Patient Education

If you’ve been diagnosed with basal cell carcinoma, you are not alone. BCC is the most common form of skin cancer. Each year, millions of cases of BCC are diagnosed in the United States. BCC is highly treatable when detected early.

WHAT DOES BCC LOOK LIKE?

BCC appears on the skin in many shapes and sizes. You may see a:

• Dome-shaped growth with visible blood vessels.
• Shiny, pinkish patch.
• Sore that heals and then returns, often more than once.
• Brown or blackgrowth.
• White or yellow waxy growth that looks like a scar.

Most BCCs develop on skin that gets repeated sun exposure, such as the head, neck and hands. BCC is especially common on the face, often forming on the nose, cheeks and forehead. However, BCC can develop anywhere on the body.

Basal cell carcinoma

WHO GETS BCC?

People of all skin colors can get BCC, although it is much more common in people with lighter skin.

The sun’s ultraviolet rays damage your skin.

Your risk of developing skin cancer increases as this damage accumulates.

Your everyday activities — such as going outdoors during the day without sun protection, driving your car or sitting near your office window — expose you to UV rays. Using indoor tanning beds also exposes your skin to dangerous UV radiation.

There are some people who have a higher risk of getting BCC. For example, your risk increases with age. The older you are, the longer you have been exposed to the sun’s harmful UV rays.

People also may have a higher risk of developing BCC if they have:

• Pale, light-colored or freckled skin.
• Blond or red hair.
• Blue, green or gray eyes.
• A family history of skin cancer.
• A weakened immune system (due to disease, organ transplant or medications).
• Used tanning beds or other indoor tanning devices.
• Gorlin syndrome, an inherited condition that increases a person’s risk of BCC, as well as other medical issues.

IS BCC SERIOUS?

While BCC rarely spreads to other areas of the body, treatment is important. Over time, BCC can grow wide and deep, destroying skin tissue, wrapping around nerves and invading muscle or bone.

WHAT ARE THE TREATMENT OPTIONS FOR BCC?

When detected early, BCC is highly treatable.

Proper treatment begins with the right diagnosis. To diagnose BCC, a dermatologist performs a skin biopsy. This is the only way to confirm a diagnosis of skin cancer, including BCC. Your dermatologist can perform a biopsy using local anesthesia during an office visit.

To perform a biopsy, your dermatologist will remove the entire suspected BCC, or a part of it, for examination under a microscope.

If you are diagnosed with BCC, your dermatologist will consider many factors to determine the best treatment for you, including where the BCC appears on your body, the size and features of the BCC, and your overall health.

Treatment for BCC typically involves one or more of the following:

Excision. This is a surgical procedure. Your dermatologist can perform this during an office visit, using local anesthesia. Excision involves removing the BCC and some normal-looking skin. You may need stitches to repair the wound.

The BCC and surrounding skin that your dermatologist removes will be examined under a microscope to ensure that the cancer has been completely removed. If the cancer has not been completely removed, you may need another excision later.

Mohs surgery. Mohs surgery is usually performed in a medical office under local anesthesia while you remain awake. Your dermatologist may be a Mohs surgeon or may refer you to a dermatology colleague who has received specialized training to become a Mohs surgeon.

During the surgery, the Mohs surgeon first removes the BCC and some normal-looking surrounding skin around and below it.

While you wait, the surgeon uses a microscope to look at what was removed. If the surgeon sees cancer cells, he or she will continue to remove layers of skin and examine them under the microscope. This process continues until cancer cells are no longer seen. You may require stitches or another procedure to repair the wound.

Electrodesiccation and curettage. This treatment removes the cancer by first scraping (curetting) the growth from the skin and then heating the treated area to destroy any remaining cancer cells.

In general, excision, Mohs surgery, and electrodesiccation and curettage are the most effective treatments for BCC. However, if surgery is not possible or preferred, the following treatments may be considered:

Radiation. This type of therapy involves a series of radiation treatments that destroy the cancer cells. Radiation may be recommended when a patient cannot undergo surgery to remove the cancer, when more aggressive cancers require additional treatment following surgery or when surgery may not be the best choice.

Cryosurgery. This treatment destroys the cancer cells by freezing them with liquid nitrogen.

Photodynamic therapy. Some early BCCs can be destroyed with this light treatment. PDT is a two-step process. First, a chemical is applied to the skin and remains on the skin for some time so that it can be absorbed. Then the skin is exposed to a special light to kill the cancer cells.

Topical therapy. When BCC is caught early, a dermatologist may prescribe medicine that you can apply to your skin at home to destroy the cancer cells.

Oral medication. This type of medicine may be prescribed for patients who have advanced BCC that cannot be cut out or treated with radiation, or in rare cases when BCC has spread to other parts of the body.

Basal cell carcinoma

HOW CAN I REDUCE MY RISK OF SKIN CANCER?

People who have been diagnosed with BCC are at increased risk for the development of future skin cancers, including melanoma. The following can help you detect and prevent new skin cancers:

• Keep all appointments with your dermatologist. When detected early, skin cancer is highly treatable.
• Perform skin self-exams. Examine your skin as often as your dermatologist recommends. Be sure to check your scalp, ears, genitals and buttocks.
• If you notice any new or suspicious spots on your skin, or anything changing, itching or bleeding, make an appointment to see your dermatologist. Tell the person who schedules the appointment why you want to see your dermatologist.
• Protect your skin every day by:
  • Seeking shade. Shade is especially important between 10 a.m. and 2 p.m., when the sun’s rays are strongest. If your shadow appears to be shorter than you are, seek shade.
  • Dressing to protect yourself from the sun by wearing a lightweight long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, when possible.
  • Applying a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. Broad-spectrum sunscreen provides protection from both UVA and UVB rays.
    • Use sunscreen whenever you are going to be outside, even on cloudy days.
    • Apply enough sunscreen to cover all exposed skin. Most adults need about 1 ounce — or enough to fill a shot glass — to fully cover their body.
    • Don’t forget to apply to the tops of your feet, your neck, your ears and the top of your head
    • Reapplying sunscreen every two hours when outdoors, or after swimming or sweating.
  • Using extra caution near water, snow and sand. These reflect and intensify the damaging rays of the sun.
• Avoid tanning — both indoors and out.

UV light from the sun and tanning beds can cause skin cancer and premature skin aging. If you want to look tan, consider using a self-tanning product but continue to use sunscreen with it.

A board-certified dermatologist is a medical doctor who specializes in the diagnosis and medical, surgical and cosmetic treatment of skin, hair and nail conditions. To learn more about BCC or to find a board-certified dermatologist in your area, visit aad.org/BCC or call toll-free (888) 462-DERM (3376).

Visit the SPOT Skin Cancer® website — SpotSkinCancer.org — to learn how to perform a skin self-exam, download a body mole map for tracking changes on your skin and find free skin cancer screenings in your area. Those affected by skin cancer can also share their story via the website and download free materials to educate others in their community.

All content solely developed by the American Academy of Dermatology.

Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology P.O. Box 1968, Des Plaines, Illinois 60017

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