Basal cell carcinoma

This is one of two types of skin cancer, the other being malignant melanoma. The most common form is basal cell carcinoma which is highly treatable irrespective of whether it is caught early or late on. However, it is very rare for it to spread to other areas of the body so is not considered life threatening unlike melanoma.

Who is most at risk of getting basal cell carcinoma?

There is no gene for this skin cancer but there are certain features which increase the risk of developing it such as fair skin and freckles. So if anyone in your family has fair skin and tends to burns rather than tan then they are at greater risk of this disease.

If you have a fair skin, blue eyes and plenty of freckles it doesn’t automatically mean you will get skin cancer. But it does mean you are at higher risk of doing so.

Other high risk groups include:

  • People with an outdoor job who are constantly exposed to the sun.
  • People who live in hot, sunny climates
  • People who use a sunbed or sunbathe on a regular basis

This also includes anyone who has previously experienced basal cell carcinoma.

Fair skinned people are most at risk but this doesn’t exclude any other skin type. Anyone who is constantly exposed to the sun is at risk.

Signs of possible basal skin carcinoma

Not sure if you have basal cell carcinoma? There are few warning signs which will help you decide. These are:

  • Spots, scabs or marks which are increasing in size
  • Spots, scabs or marks which bleed on occasion and don’t heal
  • Spots, scabs and marks which have changed in appearance

Check your skin once a month for any of these. You may have these signs which turn out not to be skin cancer but it is better to be safe than sorry. Visit your GP if you notice these or any other changes in spots, freckles or marks on your skin.

Causes of basal cell carcinoma

Excessive exposure to ultraviolet (UV) light – from sunbeds or sunlight is the main cause. This leads to the formation of these lesions on parts of the body which are constantly exposed such as the face, arms and legs. But these lesions can develop in areas of the skin which are already damaged as a result of a burn, ulcer or scar.

Symptoms of basal cell carcinoma

These take on different forms: some resemble small, red scaly marks, other look like small craters with a white rim which if left untreated, can turn into ulcers.

Another version is similar in appearance to scabs and bleeds on occasions. Alternately, you may get a series of lumpy, shiny nodules with noticeable blood vessels across their surface.

Most carcinomas are painless although some will itch and bleed if scratched, picked or rubbed against clothing.

Diagnosing basal cell carcinoma

If you have any of these symptoms then see your GP. This condition is curable but the procedures are easier if it is caught an early stage.

Your GP will refer you to a dermatologist if necessary for further investigation. The dermatologist will carry out a series of tests which include a skin biopsy. A small section of a lesion will be removed for analysis or in some cases the entire lesion is removed.

The biopsy is performed under a local anaesthetic.

Treatment for basal cell carcinoma

This depends upon the type and extent of your basal cell carcinoma. Superficial versions can be treated with cryotherapy (freezing) or photodynamic therapy in which the affected areas are covered with a special cream before exposure to a particular wavelength of light. This light kills the basal cell carcinoma.

Surgery is the preferred option but it all depends upon the extent of your skin cancer. Mild forms of basal cell carcinoma can be removed via a curettage and cauterisation procedure in which the lesions are scraped away (curettage) before sealing the area with heat (cauterisation).

There is also micrographic surgery in which the individual lesions are cut away (excised) from the skin and the treated areas closed with stitches or a small skin graft. This is a time consuming procedure which is only performed on hard to reach areas of the body.

For more information visit our dermatology treatments section.

Prevention of basal cell carcinoma

Minimise the risk of this occurring particularly if you fit into a high risk group, e.g. are fair skinned. Wear loose clothing and a hat, avoid exposure between 10am and 3pm when the sun is at its strongest and go indoors before you start to burn.

Wear a sun cream with a high sun protection factor (SPF) such as +30. Don’t forget to reapply this every 2 hours and after you have been swimming.

If you are a parent then keep babies and infants out of direct sunlight and use a sun cream which is specially formulated for them.