Basal cell carcinoma

Created: 09.01.2025

Updated 09.01.2025

Approved by: Consultant Dermatologist, Dr James Denny

What is a Basal Cell Carcinoma?

The majority of cases of skin cancer in Europe are due to Basal Cell Carcinoma (BCC). The cases are almost exclusively related to exposure to the sun. People with fair skin have the highest risk of developing cancer. It is important to avoid getting sunburned as this significantly increases the chance of getting skin cancer.

What are the symptoms?

BCC can take many forms, such as a faint transparent small lump, a black mark, a flat flaky red area or an area resembling a scar. Most of the activity in basal cell carcinoma takes place under the outer layer of the skin (epidermis) which is slow growing.

It is a good idea to be familiar with your skin so that you are aware of any new changes, for example by checking your skin once a month. Look for marks or blemishes on the skin that change, do not go away, or seem unusual.

What are the treatments?

The most common treatment of BCC is by surgical removal. If the cancer is more complex, a surgical procedure called "Mohs surgery" is used. Mohs surgery is performed in specialist units and involves removing small pieces of the affected skin at a time and examining it for cancer cells. You stop removing tissue as soon as you can no longer find cancer cells. This is done to remove as little skin as possible and thus avoid unnecessary damage/scars in, for example, the face, where many cases of BCC occur.

Creams can also be applied to the skin, the most commonly used are Imiquimod cream and 5-Fluorouracil cream. Cryotherapy can be used for very superficial and early types.

What is the prognosis?

BCC, whilst generally not life-threatening, should be promptly addressed. Early treatment can prevent the spread of the cancer and minimise the extent of skin removal, particularly in sensitive areas like the face, where more extensive procedures could result in noticeable scarring.

That being said, the prognosis is usually excellent with metastasis (spread) being extremely rare (0.0028% to 0.55%).