OVERVIEW

SYMPOTMS

There are several types of basal cell carcinomas.

The nodular type of basal cell carcinoma usually begins as small, shiny, firm, almost clear to pink in color, raised growth. After a few months or years, visible dilated blood vessels (telangiectasias) may appear on the surface, and the center may break open and form a scab. The border of the cancer is sometimes thickened and pearly white. The cancer may alternately bleed and form a scab and heal, leading a person to falsely think that it is a sore rather than a cancer.

Other types of basal cell carcinomas vary greatly in appearance. For example, the superficial type appears as flat thin red or pink patches, and the morphea form type appears as thicker flesh-colored or light red patches that look somewhat like scars.

Risk factors

Factors that increase your risk of basal cell carcinoma include:

• Chronic sun exposure. A lot of time spent in the sun — or in commercial tanning beds — increases the risk of basal cell carcinoma. The threat is greater if you live in a sunny or high-altitude location, both of which expose you to more UV radiation. Severe sunburns also increase your risk.
• Radiation therapy. Radiation therapy to treat acne or other skin conditions may increase the risk of basal cell carcinoma at previous treatment sites on the skin.
• Fair skin. The risk of basal cell carcinoma is higher among people who freckle or burn easily or who have very light skin, red or blond hair, or light-colored eyes.
• Increasing age. Because basal cell carcinoma often takes decades to develop, the majority of basal cell carcinomas occur in older adults. But it can also affect younger adults and is becoming more common in people in their 20s and 30s.
• A personal or family history of skin cancer. If you’ve had basal cell carcinoma one or more times, you have a good chance of developing it again. If you have a family history of skin cancer, you may have an increased risk of developing basal cell carcinoma.
• Immune-suppressing drugs. Taking medications that suppress your immune system, such as anti-rejection drugs used after transplant surgery, significantly increases your risk of skin cancer.
• Exposure to arsenic. Arsenic, a toxic metal that’s found widely in the environment, increases the risk of basal cell carcinoma and other cancers. Everyone has some arsenic exposure because it occurs naturally. But some people may have higher exposure if they drink contaminated well water or have a job that involves producing or using arsenic.
• Inherited syndromes that cause skin cancer. Certain rare genetic diseases can increase the risk of basal cell carcinoma, including nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome) and xeroderma pigmentosum.

Complications

Complications of basal cell carcinoma can include:

• A risk of recurrence. Basal cell carcinomas commonly recur, even after successful treatment.
• An increased risk of other types of skin cancer. A history of basal cell carcinoma may also increase the chance of developing other types of skin cancer, such as squamous cell carcinoma.
• Cancer that spreads beyond the skin. Very rarely, basal cell carcinoma can spread (metastasize) to nearby lymph nodes and other areas of the body, such as the bones and lungs.

Prevention

To reduce your risk of basal cell carcinoma you can:

• Avoid the sun during the middle of the day. In many places, the sun’s rays are strongest between about 10 a.m. and 4 p.m. Schedule outdoor activities for other times of the day, even during winter or when the sky is cloudy.
• Wear sunscreen year-round. Use a broad-spectrum sunscreen with an SPF of at least 30, even on cloudy days. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or perspiring.
• Wear protective clothing. Cover your skin with dark, tightly woven clothing that covers your arms and legs, and a broad-brimmed hat, which provides more protection than does a baseball cap or visor.Some companies also sell protective clothing. A dermatologist can recommend an appropriate brand. Don’t forget sunglasses. Look for those that block both types of UV radiation — UVA and UVB rays.
• Avoid tanning beds. Tanning beds emit UV rays and can increase your risk of skin cancer.
• Check your skin regularly and report changes to your doctor. Examine your skin often for new skin growths or changes in existing moles, freckles, bumps and birthmarks. With the help of mirrors, check your face, neck, ears and scalp.Examine your chest and trunk and the tops and undersides of your arms and hands. Examine both the front and the back of your legs and your feet, including the soles and the spaces between your toes. Also check your genital area and between your buttocks.

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