Basal cell carcinoma (BCC) is the most common type of cancer in the United States. BCC is a cancer of the skin caused by ultraviolet (UV) light exposure. BCC begins in the deepest layer of the epidermis of the skin: the basal layer. BCC typically occurs in areas that are exposed to the sun, such as the head, face, and neck, but it can occur in any area of the body.
BCC is a slow-growing cancer that rarely metastasizes. Even so, BCC can be very damaging. If left untreated, BCC will continue to grow and will invade and destroy the surrounding skin and tissues beneath the skin.
The major risk factor for BCC is UV light exposure, whether from the sun or tanning beds. Although anyone can develop BCC, people with certain physical characteristics (such as light or freckled skin, light eyes or hair, or difficulty getting a tan) are at increased risk. Other risk factors include taking immunosuppressant medications, overexposure to X-rays, having a close relative who had a BCC growth, or previously having had a BCC growth.
Generally, a BCC growth looks like a pink or pearly white lesion or sore. BCC lesions commonly bleed easily, crust over, and heal poorly. There may be tiny blood vessels on the lesion (called ‘telangiectasias’), or the lesion may have a center that appears depressed (like a pie that deflated in the middle).
Some BCC subtypes have special characteristics. For example, BCC can also appear as any of the following:
The one and the only way to diagnose any type of skin cancer is to biopsy the skin. Skin biopsy is a simple procedure in which part of the lesion is removed and examined under a microscope to detect any cancerous cells.
The method of treatment for BCC depends on many factors, including the subtype and location of the BCC growth. Methods of treatment include the following:
Dr. Rokhsar is a trained Mohs and cosmetic surgeon. As a fellowship-trained dermatologist surgeon, he specializes in Mohs Micrographic surgery which is the most precise way to remove skin cancer. Fellowship-trained doctors gain a significant amount of intensive training after they complete their bachelor’s degree, medical school requirements, residential training, and dermatology training. The additional training results in a level of expertise and knowledge beyond most dermatologists.
Basal cell carcinoma (BCC) is the most common type of skin cancer, accounting for approximately 80% of all cases. BCC is usually caused by long-term sun exposure and typically occurs in older adults, although it can also affect younger adults. According to the American Cancer Society, an estimated 3.6 million Americans are diagnosed with BCC each year, and the number of reported cases in the US has been steadily increasing. BCC is rarely fatal, but it can be highly destructive and disfiguring if left untreated.
There are several risk factors that increase the likelihood of developing BCC, including UV exposure, history of skin cancer (including squamous cell carcinoma or melanoma), fair skin, age over 50, male gender, and a tendency to freckle or burn easily. Other risk factors include radiation exposure from cancer treatment, exposure to industrial compounds, weakened immune system, and genetic factors such as nevoid basal cell carcinoma syndrome.
The best way to prevent basal cell carcinoma is by protecting your skin from UV radiation:
It typically appears as a small, shiny, pink or red bump or growth that may have a raised, rolled edge and a crusted indentation in the center. BCC can also have a smooth surface or cause an open sore that does not heal, and it may be raised in some parts, sunken in some parts, or both. Some types of BCC may be soft and have a jelly-like texture and darker coloring. Additionally, BCC may have visible blood vessels on the surface and crust and bleed. BCC can vary in appearance and may be mistaken for other skin conditions such as a wart, mole, or pimple, but if you notice a spot or growth on your skin that is growing or changing in any way, it’s important to see a board-certified dermatologist for an evaluation.
In most cases, basal cell carcinoma is not life-threatening and rarely spreads to other parts of the body. However, if left untreated, it can grow deeper into the skin and damage nearby tissues, including bones, nerves, and muscles. This can cause disfigurement and loss of function, particularly if it affects the face or other sensitive areas.
Basal cell carcinoma should be treated as soon as possible after diagnosis. BCC is a slow-growing form of skin cancer, and while it is rarely fatal, it can cause significant damage and disfigurement if left untreated. Waiting to treat BCC can also increase the likelihood of recurrence, as approximately 25% of people with a history of BCC develop a new lesion within 5 years of the first one.
The best treatment for BCC depends on the type, location, and size of cancer, as well as your preferences and ability to do follow-up visits. Options for treatment include Mohs surgery, excision, curettage, and electrodesiccation, and topical medications such as imiquimod and 5-fluorouracil. Dr. Cameron Rokhsar will work with you to determine the best treatment plan for your individual case. Dr. Rokhsar is a double board-certified Mohs dermatologic surgeon.
For simple surgical procedures like excision or curettage and desiccation, healing may take just a few weeks. However, for more complex surgeries like Mohs micrographic surgery, which is considered the most thorough method for treating basal cell carcinoma, the procedure may take several hours or longer, and recovery may take longer, up to several months.
In general, the wound may take 3 to 6 weeks to heal, and the scar may fade with time if good wound care is provided. It’s essential to follow your doctor’s instructions carefully and avoid strenuous activities that may disrupt the wound’s healing process.
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Dr. Cameron Rokhsar, MD, FAAD, FAACS, is the founder and medical director of the New York Cosmetic, Skin, & Laser Surgery Center. Dr. Rokhsar is a graduate of Harvard College and NYU School of Medicine. Dr. Rokhsar is double board certified in dermatology and micrographic dermatologic surgery, being one of the few select dermatologists in the country who is also fellowship trained in laser surgery. A researcher and innovator, Dr. Rokhsar is the creator of the non-surgical nose job and has been instrumental in the research and development of laser systems such as the Fraxel, CO2, Mirady, Vbeam, Themitight, and Ulthera devices. An Associate Professor of Dermatology at Mount Sinai Hospital in NYC, Dr. Rokhsar actively teaches the cosmetic dermatology clinic to the resident at Mount Sinai. An expert injector of fillers, and a trainer for many companies, patients fly in from around the world to see Dr. Rokhsar in his Garden City and Manhattan offices in New York.
Dr. Rokhsar was chosen by
magazine as a top dermatologist in its Best Doctors 2017, 2018, 2019, 2020, 2021, 2022 and 2023 issues.
