Basal Cell Carcinoma

Basal cell carcinoma is the most common, yet least harmful type of skin cancer. It commonly appears as a small, pearly white growth with a waxy texture. It can also appear as a brown or flesh-colored patch of skin that grows over time. In time the bump may bleed and develop a crust. Some BCC are pigmented while others especially on the non facial skin appear as red patches sometimes confused with psoriasis. There is a uncommon type called a sclerotic BCC wich appears like a scar on the face without a history of trauma.

Although basal cell carcinoma rarely metastasizes and spreads to other parts of the body, it can be very destructive to skin tissue, often causing sores that bleed and don’t heal easily. Basal cell carcinoma is usually caused by sun damage. Chronic sun exposure and sunburns at an early age greatly increase the chances of developing this condition as an adult. There are also genetic factors that permit the tumors to develop. (New drugs that block a pathway called hedgehog have been developed for extreme cases.) For example, people who have ulcers, thermal burns and other non-healing wounds have an increased risk of basal cell carcinoma. Individuals who are immunosuppressed, such as those who have recently undergone kidney or heart transplants, have an increased risk of developing basal cell cancer, and an even higher risk of developing squamous cell carcinoma.

 

Common features of basal cell carcinoma include:

  • A pearly or skin-colored bump
  • Covered with tiny blood vessels – easily seen over the top and around the tumor In some cases, it may appear as a brown or flesh-colored patch of skin that can grow larger over time.
  • These growths may also look like a pimple that won’t heal – ulcerated and bleeding at the center.
  • On the limbs, the growths often appear as red patches that look similar to psoriasis. Occasionally they are pigmented.

Chronic exposure to the sun’s UV rays is the primary cause of skin cancer including basal cell carcinoma. Over time, skin damage from UV radiation can accumulate, causing damage to the skin’s basal cells.

A mutation of their DNA causes the basal cells to multiply rapidly and keep growing on top of each other, resulting in the development of a cancerous tumor. There is a rare genetic condition known as basal cell nevus syndrome where multiple basal cell carcinomas are produced.

Proper and gentle skin care measures should be taken when caring for skin damaged by UV light.Use gentle cleansers that are fragrance and allergen free to avoid irritating damaged areas of the skin.

Look for moisturizers that contain UV filters, which can offer additional safeguards against UV radiation. Make sure to apply these frequently and generously, to adequately hydrate and protect the skin.

Since basal cell carcinoma is caused by exposure to UV rays, it’s important to take preventive measures when going outdoors.

Limit sun exposure:
Reducing your time in the sun is perhaps the easiest way to avoid damage to your skin caused by UV rays. When outdoors, set a time limit and seek shade when necessary. Also keep in mind that UV radiation is the strongest between the hours of 10 a.m. to 4 p.m.

Cover and protect:
Wrap-around sunglasses, wide-brimmed hats and clothing that covers your arms and legs can offer extra protection against the sun’s harmful UV rays.

Use Sunscreen:
In addition to covering up, use a “broad spectrum” sunscreen, which can help protect the skin from both UVA and UVB rays. Make sure to apply generously and frequently.

Look for any changes in your skin: If any changes in existing moles, or new skin growths are noticed, consult with a dermatologist immediately to determine if the symptoms are precancerous.

OTC
The daily use of a sunscreen can help reduce your chances of developing basal cell carcinoma. Look for sunscreens that contain the following ingredients: benzophenone, oxybenzone, avobenzone, titanium dioxide and zinc oxide. These are all active ingredients that are helpful in preventing sun damage to the skin.

Prescription
A doctor may prescribe Imiquimod 5% Cream (Aldara™), which is used treat superficial basal cell cancer. Other topical medications such as 5-Fluorouracil (5-FU), are also used to treat superficial tumors or as an alternate treatment for people who are unable to receive chemotherapy.

Procedures
There are a variety of medical procedures available to treat basal cell carcinoma. Curettage and electrodessication are used to remove small lesions that are less than 2cm in diameter. Radiation is used for small to medium lesions, lesions that have recurred after surgery and to control the symptoms/growth of large tumors.
Mohs micrographic surgery is used for all types of basal cell cancers. Surgical excision is used for larger tumors (along with a margin of cancer free skin).