A basal cell carcinoma is a form of skin cancer that originates from the basal cells of the epidermis. These basal cells reside in the lower layer of the epidermis that produces new skin cells as old cells die off. The condition presents as a slightly transparent skin bump and often occurs in the areas of the body that are exposed to the sun most. Usually, these bumps occur on the head and neck and can significantly affect one’s physical appearance and emotional state.
Basal cell carcinoma can have severe physical and psychosocial effects on a person, so early detection and treatment are vital to eliminating the cancerous cells. Our team at Surgical Dermatology Group would be happy to assist you in finding the best solution for your condition.
Basal cell carcinoma occurs when one of the basal cells that make up the skin experiences a DNA mutation. The cells’ DNA controls the process of skin creation. However, when there is a mutation, the DNA gives a wrong instruction for the cells to proliferate instead of dying off for new cells to replace them. This leads to an accumulation of the abnormal cells, which is the lesion that appears on the skin. This mutation of the DNA typically occurs due to extensive exposure to ultraviolet rays.
There are different types of basal cell carcinoma (BCC); hence, the signs and symptoms vary with the kind of BCC. Note that it’s often difficult to visually distinguish the condition from other skin conditions like acne scars, actinic elastosis, and some other conditions. This makes it vital for you to consult with an expert dermatologist to carry out necessary diagnostic tests.
Some of these types of BCC and their signs and symptoms include:
- Nodular BCC: The signs and symptoms of nodular BCC consist of the onset of small, pearly, firm, shiny, and raised pink growths. With time (months or years), visible telangiectases (dilated blood vessels) may appear on the skin surface, after which the center of the lesion breaks open, and a scab is formed.
- Superficial BCC: Superficial BCC occurs as a red scaly macule or thin plaque. It can also present as flat red or pink patches on the skin.
- Morpheaform BCC: Morpheaform type BCC typically presents as a flat white or yellow, waxy, sclerotic plaque which appears firm, flat, and fibrotic. It slightly resembles the nodular type but is the least common form of basal cell carcinoma. This type of BCC can sometimes appear as a skin thickening or scar tissue, which makes diagnosis difficult.
Basal cell carcinoma risk factors include:
- Chronic exposure to UV radiation: Extensive ultraviolet radiation from direct sunlight on a person’s skin predisposes the person to BCC. Also, people who live in areas with high sun intensity or high altitudes are at a greater chance of suffering from basal cell carcinoma. Furthermore, people who use artificial tanning services are also at a higher risk of suffering from the condition. Sunburns are a major risk factor for development of Basal Cell Carcinoma.
- Skin color: The risk of basal cell carcinoma is higher among people who are fair-skinned and/or have red or blonde hair. Individuals with green, blue, or grey colored eyes are also predisposed as they easily get burnt by the sun’s intensity. Individuals with skin that freckles also fall under this category. Comprehensively, white-skinned people are more likely to suffer BCC than black-skinned individuals, though, it can be seen in any skin type.
- Age: BCC is usually a result of long-term exposure. It could take decades to manifest. This is the reason it appears to be more prevalent among older adults, especially adults from 50 years of age and above. However, it’s becoming a frequent occurrence among teenagers and younger adults.
- Sex: BCC affects more men than women. This is usually due to men’s higher involvement in recreational and occupational activities, which increases their risk of exposure to the sun’s rays.
- Pre-existing conditions and chronic skin infections: Pre-existing scars, burns, injuries, or skin inflammation also predispose the skin to basal cell carcinoma.
- History of skin cancer: People with a family history of the condition are more likely to suffer from it.
- Exposure to some natural substance like arsenic: Arsenic is a toxic metal that occurs naturally in the atmosphere and could cause skin cancer or skin lesions when there is long-term exposure to it. Also, drinking contaminated well water exposes one to arsenic, which could lead to basal cell carcinoma.
Basal cell carcinoma grows and enlarges slowly and is unlikely to spread to other parts of the body. Nonetheless, it can spread to nearby tissues like the bone and other underlying tissues. Just like every other preventable condition, the best way to live above BCC is by preventing it from occurring. Most of the preventive actions against BCC involve lifestyle changes that are easy to achieve, with determination. Some of the ways to prevent BCC include:
- Minimize sun exposure: Avoid being under the sun at midday or at other times when the sun’s intensity is high. Reschedule your outdoor activities to a time when the sun is less intense.
- Monitor your skin: Early detection of cancerous growths is a critical component of a successful treatment. Examine your skin regularly for uncommon growths and contact your dermatologist immediately if you notice anything out of the ordinary.
- Avoid artificial tanning: Avoid visiting tanning houses and using tanning equipment. Tanning is a source of UV rays and should be avoided.
- Use of sunscreen: Wearing sunscreens daily will help you reduce the effects of the sun on your skin. Sun damage is cumulative, so the long term effects of daily activities such as driving to work and outdoor activities can result in significant damage.
- Wear protective clothing: Protective clothing that covers your arms and legs, and broad-brimmed hats to shield your face, neck, ears and scalp will help protect you from excessive sunlight. Sunglasses can also help protect your eyes from UV radiation.
- Reduce exposure to toxic metals: When at places where you’re exposed to arsenic, we advise you to wear the recommended protective equipment to protect yourself from the toxic effect of metal. Also, ensure you drink uncontaminated, clean water to reduce your exposure to arsenic.
Basal cell carcinoma can be cured when detected and reported early. The condition is a tumor that grows if not detected early. The treatment of the condition can become complicated when discovered late. The earlier treatment is sought, the less complicated the treatment becomes.
Standard treatment methods for BCC include:
- Mohs surgery: This is a gold standard for treating basal cell carcinoma. It’s regarded as the most effective method for removing BCC without causing harm to the surrounding tissues. The procedure involves the surgeon removing the tumor and a little extra tissue surrounding the tumor site. After that, the surgeon will examine the tissue to see if there are cancer cells left. If there are traces of the cancerous cells in the tissue, the procedure will be repeated until the entire carcinoma is eliminated. This treatment offers the highest cure rate of all treatments available.
- Curettage and electrodesiccation: This treatment involves the doctor removing the tumor by scraping it out with a curette (a spoon-shaped instrument) and cauterizing (burning with an electronic needle) the site to minimize bleeding. This process is also known as Electrosurgery.
- Chemotherapy: The use of drugs to destroy cancerous cells or tumors. The drugs shrink cancer cells or slow down their growth. Ideally, a chemotherapeutic drug is made to destroy the cancer cells without affecting other surrounding cells. However, some of the drugs have side effects on other body cells.
- Topical medications: These are medications (gels or creams) applied on the site of the cancer cell to treat the condition. This is often used for superficial BCC with minimal scars.
- Cryosurgery: This treatment involves the surgeon using a spray device or extreme cold produced by nitrogen to destroy abnormal tissues or tumors by freezing them. This procedure is, however, effective for only smaller BCC.