Basal Cell Carcinoma – Symptoms and Causes

Basal cell carcinoma typically develops on sun-exposed skin areas, particularly the face, in people with lighter skin tones. It usually appears as a small bump that might be flesh-colored or pinkish.

These growths often have a pearly or waxy appearance and may have visible blood vessels running through them.

Some people notice a depression in the center of the bump or small sores that bleed easily and don’t heal completely. The edges of the growth might look slightly raised or rolled.

On brown or Black skin, basal cell carcinomas often present differently than on lighter skin tones. These cancers typically appear as brown or glossy black bumps with distinctive rolled borders.

The growth may also look like a dark patch with an irregular outline. Because these cancers can be less noticeable on darker skin, diagnosis sometimes happens at later stages.

Treatment Options

• Surgical removal – Several techniques can remove the cancer while preserving healthy tissue.
• Radiation therapy – May be recommended when surgery isn’t possible.
• Topical medications – Prescription creams that trigger the immune system to fight cancer cells.

Treatments vary based on cancer size, location, and depth. Regular follow-up appointments are essential after treatment to check for recurrence.

Signs and Warnings

Basal cell carcinoma typically forms on skin areas that get a lot of sun, mainly on the head and neck. Sometimes it can appear in places usually covered from the sun, like the genital area.

This skin cancer shows up as changes on your skin that might look like a growth or a sore that doesn’t heal. Look for these common features:

• Shiny, rounded bump that’s somewhat see-through. On lighter skin, it may look white or pink with a pearly appearance. On darker skin tones, it often appears brown or glossy black.

  • Tiny blood vessels might be visible inside the bump. These bumps can bleed and form scabs.

• Dark-colored spot in brown, black, or blue shades with a slightly raised, see-through border around it.

• Flat, scaly area with raised edges. These patches can grow larger as time passes.

• White, waxy patch that looks similar to a scar but doesn’t have clear borders.

When to see a doctor

If you notice any changes in your skin, it’s important to contact your healthcare provider. This includes:

• A new growth
• Changes in a growth you already have
• A sore that doesn’t heal

Schedule an appointment promptly when you observe these signs. Early detection of skin issues can lead to better treatment outcomes.

What Causes Skin Cancer

Skin cancer starts in the epidermis, which is the outer layer of your skin. This layer contains different types of cells, each giving rise to specific kinds of skin cancer:

• Basal cells: Located at the bottom of the epidermis, these cells constantly produce new skin cells. When DNA in these cells gets damaged, basal cell carcinoma can develop.
• Squamous cells: These are flattened cells found in the upper parts of the epidermis. DNA damage here can lead to squamous cell carcinoma.
• Melanocytes: These cells make melanin, the pigment that gives skin its color. When damaged, they can develop into melanoma.

When a cell’s DNA gets mutated, it changes how the cell works. For example, damaged basal cells may start multiplying too quickly and not die when they should. The extra cells build up and form a tumor on the skin.

Sunlight and Other Risk Factors

UV radiation is the main cause of DNA damage that leads to skin cancer. This radiation comes from:

• Natural sunlight
• Tanning beds
• Tanning lamps

However, some skin cancers appear on parts of the body that rarely see the sun. This suggests other factors play a role too. These might include:

1. Genetic factors
2. Immune system problems
3. Exposure to certain chemicals
4. Past skin injuries

Sometimes doctors can’t pinpoint exactly what caused a person’s skin cancer. What’s important is that many skin cancers can be prevented by protecting yourself from UV radiation and getting regular skin checks.

Risk Factors

Several factors can increase a person’s chance of developing basal cell carcinoma:

Sun Exposure

Spending long periods in the sun without protection raises risk significantly. People who live in sunny areas or at high altitudes face greater exposure to harmful UV rays. Severe sunburns and tanning bed use also increase risk.

Skin Type

Individuals with fair skin, light-colored eyes, blonde or red hair, or those who burn easily face higher risks than people with darker skin tones.

Age

Most cases occur in older adults because this cancer typically develops slowly over decades. However, doctors now see more cases in younger people, even those in their 20s and 30s.

Medical History

People who have had basal cell carcinoma before are likely to develop it again. Family history of skin cancer also raises risk.

Radiation Treatment

Previous radiation therapy for skin conditions like acne can increase cancer risk at treatment sites.

Weakened Immune System

Medications that suppress the immune system, particularly anti-rejection drugs used after organ transplants, significantly increase skin cancer risk.

Arsenic Exposure

Contact with arsenic, found naturally in the environment, increases risk. Higher exposure may come from contaminated well water or occupations involving arsenic.

Genetic Conditions

Certain inherited syndromes raise risk, including:

• Gorlin-Goltz syndrome (nevoid basal cell carcinoma syndrome)
• Xeroderma pigmentosum

People with multiple risk factors should be especially vigilant about skin protection and regular skin checks.

Complications

Basal cell carcinoma may lead to several complications after diagnosis.

Patients face a significant risk of cancer returning, even after treatment appears successful. Those with a history of this skin cancer also have higher chances of developing other skin cancers, particularly squamous cell carcinoma.

In rare cases, basal cell carcinoma can spread beyond the skin. This metastasis may affect:

• Nearby lymph nodes
• Bones
• Lungs

Regular follow-up appointments with healthcare providers are important for monitoring and early detection of any recurrence or new cancers.

Prevention

Protecting yourself from basal cell carcinoma requires several key preventive measures. These steps can significantly reduce your risk of developing this common skin cancer.

Limit sun exposure during peak hours. The sun’s rays are most intense between 10 a.m. and 4 p.m. Plan outdoor activities outside these hours when possible. This applies even on cloudy days or during winter months.

Sunscreen is essential year-round. Apply a broad-spectrum product with SPF 30 or higher every day, regardless of weather conditions. Make sure to use plenty of sunscreen and reapply every two hours. If you’re swimming or sweating, reapply it more often.

Protective clothing provides an important barrier against harmful rays. Choose:

• Dark, tightly woven fabrics
• Long-sleeved shirts and pants
• Broad-brimmed hats (better protection than baseball caps)
• Sunglasses that block both UVA and UVB rays

Some specialty retailers offer clothing specifically designed for sun protection. A skin doctor can recommend reliable brands if you’re interested.

Stay away from tanning beds completely. These devices emit harmful UV radiation and raise your skin cancer risk significantly.

Examine your skin thoroughly once a month, looking for:

• New growths
• Changes in existing moles or freckles
• Unusual bumps or spots
• Changes in birthmarks

Use mirrors to check hard-to-see areas like your back, scalp, and between toes. Be thorough and check all body areas, including your chest, arms, legs, feet, and genital region.