SKIN CANCERS & CONDITIONS
Basal cell carcinoma
Basal cell carcinoma, the most common skin cancer in Australia, often appears as a pink lump or non-healing sore. It grows slowly and rarely spreads, with various effective treatments available.
- Approximately 50% of Australians will develop BCC
- Slow-growing and rarely spreads
- Multiple treatment options may be available
Basal cell carcinoma (also known as BCC) is the most common form of skin cancer, affecting 50% of Australians in their lifetime.
It often forms a pink lump or rough patch of skin but sometimes presents as a longstanding, non-healing sore. It grows slowly and rarely spreads to other organs. Multiple effective treatment options may be available depending on the basal cell carcinoma sub-type.
Basal cell carcinoma (BCC) affects approximately 50% of Australians in their lifetime1. It tends to grow slowly and almost always remains confined to one location. BCC can be treated by surgical removal and, in some cases, cryotherapy (freezing) or applying a cream.
Other names for basal cell carcinoma include rodent ulcer, keratinocyte cancer, non-melanoma skin cancer, NMSC, nodular basal cell carcinoma and nBCC.
What does BCC look like?
Basal cell carcinomas can be thin or thick, and their appearance varies. They are most common on areas that have long-term exposure to the sun, such as the face and arms, although they are also common on the back and chest.
Nodular basal cell carcinoma
Nodular basal cell carcinoma (nBCC) often appears as a pink lump with a pearly consistency. Close-up, it may appear to have prominent blood vessels on its surface.
If it has been present for a long time, the BCC may spread outward, and the surface becomes ulcerated or crusted. This is why sores that take a long time to heal are suspicious for skin cancer.
Superficial basal cell carcinoma
Superficial basal cell carcinoma (sBCC) is thin and affects the uppermost level of the skin. It may appear as a pink or red rough patch and can easily be mistaken for dermatitis or another type of rash. Learn more about superficial basal cell carcinoma.
Infiltrative basal cell carcinoma
Infiltrative BCC (also called morpheic BCC) is a less common variant with edges that cannot always be clearly seen. This type of BCC can be difficult to remove surgically and often needs to be removed by a plastic surgeon or dermatologist specialising in Moh’s surgery (where the removed tissue is examined microscopically during the procedure to ensure that the entire BCC has been removed).
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Nodular basal cell carcinoma on the back of the scalp
Overview of basal cell carcinoma behind the right shoulder of a young man.
Nodular basal cell carcinoma on the side of the nose
Basal cell carcinoma on the upper back.
Dermoscopic view of the BCC shown in the image on the left
Dermoscopic view of a basal cell carcinoma showing characteristic branching bright red blood vessels.
What happens if basal cell carcinoma is untreated?
Without treatment, basal cell carcinoma usually grows slowly over many months. It is sometimes present for years before it is noticed.
Basal cell carcinoma tends to remain in one location without spreading to other body parts via the blood or lymphatic circulation. As it grows, it causes damage to the area, including:
- Sores that bleed and don’t heal (this type of sore used to be called a rodent ulcer because it looks like a rat or mouse has chewed the skin).
- Damage to underlying tissues such as muscles, blood vessels and nerves.
How is basal cell carcinoma treated?
Nodular basal cell carcinoma is usually treated by surgical removal. In some cases, photodynamic therapy is used. Curettage may be used for nodular basal carcinomas in cases where complete surgical removal isn’t suitable.
Superficial basal cell carcinoma can be treated by surgical removal, application of a cream or cryotherapy (freezing).
Risk factors of basal cell carcinoma
Risk factors for developing basal cell carcinoma include:
- Outdoor occupations where there is prolonged daily exposure.
- Previous radiotherapy.
- Solarium use.
- Fair or red hair colour.
- Skin that burns and does not tan.
- Tendency to freckle.
- A history of blistering sunburn.
- A previous BCC.
- Increasing age.
- Past exposure to arsenic.
Prevention of basal cell carcinoma
People with a history of basal cell carcinoma are at high risk of developing future BCCs (as well as having an increased risk of melanoma). Because many of the risk factors for basal cell carcinoma cannot be reversed, preventing future BCCs can be difficult. Up to 60 per cent of people with BCC will develop another within three years.2 Vitamin B3 (nicotinamide) taken orally has been shown to reduce the rate of basal cell carcinoma and squamous cell carcinoma by 20-30%.
“Vitamin B3 (nicotinamide) taken orally has been shown to reduce the rate of basal cell carcinoma and squamous cell carcinoma by 20-30%.”
If you are considering taking vitamin B3 for the prevention of basal cell carcinoma, discuss the potential benefits and side effects with your doctor. There is new evidence that, in some cases, high doses of vitamin B3 could possibly increase the risk of cardiovascular conditions such as stroke and heart attack in some patients.3
Avoid unnecessary prolonged exposure to sunlight. Protect against ultraviolet radiation with sunscreen, hats, protective clothing, sunglasses and shade.
A yearly full-body skin check allows basal cell carcinoma to be detected at an early, more easily treated stage. People with a history of many BCCs may need to have their skin checked more frequently.
References
- Staples MP, Elwood M, Burton RC, Williams JL, Marks R, Giles GG Non-melanoma skin cancer in Australia: the 2002 national survey and trends since 1985 Med J Aust 2006 Jan 2;184(1):6-10
- Cancer Council Australia Optimal care pathway for people with keratinocyte cancer (basal cell carcinoma or squamous cell carcinoma), second edition Optimal cancer care pathways 2021
- Ferrell, M., Wang, Z., Anderson, J.T. et al. A terminal metabolite of niacin promotes vascular inflammation and contributes to cardiovascular disease risk. Nat Med 30, 424–434 (2024).
Basal cell carcinoma treatments
Time to check for basal cell carcinoma?
Basal cell carcinoma detected at skin cancer checks tend to be diagnosed earlier and are easier to treat.
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