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Basal Cell Carcinomas PDF Print
Basal cell carcinoma is the most common form of skin cancer worldwide. In the majority of cases, it is thought to be caused by exposure to the harmful ultraviolet (UV) rays of the sun. Basal cell carcinoma is becoming more common, perhaps because people may be spending more time outdoors and the decrease in the ozone layer may be allowing more UV radiation from the sun to reach the earth's surface. Basal cell carcinoma does not usually metastasize or spread in the bloodstream to other organs; rather, it infiltrates the surrounding area destroying tissue. For this reason, basal cell carcinomas should be treated promptly by a dermatologist.

What do basal cell carcinomas look like?   

Basal cell carcinomas appear most often on sun-­exposed areas such as the face, scalp, ears, chest, back, and legs. These tumors can have several different forms. The most common appearance of basal cell carcinoma is a small, dome-shaped pimple-like growth that has a pearly color. Blood vessels may be seen on the surface. A basal cell carcinoma can also appear as a sore that seems to heal but recurs repeatedly. Superficial basal cell carcinomas, a very early form, may appear as shiny, pinkish patches on the skin. A less common form, morpheaform, looks like a smooth white or yellowish waxy scar.

What are the consequences of basal cell carcinomas?

  Basal cell carcinomas usually do not metastasize; however, they do not spontaneously go away. This is a cancer which will continue to grow locally, bleed, and destroy tissue unless treated. If the skin cancer is located near organs such as the eyes, ears, and nose, or is growing near a nerve, serious problems can arise; therefore, it should be treated promptly.


Any lesion or sore that does not heal should be evaluated by a dermatologist who will examine it and decide whether to perform a biopsy. A biopsy is a simple procedure done in the office under local anesthesia to obtain a small amount of tissue for a microscopic examination. In some cases, the dermatologist may choose to perform the biopsy and treat the skin cancer at the same time.


The dermatologist will discuss the various surgical and non-surgical options available.
Simple surgical excision - removal by cutting out the cancer; the skin is sewn together using cosmetic dermatologic surgical techniques. The specimen is examined under a microscope after the procedure to determine that all the skin cancer has been removed.   
Electrodesiccation and curettage - removal by scraping or "curetting"; the base is burned or "cauterized" with an electric needle.

Cryosurgery - removal by freezing the tissue with liquid nitrogen. 

Radiation therapy (x-ray), and laser surgery (using wavelengths of light) - removal by destroying the cancerous tissue.

Topical Therapy - medications such as imiquimod and 5-fluorouracil applied to the skin; especially useful to treat superficial basal cell carcinoma.

micrographic controlled surgery (a specialized technique) - performed by a specially trained dermatologic surgeon, this method is valuable in certain situations. The skin cancer is removed under local anesthesia in an office setting and microscopic sections are examined during the procedure. Additional layers are taken until the cancer is completely excised. The advantage of this technique is that a minimum amount of tissue is removed and carefully studied. This method has a high cure rate but is not required for all skin cancers. Recurrent skin cancers (skin cancers that were previously treated and have returned), incompletely removed skin cancers, large skin cancers, and skin cancers in cosmetically important areas like eyes, ears and nose, may benefit from the Mohs technique. After the cancer has been removed using this method, it may be allowed to heal naturally, or reconstructive surgery, using a skin flap or skin graft, may be performed.

Will there be a scar?

 Because the vast majority of skin cancers occur on the face, many patients are understandably concerned about the cosmetic outcome. If the skin cancer is small, conservative methods usually produce an excellent cosmetic result. If the skin cancer requires more specialized treatment such as Mobs surgery, reconstructive options are available that, in most cases, result in an excellent cosmetic outcome. Irniquirnod, a topical medication, may belp decrease scarring.

Follow Up   

 Studies show that a person who develops a basal cell carcinoma has a 40 percent risk of getting a second basal cell carcinoma within five years. It is important to monitor and keep follow-up appointments with a dermatologist. Be alert to any non-healing sores and other changes that develop on the skin. Use sunscreen and follow a good sun-protection regime.


   Individuals who have had multiple basal cell carcinomas or other skin cancers, such as squamous cell carcinoma, are at an increased risk for developing melanoma. 11 is also important to know that basal cell carcinoma does not turn into melanoma. People should do self-examinations regularly and have a full body skin examination at least once a year to check for abnormal moles or lesions.


Because basal cell carcinoma is frequently caused by UY radiation from the sun, proper sun protection may help in prevention. Sun protection in children is especially important.

   ·     Seek shade when appropriate, remembering that the ultraviolet rays are the most intense between 10:00 a.m. and 4:00 p.m.

   ·     Wear light-colored, tightly woven, protective clothing like long sleeves and pants, a wide ­brimmed hat and sunglasses.

   ·      Apply a broad-spectrum sunscreen that protects against both UYA and UYB rays with a SPF (Sun Protection Factor) of at least 15.

   ·     Reapply sunscreen every two hours when in the sun and even on cloudy days.