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Basal Cell Carcinoma: Risk Factors and Symptoms

Contributor: Shawn Demehri, MD, PhD
6 minute read
A man applying sunscreen

“Each year, there are more new cases of skin cancer diagnosed than breast, prostate, lung, and colon cancer combined,” says Shawn Demehri, MD, PhD, citing research from the National Cancer Institute (NCI). Dr. Demehri is a dermatologist and principal investigator at the Krantz Family Center for Cancer Research at Mass General Cancer Center, and director of the Massachusetts General Hospital High Risk Skin Cancer Clinic.

Basal cell carcinomas are the most common type of skin cancer, making up about 80% of all skin cancer cases. Fortunately, it’s also very treatable, especially if caught early. A primary care provider (PCP) or dermatologist can find basal cell carcinoma at an early stage by performing skin checks. It can also be found with skin self-exams, which we all should do every month, says Dr. Demehri.

Learn more about the risk factors for basal cell carcinoma, the signs of skin cancer, and prevention tips that can help you protect your skin all year round.

What is basal cell carcinoma?

Basal cell carcinoma starts in the basal cells, which are one of three kinds of cells found in the epidermis. The epidermis is the top layer of the skin. Its job is to protect your body from environmental factors like pathogens (bacteria, viruses, parasites, and fungi). It also helps maintain moisture, regulate body temperature, and produce melanin, which gives your skin its color. Basal cells produce new skin cells at the bottom of the epidermis. As new cells emerge, they push the old cells to the skin’s surface before they shed.

Basal cell carcinoma is usually caused by exposure to the sun’s UVA and UVB rays, which is a form of radiation. UV rays can burn the skin and damage the DNA of skin cells. The result can be uncontrolled cell growth, or cancer.

“Basal cell carcinoma can develop on any area of your skin, but it’s often found on the head and neck, which both get a lot of sun exposure,” says Dr. Demehri.

If you notice anything unusual on your skin, you should contact your primary care provider or dermatologist. The sooner we find skin cancer, the easier it is to treat and cure.

Shawn Demehri, MD, PhD
Mass General Cancer Center

Basal cell carcinoma risk factors

“More than 3 million Americans get a basal cell carcinoma diagnosis each year,” says Dr. Demehri, citing figures from The Skin Cancer Foundation. Risk factors for basal cell carcinoma may include:

  • Overexposure to UV rays

  • Use of indoor tanning beds

  • A family history or personal history of skin cancer

  • Older age

  • Fair hair or skin, or skin that burns, freckles, or is painful under the sun

“This is a slow-growing skin cancer. It doesn’t usually spread to other parts of the body. That makes it easier for us to treat — and cure,” Dr. Demehri says.

Basal cell carcinoma signs and symptoms

It’s easy to mistake basal cell carcinoma for acne or harmless skin wounds. The following warning signs may indicate cancer:

  • A sore that doesn’t heal after a month or two

  • A small, fleshy bump or skin tag

  • A smooth growth with a wound in its middle

  • A scaly spot on your skin

  • A lump with a waxy or pearly appearance

“If you notice anything unusual on your skin, you should contact your primary care provider (PCP) or dermatologist. The sooner we find skin cancer, the easier it is to treat and cure,” says Dr. Demehri.

Basal cell carcinoma screening

Your PCP or dermatologist asks about your health and family cancer history. They also examine the entire surface of your skin. “We won’t just check the suspicious area,” says Dr. Demehri. “We’ll examine the rest of your body too.”

If your provider sees a concerning skin growth or suspects you have skin cancer, they’ll remove all or part of the growth and send it to the lab for further testing.

It’s a good idea to check your skin every month for changes. Depending on your risk factors, you may want to get an annual skin cancer check. Ask your care team if this is something they would recommend.

Prevention tips

Wearing sunscreen helps prevent skin cancer.

Protect your skin from the sun and get regular skin checks to prevent basal cell carcinoma. Steps you can take for prevention include:

  • Wear sunscreen every day, including on cloudy days and during the winter. Apply a facial moisturizer that has sunscreen of at least SPF 30 every morning, even if you plan to stay indoors.
  • Apply sunscreen 30 minutes before going out, and reapply every 2 hours, especially after swimming and sweating.
  • Cover skin with clothing that has a tight weave. You can also get sun-protective clothing with an ultraviolet protection factor, or UPF, which measures how much UV rays penetrate the fabric. According to The Skin Cancer Foundation, a UPF of 30+ offers very good protection.
  • Wear protective accessories like a hat and polarized sunglasses.
  • Avoid tanning beds.
  • Check your skin once a month and get annual checkups with your primary care provider.

If you have questions or concerns about unusual changes on your skin, be sure to notify your care team.  

The good news? “Remember that basal cell carcinoma is usually easy to treat. The five-year survival rate is an amazing 100%,” says Dr. Demehri. 

Shawn Demehri, MD, PhD