What It Is

example of basal cell carcinomaBasal cell carcinoma (also known as BCC) is the most common form of skin cancer in Canada.  This type of skin cancer is the least dangerous, but it must be treated. Otherwise, it will continue to grow, invading and destroying surrounding tissue causing pain, bleeding and eventually causing disfigurement.

Risk Factors

The people most at risk are:

  • Those who have blond or red hair, and skin that burns easily from sun exposure
  • People who have increased risk from long sun exposure over the life span, especially those over age 50
  • Organ transplant patients whose immune systems are compromised

These tumours are now being seen in teenagers and in people in their early 20s. More men get this disease than women. People who have already had one basal cell skin cancer have higher risk for developing another.


Basal cell skin cancers usually appear on sun-exposed areas, most commonly the face, neck, ears, scalp but also the torso, arms and legs. The appearance of this skin cancer can vary.

Early warning signs

  • Firm, flesh-coloured or slightly pink bump, often with a pearly border; may have small surface blood vessels giving it a red colour
  • Whitish scar where there is no reason for scarring
  • Sore or pimple-like growth that bleeds, crusts over and then reappears
  • Small, red scaly patch most often seen on torso or limbs

Any sore that does not heal within four weeks should be examined by your doctor or dermatologist.


Ultraviolet radiation from the sun is the prime cause of this skin cancer. Frequent severe sunburns and intense sun exposure increase the risk of basal cell skin cancer in adulthood.


Treatment options depend on the tumour (size, location, subtype) and the patient’s health status. Your dermatologist will discuss treatment options with you.

Some treatment options include:

  • Surgical excision (removing the cancer surgically then suturing the area closed) or
  • A procedure called electrodessication and curettage (where the cancer is removed by scraping and cauterizing the skin).
  • Topical creams that modulate the immune system are also used for some forms of this skin cancer.
  • Other treatment modalities such as PDT (photodynamic therapy) may also be used in certain circumstances.

For more complicated tumours or those that arise on the head, neck, hands, feet or genitals, a specialized form of surgery called Mohs surgery is used. Performed by a dermatologist trained in this technique, Mohs surgery has a high success rate. It is indicated for tumors in sensitive areas or tumors that are recurrent.

Vismodegib, an oral medication, has been approved to treat large basal cell cancers on the skin, as well as those that have spread to other parts of the body.

Skin of Colour

Basal cell carcinoma is not common but does occur in the Indigenous, Asian, Hispanic, and African-Canadian population. They often present as a glossy dark brown to black bump or patch that is enlarging.  The bump can be pink, itchy, bleed or scab but does not fully heal. Sometimes, it does not cause any symptoms at all.