Basal Cell Carcinoma

Basal cell carcinoma (BCC): What to know

Unlike melanoma, which usually develops from an existing mole, basal cell carcinoma develops from the basal cells. These are the skin cells that lie at the bottom layer of the epidermis and surround the hair follicles.

Which areas are affected?

Basal cell carcinoma develops in the skin that is most frequently exposed to the sun. Because of this, it is commonly found on the nose, forehead, and cheeks. Though it sometimes develops on the back and lower legs too.

Who is affected by basal cell carcinoma?

Basal cell carcinoma (BCC) can affect people of all ages, but it most commonly affects people who are middle-aged or elderly.

Are there any other names for basal cell carcinoma?

As well as being known as basal cell carcinoma or BCC, this type of cancer is often referred to as basal cell skin cancer. The lesion that develops is also known as a rodent ulcer.

What are the signs and symptoms of this type of cancer?

Basal cell carcinomas usually start as small lumps that gradually get bigger over time. The edges are often shiny or pearly, and the middle tends to be somewhat sunken in or depressed. After some time, the center will start to become crusty and develop into an ulcer. Basal cell carcinomas do not usually cause any pain or discomfort; however, they can be slightly itchy. If they are scratched, they will tend to bleed, but otherwise, they are known to be pain-free.

Is basal cell carcinoma itchy?

What happens to a BCC that is left untreated?

Without treatment, the BCC will grow in size, getting deeper as well as bigger. The tissue around the area may get infected too, bone tissue and cartilage are often affected if a BCC is not treated. In Australia and Europe, it is unlikely that a rodent ulcer will develop to the stage where it is affecting the tissue around it. This form of skin cancer is usually caught early on in these countries, and treatment has a very high success rate.

Are there a number of different types of BCC?

There are several different types of BCC, but the most common is the nodular type, with around half of diagnosed BCCs being classed as nodular. You can also get superficial, morphotic, and pigmented BCCs.

  • Nodular – single, shiny, red nodules. Often on the face.
  • Superficial – Often multiple, common on back and shoulders. Tend to be larger than 20mm at presentation. Lesions may weep and bleed.
  • Morphotic – Often found on the face. Lesions are aggressive with poorly defined borders and thick yellow plaque. Often very large on presentation.
  • Pigmented – Lesions are brown, blue, or grey. More common in those with darker skin. It can resemble malignant melanoma.

Because several of these types of BCC are rather large on presentation, you must perform regular skin checks. This means you can start treatment as soon as possible. Because basal cell carcinomas occur in the deep layers of the skin, it can take some time for the lesions to present themselves. As they are also painless, it is only when the lesions are visible that we know to seek medical help. By performing regular skin checks and familiarizing yourself with the symptoms of skin cancer, you will be able to act quickly.

How does basal cell carcinoma form?

Can basal cell skin cancer develop into secondary cancer?

It is incredibly rare for basal cell skin cancer to develop into secondary cancer, but it is possible to have several BCCs at any given time. If you have one BCC, the likelihood of you developing another one is higher.

How is basal cell carcinoma diagnosed?

Like any form of skin cancer, the only way for your doctor to establish a diagnosis is through a biopsy. Your doctor will examine the area, and if there is any possibility that the lesions are a result of skin cancer, they will arrange for you to have a biopsy as soon as possible. During a biopsy, the whole growth or part of it will be removed.

How is BCC treated?

If the biopsy shows that you have skin cancer, then you will need to have the growth or lesion removed as a matter of urgency. The most common method for treating BCC is excision. During this procedure, the area is numbed, and then the affected area is cut away, along with some of the healthy-looking skin around it. The tumor and normal skin cells will then be examined. If the normal-looking skin cells are free from cancer cells, then no further treatment will be needed at that time. If the normal-looking skin cells have been affected, then you will need to have another excision.

Other methods of treating BCC include medicated creams, which are used to treat the early stages of basal cell carcinoma. This can be applied at home. Radiation therapy is used in rare cases when surgery is not an option. It often takes 15 to 30 sessions to treat basal cell skin cancer successfully. Cryosurgery is used in some cases, and the use of electricity to kill the cancer cells (electrodesiccation) is also an effective method of treatment.

Mohs surgery is used for difficult-to-treat basal cell skin cancer. It involves the surgeon examining skin cells under the microscope to establish what is healthy skin tissue and what has been infected by cancer cells.


Basal cell carcinoma is very easy to treat and survival rates are high. If BCC is left untreated, then it can soon become destructive, invading other tissues and causing permanent disfigurement. Be sure to perform regular skin checks to keep yourself self from the damaging and destructive elements of basal cell carcinomas.