Medically reviewed by Dr. A.M. van Coevorden, dermatologist
Basal cell carcinomathe most common, slow-growing form of skin cancer
Basal cell carcinoma is the most common form of skin cancer. It begins in the top layer of the skin and almost never spreads to other parts of the body. About one in five people develop one in their lifetime. Because a basal cell carcinoma keeps growing, treatment is always needed.
- What is basal cell carcinoma?
- How do you get basal cell carcinoma?
- What symptoms does basal cell carcinoma cause?
- Is basal cell carcinoma contagious?
- How is the diagnosis made?
- What treatments are there?
- Can basal cell carcinoma be cured?
- What can you do yourself?
- Frequently asked questions about basal cell carcinoma
What is basal cell carcinoma?
Basal cell carcinoma, also called basalioma, is the most common form of skin cancer. About one in five people develop one in their lifetime. It starts in the top layer of the skin and almost never spreads to other parts of the body.
How do you get basal cell carcinoma?
The main cause is the sun. Often it involves a lot of sun exposure over a lifetime or acute exposure with burning, which damages the skin. A lot of sun in childhood in particular is a risk for basal cell carcinomas later in life. People with fair skin are at greater risk than people with dark skin. A rare form is Gorlin syndrome, a DNA fault that causes many basal cell carcinomas from a young age.
What symptoms does basal cell carcinoma cause?
Usually a basal cell carcinoma causes no symptoms and is found by chance. It often looks like a small sore that will not heal, or a shiny bump or spot that bleeds easily. There are three common forms. The superficial form appears mainly on the chest and back, resembles a patch of eczema but usually does not itch, and has a typical sheen in bright light. The nodular (solid) form is a slow-growing, red and slightly shiny bump, sometimes with small blood vessels, in which a non-healing wound can develop. The infiltrative form has strands reaching into the skin, often lies flatter and is harder to recognise because the border with normal skin is unclear. A basal cell carcinoma usually develops where the skin has had a lot of sun, such as the face and ears, and keeps growing. That is why treatment is always needed.
Is basal cell carcinoma contagious?
No. Basal cell carcinoma is a form of skin cancer and cannot be passed from person to person.
How is the diagnosis made?
The dermatologist usually recognises a basal cell carcinoma quickly. Only in case of doubt is a small piece of skin removed (a biopsy) to confirm the diagnosis.
What treatments are there?
Treatment depends on the form and growth, and is chosen together with the doctor.
Excision (cutting out) under local anaesthetic is suitable for all forms; the removed tissue is examined in the laboratory, and if the carcinoma is not fully gone, more is cut away.
Fluorouracil cream (Efudix) inhibits the growth of the cells and is only suitable for the superficial form; redness and crusting appear first, after which healthy skin grows back.
Imiquimod cream (Aldara) locally activates the immune system and is also only for the superficial form.
Photodynamic therapy applies a cream that makes the cells sensitive to light, after which illumination with a special lamp kills the cancer cells.
Cryosurgery freezes the carcinoma with liquid nitrogen; it is quick but often leaves scars and the chance that everything is gone is small.
Curettage and coagulation scrapes the carcinoma away and cauterises the skin; quick, but the depth cannot be checked.
Radiotherapy gives a good result and is often used only when surgery is not possible, for example on the nose or ear.
Mohs micrographic surgery removes the carcinoma completely with as little loss of healthy skin as possible, especially important on the face, with unclear borders, with infiltrative growth or on recurrence.
Can basal cell carcinoma be cured?
Yes, a basal cell carcinoma can be cured completely. You do remain at risk of developing a new one elsewhere.
What can you do yourself?
Keep a close eye on your skin. Benign spots should clear on their own within about six to eight weeks. If you have a red bump that keeps growing or a wound that will not heal, make an appointment with your GP or dermatologist. Protect your skin well against the sun to prevent new basal cell carcinomas.
Frequently asked questions about basal cell carcinoma
Is a basal cell carcinoma dangerous?
It is the most common form of skin cancer and almost never spreads to other parts of the body. It does keep growing, so treatment is always needed.
How do I recognise one?
It often looks like a small sore that will not heal, or a shiny bump that bleeds easily. If in doubt, have it assessed.
Can it be cured?
Yes, completely. There is a risk of a new basal cell carcinoma developing elsewhere later.
What treatments are there?
Depending on the form: cutting out, creams (fluorouracil or imiquimod) for the superficial type, photodynamic therapy, freezing, scraping, radiotherapy or Mohs surgery.
When should I see a doctor?
For a sore that will not heal or a bump that keeps growing. Benign spots usually clear on their own within six to eight weeks.
Sources and more information
- Basaalcelcarcinoom, basalioom (nvdv.nl)
- NHG-Standaard Verdachte huidafwijkingen (richtlijnen.nhg.org)