Basal Cell Carcinoma (BCC)

Basal cell carcinoma (BCC) is a type of skin cancer. It is the most common form of any cancer diagnosed in the U.S. and accounts for the majority of all skin cancers.

BCC appears on areas of the body that have had the most sun exposure. This includes the face, ears, scalp, back of the neck, and back of the arms and hands.

Types of Basal Cell Carcinoma

There are three subtypes of basal cell carcinoma:

1) Superficial—This type of BCC is usually seen on the trunk or extremities. It appears as a reddish spot or patch with a fine scale on the top. It can appear like a small patch of psoriasis. It can occasionally appear with a small erosion on the surface.

2) Nodular—This is the most common type of BCC. It appears as a waxy or translucent nodule that may have fine blood vessels (capillaries) on its surface. The center may ulcerate, creating a sore that never completely heals. They may occasionally be pigmented like a mole (nevi).

3) Sclerosing or morpheaform—This type of BCC appears like a scar with poorly defined (blurry) borders. It is usually flat with a thinning of the skin.

Basal Cell Carcinoma Treatment Options

There are several treatment options available for BCC. Cure rates for most modes of therapy are excellent for BCCs.

Your doctor will recommend a treatment based on the type of BCC, its size, shape, and location. Your doctor will also take into account your medical history, response to any previous treatments and personal preferences.

Procedures to Treat BCC

Your doctor may choose to remove BCC using one of the following dermatological procedures:

  • ExcisionThe cancer is cut away with a scalpel and the wound is closed with sutures.
  • Mohs SurgeryMohs Surgery is a precise method for removing cancerous tissue, while sparing the greatest amount of healthy tissue. Mohs Surgery is usually recommended for skin cancer removal in anatomic areas where maximum preservation of healthy tissue is desirable for cosmetic and functional reasons, such as the face, neck or hands.
  • Photodynamic therapy. Photodynamic therapy (PDT) is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells. For skin cancer, laser light is shined onto the skin and the drug becomes active and kills the cancer cells. Photodynamic therapy causes little damage to healthy tissue.

Treatment of recurrent BCC usually requires Mohs micrographic surgery.

Medications to Treat BCC

In some cases, your doctor may prescribe a medication to treat BCC. Some of these may be used in combination with a surgical procedure, such as Mohs surgery, to improve outcomes. Medications include the following:

  • 5-fluorouracil, or 5-FU (Efudex®, Carac®)
  • Imiquimod cream (Zyclara®). Topical imiquimod therapy (a cream applied to the skin) may be used to treat some small basal cell carcinomas.
  • Vismodegib (Erivedge®). Vismodegib is a prescription medicine used to treat adults with BCCs that have come back after surgery or that your healthcare provider decides cannot be treated with surgery or radiation.

Prevention of Basal Cell Carcinoma

Because BCC can resemble other skin conditions, tell your doctor about unusual skin changes or lesions, especially these:

  • A sore that comes and goes but never completely heals
  • A shiny bump or nodule, especially if it appears pearly or translucent (these can look brown or reddish and resemble a mole)
  • A slightly raised pink growth with a crusted depression in the center, possibly with tiny blood vessels (capillaries) visible on the surface
  • A patch of skin that is red or irritated, especially on the chest, shoulders, or limbs
  • A white or yellow-ish waxy scar with poorly defined borders