Basal Cell Carcinoma

Basal cell carcinoma develops in the outermost layer of the skin, affecting the cells responsible for creating new skin cells at the base of the epidermis. Basal cell carcinoma is unlikely to be deadly, but can eventually cover a wide area of the skin, causing lasting damage and disfigurement. When left untreated, it can spread into surrounding bone and tissue, so it is important to have it diagnosed and treated as soon as possible.

People with fairer skin have a higher risk of getting basal cell carcinoma. Exposure to ultraviolet (UV) light is the main risk factor. Basal cell carcinoma usually results from many years of intense or extensive exposure to the sun or artificial sources of UV light, such as tanning beds. This radiation harms the DNA of skin cells, causing them to grow abnormally and uncontrollably.

Primary risk factors for basal cell carcinoma include:

• long-term UV light exposure
• very fair skin that freckles and burns easily
• light hair and eyes
• being an older adult
• being a man
• a family history of skin cancer
• a weakened immune system
• radiation treatment
• exposure to some chemicals
• severe or chronic skin injury or inflammation

Basal cell carcinoma grows slowly and typically appears on sun-exposed areas of the skin, such as the head, neck, arms, legs, and torso. In some cases, however, it might occur in areas that aren’t normally exposed to sunlight.

Patients may notice a small, “pimple-like” lesion or scaly patch that doesn’t go away after several months or years, and progressively increases in size.

The appearance of these marks can vary depending on the person. You may notice:

• a rounded flesh-colored or pink bump with blood vessels in it
• pink, brown, pearly-white, or black coloring
• shiny, scaly, hard, or waxy skin growths
• crusty, fragile skin that bleeds easily
• marks with a slightly raised appearance, rolled edges, and an indentation at the center

To reduce the chance of basal cell carcinoma, sun protection is most important. Try to avoid going out into the sun at the time of the day when the rays are most intense, wear broad-spectrum sunscreen with an SPF of 30 or higher throughout the year, wear protective clothing, and regularly check your skin all over so you can notice any changes.

There are various treatments available from our Bryn Mawr Skin & Cancer Institute physicians. Our dermatologists will start by discussing your medical history, examining any suspicious lesions you have noticed and performing a total body skin cancer exam. If any lesion is suspicious for cancer, a skin biopsy will be done.

The most suitable treatment option for you depends on the size of the lesion, where it is located, and the potential risk for scarring.

The comprehensive treatments we provide include Mohs surgery, excisional surgery, electrodessication and curettage, cryosurgery, and prescription topical medications.

Beyond basal cell carcinoma, the Bryn Mawr Skin & Cancer team is also qualified and experienced in diagnosing and treating the more aggressive squamous cell carcinoma, as well as melanoma.