Basal Cell Carcinoma: Symptoms, Detection, and Treatment

Michael Housley, PA-C

May is Skin Cancer Awareness Month. It was created to raise awareness and educate the public on skin cancer, the importance of keeping an eye on your skin, sun protection, and treatment options.

Basal cell carcinoma (BCC) is the most common type of skin cancer found in the United States. Fortunately, in most cases they are non-life-threatening and can be treated by a handful of options. Surgical excision is the most common treatment, but size and location can influence which treatment is needed in each case.

Identifying Basal Cell Carcinoma

Basal cell carcinoma most commonly presents as a small dome-shaped growth that resembles as a sore that refuses to heal, bleeds occasionally and slowly grows larger in size. Patients commonly report it as a non-healing pimple or injury that has persisted for months or years; longer than they would expect. They often are found in areas with high sun- exposure, such as on the face, ears, neck, arms, chest, shoulders and back. They can also be found in places you might not suspect like the scalp, legs or buttocks. It is important to have a yearly Full Skin Exam, where all your skin is examined for potential skin cancer.

Higher Risk

Who is at risk to develop basal cell carcinoma? Short answer is everyone who has a history of sun exposure, but most intensely are people with fair skin, blonde or red hair, blue or green eyes, a family history of skin cancer, weakened immune system, or a history of radiation therapy.

Treatment Options for Basal Cell Carcinoma

When a skin cancer is suspected, a biopsy of the lesion will be taken. First the area is anesthetized (made numb) with a small injection, the piece needed is then taken with an instrument, afterwards a bandage is then placed. This takes only a small amount of time to perform, 1-2 minutes from start to finish is typical. The tissue is then sent off to a dermatopathologist who will evaluate the specimen under a microscope to determine the official diagnosis.

Once a diagnosis is made, the treatment plan can be determined. Usually, the plan is a simple surgical excision. This is a process where the entire defect area is removed until the skin around and below it returns with clear margins. The area is then closed with sutures and a bandage is placed. This treatment often takes 30-45 minutes. Other options are Mohs Surgery, radiation therapy, laser surgery, or destructive techniques. Mohs Surgery is typically used on larger cancers and/or in more delicate locations; this process takes a longer time (between two to five hours). During this procedure, most of the time is spent waiting while the tissue is being evaluated until clear margins are obtained. Destructive techniques include topical creams, liquid nitrogen or electrodessication, and curettage. These techniques are less commonly used because they have a higher recurrence rate and scarring can be more pronounced.

You may be asking “why should I treat my basal cell carcinoma if it isn’t life-threatening?” Although not life-threatening, this type of skin cancer will continue to grow and destroy whatever healthy tissues it overtakes, which can lead to a loss of important structures, like the ears, nose, lips, eyelids, and underlying nerves. That’s why early detection and treatment are vital.

Prevention is key!

To do so, start by using protective clothing and avoiding sun exposure during peak hours (between 10 a.m. and 4 p.m.). Also, apply sunscreen daily, rain or shine. And don’t forget to reapply every one to two hours, particularly when you’re outdoors. Additionally, monthly self-exams and annual Full Skin Exams are important to catching skin cancer early. So be sure to schedule your Full Skin Exam online or by calling us at 208.376.4265. For more tips see our blog post about skin cancer prevention.

About Our Provider

Michael Housley is a Certified Physician Assistant. He has been treating patients at Dermatology Clinic of Idaho in Boise since 2016. He has Diplomate Fellow status from the Society of Dermatology Physician Assistants and is certified by the National Committee on Certification of Physician Assistance (NCCPA). Schedule your appointment with Michael to learn more about skin cancer here.