According to the American Academy of Dermatology, skin cancer is the most common form of cancer in America, and one in five people in the U.S. will develop some form of skin cancer. According to Dr. Jessica Dorsey of U.S. Dermatology Partners in Cedar Park, Texas, “The prevalence of skin cancer in general is on the rise, and basal cell carcinoma (BCC) is no different. It has always been the most common form of skin cancer, but a longitudinal study conducted by the Mayo Clinic in Minnesota comparing skin cancer numbers from 1976-1984 with numbers from 2000-2010 showed a 145% increase in BCC cases. This significant increase in cases indicates just how important it is for us to become more aware of what BCC looks like so we can contact dermatologists or other medical professionals right away for a diagnosis and treatment plan. While the quickly increasing rate of BCC is alarming, the good news is that it continues to have one of the lowest mortality rates among skin cancers, but it’s always essential to begin skin cancer treatment in the earliest stages. For this reason, I’m dedicated to helping people understand the importance of performing regular skin self-exams, but even more importantly, I want to educate people on exactly what they should be looking for and reporting to their dermatologists.” In this blog, Dr. Dorsey explains what BCC is, common symptoms, how it’s diagnosed and treated, and more.
What is Basal Cell Carcinoma (BCC)?
Basal cell carcinoma is often referred to simply as BCC, but you may hear it being called an atypical basalioma or basal cell skin cancer. These terms all refer to the same condition. BCC is a type of skin cancer that develops first in the basal cells of the epidermis. It most often forms on the face, but BCC may develop on other parts of the body. Basal cells make up the foundation of the epidermis, the skin’s outer layer. BCC and another common form of skin cancer, squamous cell carcinoma (SCC), are rarely life-threatening because they almost always remain in the outer layers of the skin and are unlikely to metastasize into other parts of the body. While BCC is unlikely to be life-threatening, the lesions can cause permanent damage or disfigurement if they are allowed to remain without being treated. Like all forms of cancer, BCC is much more likely to damage the body the longer it goes untreated, so early diagnosis and treatment are key.
In addition to a general BCC diagnosis, dermatologists may also assign a variation of the type of BCC to their diagnosis. There are numerous BCC variants, including:
- Superficial – A cluster of cancer cells that have not spread beyond the epidermis. They may protrude from the skin.
- Nodular – A spherical cluster of cancer cells that may protrude from the skin and spread from the epidermis down into the skin’s dermis and collagen layers.
- Morpheaform – This form of BCC does not look or feel like typical BCC or skin cancer lesions. Rather than bumps or growths, it creates thickened patches of skin called plaques that resemble scar tissue. Sometimes, these can be pale like scars as well.
Who is at Risk for BCC?
While anyone can develop BCC, some are at higher risk than others. Common risk factors for skin cancer include:
- Frequent and prolonged exposure to UVA and UVB rays.
- Pale skin type – Fitzpatrick Scale III and lower.
- Most BCC patients are over the age of 50, but there is an increase in diagnoses of younger patients.
- One or more family members have BCC or a genetic disease that causes skin cancer, including nevoid basal cell carcinoma syndrome and xeroderma pigmentosum.
- Exposure to certain toxins, including arsenic.
- Taking immune-suppressing medications or receiving radiation therapy or have had radiation therapy in the past.
Warning Signs: Symptoms of BCC
If you notice any irregularities in the appearance of skin, Dr. Dorsey says, “At the very least, schedule a visit with your local dermatology practice or general practitioner for an evaluation. In many cases, it may be nothing, but it’s always better to have a professional eye on anything suspicious. This is especially important because the appearance of BCC and other forms of skin cancer can vary so dramatically. However, there are some common basal cell skin cancer symptoms patients should be aware of and report to their dermatologists right away.” Dr. Dorsey provided the following lists of symptoms that may indicate BCC:
- Irregular skin tone or texture on an area of skin exposed to the sun.
- A lesion that seems to bleed easily.
- Sores that don’t heal.
- Shiny patches on the skin.
- Flesh-colored moles.
- Irregularly colored lesions that may be black, brown, or pink.
- Translucent (partially see-through) bumps with a pearly coloring typically a few shades lighter or darker than natural skin tone.
- Area of skin where small blood vessels are clearly visible through the skin, especially on paler skin.
- A waxy lesion that looks like a scar, but it’s difficult to define the border.
- A dark-colored lesion with a raised and translucent border.
- Thickened skin plaques with raised edges that may grow very large.
Diagnosing & Treating BCC
In most cases, a diagnosis means a skin biopsy. This procedure involves removing all or part of the irregular skin lesion. Then, the cells are examined under a microscope to look for cancer cells. If cancer cells are detected, your dermatologist will partner with you to develop the right treatment plan. Early detection of BCC and other forms of cancer is essential to increase treatment efficacy, so it’s important to bring any irregularities to the attention of your dermatologist as soon as possible. Common treatment recommendations for BCC include:
- Surgical Excision – A scalpel is used to remove the lesion and surrounding tissue.
- Mohs Surgery – The irregular lesion is removed in thin layers. As each layer is removed, it’s carefully examined under a microscope. The process is repeated until no cancerous cells are present.
- Cryotherapy – Extreme cold is applied to the irregular lesion to destroy and remove cells. An imiquimod cream is often used following cryotherapy to improve results.
- Radiotherapy – Energy beams, similar to those used in X-rays, are applied to the lesion to kill the cancerous cells. This is typically recommended for BCC tumors that have spread deeper beneath the skin or for those patients who are not good surgical candidates.
Prevention is Key: Protecting Yourself from BCC
When it comes to preventing BCC, Dr. Dorsey says, “I view treatment of skin cancer as starting with prevention. I am committed to educating my patients about how to protect their skin and what steps can be taken to reduce their risk. While not all cases of BCC are preventable, the vast majority are, so it’s important to me that patients know exactly what the causes and risk factors for BCC are, as well as the simple steps they can take to prevent the development of this form of skin cancer.” Below, Dr. Dorsey outlines the top skin cancer prevention steps to protect yourself from developing BCC:
- Apply a broad-spectrum sunscreen with an SPF of 30+ every day and reapply regularly throughout the day, especially if the sunscreen is sweated off or is removed due to swimming.
- Minimize sun exposure, especially between 10:00 AM and 4:00 PM when the sun’s UV rays are strongest.
- Skip tanning beds and UV treatments.
- Wear hats and sunglasses to protect the face and eyes from sun damage.
- Wear protective clothing like long sleeves and pants to prevent sun damage.
- Perform a thorough skin cancer self-exam every month.
- Schedule an annual skin exam with a dermatologist.
Taking Charge of Your Skin Health: What to Do Next
According to Dr. Dorsey, “It’s easy to disregard changes in the appearance or texture of the skin, but it’s always best to have any new or changing lesions addressed, including spots you suspect may be BCC. While BCC is among the least lethal cancers, it can cause serious concerns, especially when left untreated. It’s essential to protect skin to the best of your abilities, perform regular skin self-exams, and report any irregularities to a dermatologist as soon as possible to receive effective BCC treatment.”
Schedule an Annual Skin Exam
Whether you’re ready to learn more about skin cancer diagnosis and treatment or you’ve noticed a warning sign of BCC or other skin cancers, the U.S. Dermatology Partners team is here for you. Schedule an annual skin exam with one of our knowledgeable dermatologists, who can carefully examine your skin for signs of skin cancer, answer questions, address areas you’re concerned about, and work with you to plan treatment when necessary. Getting started is quick and easy. Just take a few minutes to complete our online scheduling request. Once our local dermatology team hears from you, they’ll be in touch to finalize the details of your upcoming visit. We also have a “Spot Check” program called DermAccess in our facilities, which is great for catching lesions early – if you notice a new or non-healing spot but your next visit isn’t scheduled for a few months away, then you can get a Spot Check appointment to look at this lesion specifically – our goal is to schedule you within 24-48 hours to have the lesion evaluated.
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