Basal Cell Carcinoma: Treatment and Care
Basal cell carcinoma (BCC) is a common form of skin cancer that usually develops in areas exposed to the sun. Treatment aims to remove the tumor, preserve function and appearance, and reduce the chance of recurrence. Options range from minor surgical procedures to topical or targeted medical therapies for more advanced cases. Decisions about care depend on tumor size, location, growth pattern, patient health, and cosmetic priorities, and they are often made jointly by the patient and a dermatology or surgical team.
This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.
What is basal cell carcinoma of the skin?
Basal cell carcinoma arises from the basal cells in the lowest layer of the epidermis. It most often appears as a pearly bump, scaly patch, or slowly enlarging lesion on sun-exposed areas such as the face, ears, neck, and hands. BCC typically grows slowly and rarely spreads to distant organs, but it can invade nearby tissue and cause local damage if untreated. Early detection helps preserve tissue and simplifies medical management, so regular skin checks and prompt evaluation of suspicious lesions are important.
How is this cancer diagnosed?
Diagnosis begins with a clinical skin exam: doctors look for characteristic features and compare changes over time. Dermatologists often use dermoscopy to view structures not visible to the naked eye, then confirm the diagnosis with a biopsy. A biopsy sample is examined by a pathologist to determine the subtype and depth of invasion, which guide treatment choices. Imaging studies are rarely needed for typical, small BCCs but may be used for large, recurrent, or suspected invasive tumors to assess local spread.
What role does dermatology play?
Dermatology specialists evaluate, diagnose, and treat most cases of basal cell carcinoma. They perform skin exams, biopsies, and many of the surgical procedures used to remove BCCs, including excisions and curettage with electrodessication. For complex tumors—such as those on the nose, around the eyes, or recurrent lesions—dermatologists may perform Mohs micrographic surgery or coordinate care with plastic surgeons or radiation oncologists. Patients can find local services through accredited dermatology clinics to discuss individualized plans that balance medical and cosmetic considerations.
What medical options are available?
Medical treatments include topical therapies, photodynamic therapy, and systemic drugs for advanced disease. Topical agents such as imiquimod or 5-fluorouracil may be appropriate for small, superficial tumors. Photodynamic therapy combines a photosensitizing agent and light to target superficial lesions. For locally advanced or metastatic BCCs not suitable for surgery or radiation, oral hedgehog pathway inhibitors are approved medical options; they require specialist oversight because of potential side effects. Choice of medical therapy depends on tumor subtype, depth, patient comorbidities, and monitoring capacity.
How are different treatment approaches chosen?
Selecting a treatment involves tumor characteristics (size, subtype, location), patient factors (age, health, cosmetic concerns), and prior treatments or recurrences. Standard surgical excision with histologic margin assessment is common for many BCCs. Mohs surgery offers the highest margin control and tissue preservation, often used in cosmetically sensitive or recurrent tumors. Curettage and electrodessication suit small nodular lesions in low-risk sites. Radiation can be an alternative for surgically unsuitable patients. Shared decision-making with the care team helps align outcomes with the patient’s priorities.
Conclusion
Effective management of basal cell carcinoma relies on accurate diagnosis, appropriate selection among surgical and non-surgical options, and regular follow-up to monitor healing and detect recurrence. Preventive measures—such as sun protection and routine skin checks—remain important for reducing future risk. Conversations with dermatology and oncology specialists can clarify the benefits and limitations of specific approaches for each individual case, ensuring treatment aligns with both medical needs and quality-of-life considerations.
