.
If your doctor thinks you might have skin cancer, a piece of skin will be removed. This is called a skin biopsy. The sample is sent to a lab for examination under a microscope.
A skin biopsy must be done to confirm basal cell cancer or other skin cancers.
Treatment depends on the size, depth, and location of the skin cancer, and your overall health.
Treatment may involve any of the following:
- Excision: Cutting out the skin cancer and stitching the skin together
- Curettage and electrodessication: Scraping away cancer cells and using electricity to kill any that remain; used to treat cancers that are not large or deep
- Cryosurgery: Freezing the cancer cells, which kills them; used to treat cancers that are not large or deep
- Medication: Skin creams that have medicine; used to treat cancers that are not large or deep
- Mohs surgery: Removing a layer of skin and looking at it immediately under a microscope, then removing layers of skin until there are no signs of the cancer; usually used for skin cancers on the nose, ears, and other areas of the face
- Photodynamic therapy: Treatment using light; used to treat cancers that are not large or deep
- Radiation: May be used if a basal cell cancer cannot be treated with surgery
- Chemotherapy: May be used to treat basal cell cancer that has spread to other parts of the body or that cannot be treated with surgery
Most of these cancers are cured when treated early. Some basal cell cancers return. Smaller ones are less likely to come back.
Basal cell skin cancer almost never spreads. If it is left untreated, it may spread into surrounding areas and nearby tissues and bone. In these cases, treatment can injure the appearance of the skin.