What is Basal Cell Carcinoma?

What is Basal Cell Carcinoma?

Basal cell carcinoma

Basal cell carcinoma is a skin cancer that begins in the lower part of the epidermis called the basal cell layer. Basal cell carcinoma is the most common and treatable type of cancer.

Basal cell carcinoma typically appears as a transparent, glossy, flesh-colored bump with a rolled border. Basal cell carcinoma usually develops on sun-exposed skin such as the face— it rarely spreads to other body parts. It is thought to be caused by over-exposure to the sun’s ultraviolet radiation. Wearing sunscreen and avoiding peak hours in the sun can help protect you from skin cancer.

Types of Basal Cell Carcinoma


There are four main types of basal cell carcinoma:

  • Nodular basal cell carcinoma is the most common type of skin cancer, accounting for more than 60-80% of basal cell cancers. It appears as a round, shiny, flesh-colored papule (raised bump) with small broken blood capillaries (telangiectasis).
  • Superficial spreadingbasal cell carcinoma typically presents as small plaques of light pink/red basaloid cells on the trunk, face, neck, and upper extremities. This type of cancer is associated with severe sunburns before the age of 20.
  • Sclerosing basal cell carcinoma can be challenging to diagnose as it can look more like a scar on initial presentation and can easily be missed during its early stages. However, as it progresses, it becomes more apparent. It is more common for this type to recur due to the difficulty of removing it completely with surgery.

Pigmented basal cell carcinoma is an uncommon type of nodular basal cell carcinoma that presents as brown-black, flat, distinct areas on the skin that can be mistaken for melanoma. This subtype is more common in patients with darker pigmented skin.

Signs & Symptoms of Basal Cell Carcinoma


Basal cell carcinoma symptoms can be difficult to recognize; sometimes, it’s not until the cancer has grown significantly that it becomes obvious. Basal cell skin cancer may itch or bleed. It often develops on sun-exposed body parts, especially the face, head, and neck though it can develop on other body parts. Basal cell carcinoma sometimes looks like a sore that won’t heal.

The most common signs of basal cell carcinoma are:

  • Lesions -Changes in the skin called lesions can appear as a sore that won’t heal. Sometimes these sores ooze or have crusted areas.
  • Bumps - Shiny, flesh-colored bumps that are translucent (see-through)
  • Black, brown, or blue lesions - Change in the skin with dark spots and a border that is slightly raised and translucent
  • Flat, scaly patches - Scaly patches of skin with raised edges that grow larger over time
  • White lesions - Flat, scar-like patches of skin without clearly defined borders

What Causes Basal Cell Carcinoma?


Basal cell carcinoma is skin cancer in the lower layer of the epidermis. Basal cells constantly divide and produce new skin cells that move toward the upper skin surface, ultimately becoming squamous cells. Basal cell carcinoma usually occurs on sun-exposed skin, such as the head, face, or neck.

Researchers believe this cancer is caused by long-term exposure to the sun’s damaging ultraviolet (UV) radiation. These UV rays can alter the skin’s DNA, causing mutations. The damaged, replicated skin cells change the formation of healthy cells, eventually causing skin cancer. 

Risk Factors

Risk Factors

Basal cell carcinoma occurs when there are mutations in the basal cells in the skin. Since the sun’s harmful UV rays cause these mutations, avoiding the sun and using sunscreen can help protect against skin cancer. Other risk factors can increase the chance of developing skin cancer.

Risk factors for basal cell carcinoma include:

  • Light-colored skin that freckles or burns easily
  • Having red or blonde hair
  • Having light-colored eyes
  • Increased age. Basal cell carcinoma can take many years to develop; therefore, many of those affected are older adults.
  • A family history or personal history 



Some complications can arise from basal cell carcinoma, including:

  • It can sometimes reappear even after basal cell carcinoma has been successfully treated
  • Basal cell carcinoma can increase the risk of developing squamous cell carcinoma or other types of skin cancer
  • Though it is rare, basal cell carcinoma can sometimes metastasize (spread) to lymph nodes and other organs such as the lungs or bones



Ways to decrease the risk of getting skin cancer include:

  • Avoid being out in the sun from 11:00 am to 2:00 pm–the peak hours for sun exposure
  • Wear sunscreen all year long on areas exposed to the sun, such as your face and neck
  • Wear protective clothing when spending time in the sun
  • Avoid tanning beds since they use UV lights that cause cancer
  • Examine your skin regularly for irregularities or marks you hadn’t noticed before
Get Care

Trust NewYork-Presbyterian for Basal Cell Carcinoma Care

If something ‘appears’ on your skin that you’ve never noticed before, make an appointment with a skin cancer specialist at NewYork-Presbyterian. Don’t wait. Even though basal cell skin cancer is the most common type of skin cancer, it can be serious if left untreated. The skin cancer experts at NewYork-Presbyterian focus on removing and eradicating skin cancer with the least amount of scarring.