An Overview of Basal Cell Carcinoma

Australia’s vibrant sunshine is a national treasure. But with all that sunshine comes a responsibility to protect our skin, especially since Australia has one of the highest rates of skin cancer in the world. Basal cell carcinoma (BCC), the most common type of skin cancer, is a concern that can’t be ignored.

The good news is that basal skin cancer is highly treatable when detected early. This post seeks to empower readers with knowledge about this skin condition, helping identify potential risks and prioritise skin health.

Quick Facts on Basal Cells

Basal cells are among the main types of cells found in the deepest layer of the epidermis, the outermost part of the skin. These small, round cells have a high nucleus-to-cytoplasm ratio and are responsible for the regeneration and renewal of the skin. They produce new skin cells, pushing older cells toward the skin’s surface (where the old cells die and are sloughed off).

How Does Basal Skin Cancer Develop?

Basal cells make new cells by copying and replicating themselves to replace the ones that reach the end of their lifespan. They’re able to do this through your genes, which give DNA instructions to produce new cells. If a mutation affects one of these genes, the DNA in your body won’t have the instructions to make new cells as it should.

Basal cell carcinoma usually develops when there is a change to one’s DNA, which happens after the skin has too much exposure to ultraviolet (UV) rays from sunlight or tanning beds. BCC may also appear in childhood through a rare inherited condition called basal cell nevus or Gorlin’s syndrome.

Four Types of Basal Carcinoma

There are different types of BCC, which are the following:

⦁ Nodular: It is the most common type of BCC. It looks like a round pimple with visible blood vessels (telangiectasias or commonly known as spider veins) surrounding it.
⦁ Superficial: This type of BCC causes lesions that appear as small, shallow marks on the skin that are slightly lighter in colour than the surrounding skin. The lesions usually form on the torso, arms and legs.
⦁ Morpheaform or sclerosing: This BCC are cancerous lesions that look like scars slowly expanding over time. They are commonly found on the face and can take the form of a small red dot on the skin.
⦁ Pigmented: This is a rare type of BCC. Pigmented basal carcinoma causes hyperpigmentation (an area of the skin becomes darker than the skin surrounding it).

Basal cell carcinoma (BCC) treatment varies based on how much cancer is in the body. We’ll talk more about the different treatment options for this carcinoma in the succeeding sections.

How Serious Is Basal Skin Cancer?

Basal skin cancer accounts for about 70% of non-melanoma skin cancers in Australia (as reported by the Cancer Council). It tends to grow slowly and is not life-threatening for most people. While it seldom spreads to another part of the body, it can still grow wide and deep over time, which is why treatment is important.

If left untreated, this carcinoma can become locally invasive, spreading deeply into the skin, wrapping around nerves and blood vessels and invading muscles and bones. When it grows deep, it can be disfiguring. For some people, it changes the way they look.

Some highly unusual, aggressive BCC cases occur when the cancer spreads to other parts of the body. Early detection is thus crucial since untreated BCC can be dangerous.

Who Is at High Risk of Basal Cell Carcinoma?

People of all skin tones can develop basal skin cancer. Knowing the risk factors can help you catch it early or avoid it entirely. The following factors can increase the risk of basal skin cancer:

⦁ Chronic UV exposure: The main causes of skin damage that can lead to BCCs include cumulative sun exposure and occasional extended, intense sun exposure that leads to sunburn. Most BCCs occur on parts of the body exposed to the sun.
⦁ Exposure to chemicals like arsenic: Arsenic is a toxic metal found widely in the environment. It increases the risk of basal and squamous cell carcinomas and other cancers. While everyone has some arsenic exposure because it occurs naturally, some people may have higher exposure if they drink contaminated well water or have a job that involves handling arsenic.
⦁ Fair skin: People who freckle or burn easily or who have very light skin, red or blond hair, or light-coloured eyes are at higher risk of basal cell skin cancer.
⦁ Family or personal history: Those who have a family history of skin cancer may have an increased risk of developing this type of carcinoma. If you’ve had it one or more times, you are likely to get it again.
⦁ Immune-suppressing drugs: Medications that suppress the immune system, such as anti-rejection drugs used after transplant surgery, significantly increases one’s risk of skin cancer.
⦁ Increasing age: Basal skin cancer often takes decades to develop. Most cases of BCC occur in older people, but it is also becoming more common in younger adults.

What Are the Signs and Symptoms of BCC?

This carcinoma appears as a change in the skin, such as a growth or a sore that won’t heal. It usually has one of the following characteristics:

⦁ A shiny bump. It’s translucent (you can see a bit through the surface). It can look pearly white or pink on white skin, brown or glossy black on brown and black skin.
⦁ A lesion with dark spots. It may be a brown, black or blue lesion with a slightly raised, translucent border.
⦁ A white, waxy, scar-like lesion. It appears without a clearly defined border.
⦁ A flat, scaly patch. It has a raised edge. Over time, it can grow quite large.

IMPORTANT: Anything that is growing, bleeding, or changing in any way on your skin should be checked by a board-certified dermatologist.

What Are the Treatments for BCC?

Several effective treatments can be performed on an outpatient basis if small or early BCC is detected. Treatment options are as follows:

⦁ Cryosurgery
⦁ Electrosurgery (Curettage + electrodesiccation)
⦁ Excision
⦁ Laser surgery
⦁ Medications for advanced BCC
⦁ Mohs surgery
⦁ Photodynamic therapy
⦁ Radiation therapy
⦁ Topical medications

Schedule a Full Skin Examination at Pymble Dermatology

Adopt sun-safe practices to protect your skin and reduce your risk of getting basal cell carcinoma. Apply broad-spectrum sunscreen, seek shade during peak sun hours, and schedule regular skin checks with your dermatologist.
Book an appointment with one of our dermatologists for comprehensive skin cancer screening if you notice any concerning changes on your skin.