Basal cell carcinoma

Basal cell carcinoma, or BCC, is a cancer of the basal cells at the bottom of the epidermis. It is sometimes called a rodent ulcer. It's very common.

About 75% of all skin cancers in the UK are basal cell carcinomas. Most BCCs are very slow-growing and almost never spread to other parts of the body.

When basal cell carcinomas are treated at an early stage, they are usually completely cured. However, some BCCs are aggressive, and, if left to grow, they may spread into the deeper layers of the skin and sometimes to the bones. This can make treatment difficult.

A small number of basal cell carcinomas may come back in the same area of skin after treatment. This is known as a local recurrence.

At The Christie, the head and neck and skin team in clinical oncology treat types of skin cancer.

Symptoms of basal cell carcinoma

Basal cell cancers may:

  • be smooth and pearly
  • look waxy
  • appear as a firm, red lump
  • bleed sometimes
  • develop a crust or scab
  • begin to heal but never completely heal
  • be itchy
  • look like a flat, red spot that is scaly and crusty
  • develop into a painless ulcer.

Treatment for basal cell carcinoma

When detected early, basal cell carcinoma is easily curable. Various treatment options are available, such as creams (topical chemotherapy), freezing (cryotherapy), curettage (scraping), surgery, radiotherapy, Mohs' micrographic surgery, and exposure to special light (photodynamic therapy) or laser treatment.

Your doctor will explain these treatments and advise you about which one is suitable for you. Once the lesion is completely removed, no further treatment is needed. In a small number of cases it may recur or a new lesion may develop.

How to prevent basal cell carcinoma

Basal cell carcinoma is thought to be caused by damage to the skin by ultra violet radiation contained in sunlight. To prevent further new BCCs, take the following steps:

  • Examine your skin regularly and seek medical advice for any lesion that does not heal in 6 weeks.
  • Protect your skin from ultraviolet radiation in strong sunlight:
    • Avoid exposure to the sun.
    • Cover up with loose fitting but closely woven clothes.
    • Wear a wide-brimmed hat and protective sunglasses.
    • Use a high SPF sunscreen (15 or more). When choosing a sunscreen, look for one to protect against UVB, and the UVA circle logo and/or 4 or 5 UVA stars to protect against UVA. Apply plenty of sunscreen 15 to 30 minutes before going out in the sun, and reapply every 2 hours and straight after swimming and towel-drying.
    • Avoid tanning under sunlamps.

Last updated: March 2023