Signs and Symptoms of Basal Cell Carcinomas
There are several subtypes of BCCs, including:
- Superficial BCC
- Nodular BCC
- Pigmented BCC
- Morpheaform (or Sclerosing) BCC
Depending on the subtype, BCCs may show up on the skin in different ways, including:
- A shiny, pink or red, flat, scaling patch (Superficial BCC),
- A dome-shaped, pink, pearly bump with visible blood vessels (Nodular BCC),
- A brown or black skin lesion (Pigmented BCC), or
- A white, waxy scar-like lesion (Morpheaform BCC)
BCCs may also appear as a sore that bleeds easily, does not heal, and/or crusts over. Rarely, BCCs are painful or itchy. In general, however, the main sign of BCCs is just a growth on the skin.
Causes of Basal Cell Carcinomas
BCCs are caused by a mutation in the DNA of your skin cells. This is thought to result from long-term exposure to ultraviolet (UV) radiation from sunlight and tanning bed use.
When you expose your skin to UV rays, these rays damage the DNA of your skin cells. The body attempts to repair this damage. However, with repeated and prolonged exposure to UV rays over many years, the body is no longer able to repair this damage. Consequently, skin cancer develops.
Self-Care for BCCs
Prevention is key! Sun protection can help reduce the development of BCCs.
- Use sunscreen on all exposed skin before going outdoors. Be sure the sunscreen has broad spectrum coverage which blocks both UVA and UVB light, with an SPF of at least 30 or more. Remember to reapply every 2 hours and immediately after swimming or sweating.
- Avoid sun exposure during peak hours (from 10 am to 3 pm).
- Cover up. Wear a broad-brimmed hat and tightly-woven clothing that protects your arms and legs.
- Avoid tanning bed use.
- Perform self-skin exams monthly. Monitor your skin lesions for any changes in size, shape, color, and/or skin symptoms (such as, itching, bleeding, or pain).
Treatments for Basal Cell Carcinomas
If a skin lesion is concerning for a BCC, a skin biopsy will first be performed to establish a correct diagnosis. A skin biopsy consists of removing a small sample of skin. Then, this skin sample is subsequently examined under the microscope to determine the diagnosis.
There are several possible techniques to treat BCCs, including:
- Surgical Excision – This involves cutting out any residual skin cancer as well as some healthy tissue around the skin cancer.
- Curettage and electrodessication – This is a two-step treatment that consists of 1) scraping away the skin cancer, and 2) destroying any remaining cancer cells with an electrical current.
- Mohs surgery – Named for the doctor who developed this surgery, Mohs surgery is a specialized surgical technique that offers the highest cure rate for difficult-to-treat BCCs. See Mohs Surgery for more info.
- Cryosurgery – This uses liquid nitrogen to destroy the cancer cells.
- Radiation – This treatment is reserved for BCCs that cannot be cut out or patients who are not good surgical candidates.
- Prescription topical creams – Topicals, such as imiquimod (Aldara) or 5-fluorouracil (Efudex), can be used to treat early, superficial BCCs.
- Prescription oral medications: In rare circumstances where a patient has numerous BCCs, has a BCCs that cannot be cut out, or has BCCs that has spread to other body parts, the medications vismodegib (Erivedge) or sonidegib (Odomzo) may be prescribed.
If you are interested in learning more about treatment options for your Basal Cell Carcinoma, please call Heller Dermatology & Aesthetic Surgery to schedule your appointment!