Basal Cell Carcinoma (BCC)

Basal cell carcinoma (BCC) is the most common skin cancer. It grows slowly and rarely spreads to other parts of the body, but it can be locally destructive if it is not treated, especially on the face. BCC is highly curable, and treatment is most straightforward when it is found early.

What Is Basal Cell Carcinoma?

Basal cell carcinoma arises from the basal cells in the deepest part of the epidermis, the outer layer of skin. It is usually caused by long-term ultraviolet exposure, so it most often appears on sun-exposed areas such as the face, ears, neck, scalp, and shoulders. BCC rarely spreads through the body, but left untreated it can grow into and damage nearby skin, cartilage, and bone. Compare it with squamous cell carcinoma in our guide to BCC vs. SCC.

What Does BCC Look Like?

• A pearly or translucent bump, sometimes with small visible blood vessels
• A pink or reddish patch that may be slightly scaly
• A sore that bleeds, oozes, or crusts and will not heal, or heals and returns
• A shiny, firm, or waxy area that looks like a scar

BCC appears most often on the head and neck, but it can develop anywhere. Any spot that bleeds easily or will not heal should be evaluated.

What Causes BCC and Who Is at Risk?

• Cumulative sun exposure and the use of tanning beds
• Fair skin, light eyes, and a tendency to burn
• Older age and a history of frequent sun exposure or sunburns
• A history of previous skin cancer
• A weakened immune system, or prior radiation exposure

How Is BCC Diagnosed?

A dermatology provider examines the spot, often with a dermatoscope, and confirms the diagnosis with a skin biopsy, in which a small sample is examined under the microscope. Full-body skin exams help find BCC and other skin cancers early. See how to check your skin.

How Is BCC Treated?

Mohs micrographic surgery

Mohs surgery removes the cancer one thin layer at a time, checking each layer under the microscope until the margins are clear. It offers the highest cure rate while preserving the most healthy tissue, so it is often preferred for BCC on the face, ears, nose, and other cosmetically or functionally sensitive areas, and for recurrent or aggressive tumors. For skin cancers near the eye, Belaray coordinates Mohs removal with same-visit oculofacial reconstruction.

Other treatments

• Standard surgical excision for many tumors on the trunk and limbs
• Curettage and electrodesiccation for small, low-risk tumors
• Topical prescription creams for certain superficial BCCs
• Radiation therapy for patients who are not candidates for surgery

Prevention and Follow-Up

Daily broad-spectrum sunscreen, sun-protective clothing, and avoiding tanning beds lower your risk. After a skin cancer diagnosis, regular full-body skin exams are important, because people who have had one skin cancer are more likely to develop another. Explore our Skin Cancer Center.

Frequently Asked Questions

What does basal cell carcinoma look like?

Basal cell carcinoma often looks like a pearly or translucent bump, a pink or reddish patch, a shiny scar-like area, or a sore that bleeds or crusts and will not heal. It appears most often on sun-exposed skin such as the face, ears, neck, and scalp. Any spot that bleeds easily or does not heal should be checked.

Is basal cell carcinoma dangerous or does it spread?

Basal cell carcinoma rarely spreads to other parts of the body, so it is very rarely life-threatening. However, if it is left untreated it can grow and become locally destructive, damaging nearby skin, cartilage, and bone, which is why early treatment matters, especially on the face.

How is basal cell carcinoma treated?

Treatment depends on the size, location, and type of tumor. Options include Mohs micrographic surgery, standard surgical excision, curettage and electrodesiccation for small low-risk tumors, topical prescription creams for certain superficial tumors, and radiation for patients who are not surgical candidates.

Does basal cell carcinoma require Mohs surgery?

Not always, but Mohs surgery is preferred for BCC on the face, ears, nose, and other sensitive areas, and for large, recurrent, or aggressive tumors, because it offers the highest cure rate while preserving healthy tissue. For small, low-risk BCC on the trunk or limbs, simpler treatments may be appropriate.

Can basal cell carcinoma be cured?

Yes. Basal cell carcinoma is highly curable, especially when treated early, and Mohs surgery offers cure rates around 99 percent for many tumors. After treatment, regular full-body skin exams are important because a history of one skin cancer raises the risk of another.

Where can I get basal cell carcinoma treatment on Long Island?

Belaray Dermatology treats basal cell carcinoma at its Hicksville (Nassau County) and Stony Brook (Suffolk County) offices, including Mohs surgery performed by three dual board-certified Mohs surgeons. Call or text (516) 822-7546 to schedule an evaluation.

Related reading: basal cell vs. squamous cell carcinoma, squamous cell carcinoma, what is Mohs surgery, and skin cancer screening on Long Island.