Basal cell carcinoma is a type of skin cancer that causes a lump, bump or lesion to form on the outside layer of your skin (epidermis). These lumps form on areas of your skin that get a lot of sun exposure. Treatment to remove cancer from your skin leads to a positive prognosis.
Basal cell carcinoma (BCC) is a type of skin cancer that forms in the basal cells of your skin. Basal cells exist in the lower part of your epidermis, which is the outside layer of your skin. Basal cell carcinoma looks like a small, sometimes shiny bump or scaly flat patch on your skin that slowly grows over time.
Basal cells are microscopic cells in the outer layer of your skin (epidermis), which is the skin layer that you can see and touch on your body. These cells are responsible for making new skin cells by dividing and copying themselves. When basal cells create new cells, the older skin cells push to the surface of your epidermis, where they die and leave your body.
There are four main types of basal cell carcinoma (BCC), including:
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Basal cell carcinoma (BCC) can affect anyone but it’s slightly more common among men and people assigned male at birth. It occurs more often in people older than 50 years. People with fair skin and light eyes are more likely to get BCC. People who have BCC once are at higher risk for developing another nonmelanoma skin cancer in the future.
Basal cell carcinoma is the most common type of cancer overall and the most common type of skin cancer. The number of new cases in the United States exceeds 4 million cases each year.
Signs of basal cell carcinoma include:
Basal cell carcinomas most commonly appear on areas of your body exposed to the sun. The most common places to have BCC include:
A change to your DNA causes basal cell carcinoma. This change usually happens after your skin has too much exposure to ultraviolet (UV) rays from sunlight or tanning beds.
Your genes give your body’s DNA instructions to make new cells to replace cells that reach the end of their lifespan by copying and replicating themselves. If a mutation affects one of your genes, your DNA won’t have the instructions to make new cells as it should.
Basal cells make new cells similar to how you’d turn on a light switch when you enter a room. When you need to enter a room, you turn on the light. When you leave that room, you turn the light switch off. Basal cells make new cells when their light switch is in the on position. If a genetic mutation targets your DNA, your basal cells aren’t able to turn off the light switch when they leave a room. This causes your basal cells to make too many cells, which causes lumps (tumors) or lesions to form in the outer layer of your skin (epidermis).
A rare inherited condition called basal cell nevus syndrome (Gorlin’s syndrome) causes BCC to appear in childhood.
Depending on the appearance of the skin lesion, your healthcare provider might immediately suspect a basal cell carcinoma diagnosis. To confirm the diagnosis, your provider will complete a physical exam and ask you questions about your symptoms, including:
After a physical exam, your provider might offer tests to confirm a diagnosis, which could include:
Your provider will determine the stage of your diagnosis after providing a physical exam and reviewing the results of your tests. Qualifiers to determine the stage includes:
Your provider will treat basal cell carcinoma by removing cancer from your body. To remove cancer, your treatment options could include:
Your provider will choose the best treatment option for you and your diagnosis by factoring in your overall health, your age, the location of the cancer and the size of the BCC.
If you don’t receive treatment for basal cell carcinoma, the skin cancer can slowly grow in size and invade deeper tissues like muscle and bone and cartilage. The BCC may become painful and ulcerated, which can cause bleeding and infection.
In extremely rare cases, basal cell carcinoma can spread to other parts of your body and cause life-threatening side effects.
Although rare, if your basal cell carcinoma becomes locally advanced or spreads (metastasizes) to another location in your body, the U.S. Food and Drug Administration (FDA) has approved two medicines:
These drugs can be used in people who aren’t good candidates for surgery or radiation therapy. Vismodegib and sonidegib can cause several side effects, most commonly muscle cramps, change in taste and hair thinning. You must not get pregnant while on therapy and for several months after the completion of therapy.
Any type of surgical removal will leave a scar. There’s a low risk of bleeding or infection.
While all cases of basal cell carcinoma can’t be prevented, you can take steps to reduce your risk by:
The prognosis for people diagnosed with basal cell carcinoma (BCC) is excellent. BCC will rarely spread to other areas of your body and cause harm.
There’s a low chance that BCC can return after you have it removed. If you notice a new lesion around the scar from previous treatment, visit your healthcare provider immediately.
It’s important to contact a healthcare provider any time you have a skin problem that doesn’t resolve on its own. If you develop any new marks on your skin, if you have a mole that gets larger or if you experience any symptoms like pain or itchiness associated with the lump or lesion on your skin, contact a provider.
Basal cell carcinoma (BCC) is a common type of skin cancer that can affect your health. Other types of skin cancer include:
Actinic keratosis (AK) isn’t a skin cancer. AKs are growths of cells in your epidermis caused by long-term sun exposure. This condition isn’t cancerous (it’s benign), but it can develop into skin cancer (squamous cell carcinoma). Actinic keratoses are most commonly seen on the sun-exposed skin of your head and neck, including the tops of your ears and lips, as well as your arms and legs.
A note from Cleveland Clinic
It can be scary to find a cancerous lump on your skin. Basal cell carcinoma (BCC) is common and treatment is effective at removing the cancer from your body to get you back to your normal routine quickly. Take steps to prevent basal cell carcinoma by protecting yourself from the sun’s UV rays and avoiding tanning beds. Call your provider if you find any new lumps or bumps on your skin to get them examined and treated immediately.
Last reviewed by a Cleveland Clinic medical professional on 08/31/2022.
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