At first, it rarely looks serious. A small bump on the face that seems shiny, a tiny sore that scabs over and then opens again, or a spot that resembles a stubborn pimple. Many people watch it for weeks, sometimes months, assuming it will heal on its own. What stands out later is that it never fully does. The surface breaks down repeatedly, a crust forms and falls off, and the area slowly changes shape. This pattern is often how basal cell carcinoma is first noticed.
Basal cell carcinoma is the most common type of non-melanoma skin cancer. It develops mainly on sun-exposed areas such as the face, ears, scalp, and neck. The cancer grows slowly and almost never spreads to distant organs. Even so, leaving it untreated can allow it to invade nearby skin, soft tissue, and in rare cases underlying bone. Because it often appears harmless at the beginning, early diagnosis can be delayed. Recognizing persistent ulcers or nodules that do not heal is key to preventing more extensive damage.
Basal Cell Carcinoma Quick Overview
| Category | Details |
|---|---|
| Main cause | Long-term ultraviolet exposure |
| Typical appearance | Nodule, patch, or non-healing ulcer |
| Common locations | Face, nose, ears, scalp |
| Spread risk | Very low |
| Treatment focus | Complete surgical removal |
Basal cell carcinoma is usually curable when detected early, but neglect can lead to local destruction.
Causes
| Factor | How it contributes |
|---|---|
| Chronic sun exposure | Cumulative UV damage to skin cells |
| Fair skin | Lower natural UV protection |
| Outdoor lifestyle | Higher lifetime exposure |
| Aging | Damage builds up over time |
The damage responsible for basal cell carcinoma often occurs years or decades before the lesion becomes visible. This is why it is more common in older adults, though younger people with intense sun exposure can also be affected.
Key Symptoms
| Symptom | Common description |
|---|---|
| Pearly or shiny nodule | Often flesh-colored or pink |
| Flat scaly patch | May resemble eczema or scar |
| Ulcer or sore | Does not heal over weeks |
| Recurrent crusting | Scab forms and falls off repeatedly |
Bleeding with minor trauma or shaving is a frequent clue, especially for facial lesions.
Diagnosis Focus
| Method | What is assessed |
|---|---|
| Visual examination | Shape, color, location |
| Palpation | Firmness or tissue loss |
| Skin biopsy | Confirms cancer cells |
Although experienced clinicians may strongly suspect basal cell carcinoma based on appearance, a biopsy is required to confirm the diagnosis and guide treatment planning.
Treatment Direction
| Approach | Purpose |
|---|---|
| Surgical excision | Removes tumor completely |
| Mohs micrographic surgery | Maximizes cure, preserves tissue |
| Alternative treatments | Selected low-risk cases |
Surgery is the mainstay of treatment. Mohs surgery is often chosen for facial lesions or recurrent tumors because it allows precise removal while sparing as much healthy tissue as possible.
Warning Signs
| Sign | Why it matters |
|---|---|
| Non-healing ulcer | Classic sign of skin cancer |
| Repeated bleeding | Indicates fragile tumor tissue |
| Rapid local growth | Suggests aggressive behavior |
| Facial distortion | Possible deep invasion |
Any skin lesion that does not heal within a few weeks should be medically evaluated.
Real-Life Experience Example
Some people notice basal cell carcinoma while shaving or washing their face. A tiny sore near the nose keeps reopening, even though it never seems painful. Months pass, and the area slowly widens. Once examined, the lesion is found to be a basal cell carcinoma. After surgical removal, healing is usually straightforward, and regular follow-up helps ensure no recurrence develops.
FAQ
Is basal cell carcinoma life-threatening?
It is rarely life-threatening, but it can cause significant local damage if untreated.
Is it contagious?
No. It is not an infectious condition.
How can it be distinguished from a simple wound?
A wound that does not heal and repeatedly crusts should raise suspicion.
Can it come back after surgery?
Recurrence is uncommon, especially after Mohs surgery, but follow-up is important.
Can younger people develop it?
Yes, though it is less common, especially with high UV exposure.
Does it turn into other skin cancers?
It usually progresses locally rather than transforming into another cancer type.
References
- Mayo Clinic – Basal Cell Carcinoma
https://www.mayoclinic.org/diseases-conditions/basal-cell-carcinoma - NHS – Basal Cell Carcinoma
https://www.nhs.uk/conditions/basal-cell-carcinoma/ - American Cancer Society – Basal and Squamous Cell Skin Cancer
https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer - DermNet NZ – Basal Cell Carcinoma
https://dermnetnz.org/topics/basal-cell-carcinoma - Medscape – Basal Cell Carcinoma Overview
https://emedicine.medscape.com/article/276624-overview
Basal cell carcinoma often develops quietly, but its persistence is a warning sign. When a skin ulcer or nodule fails to heal, especially on sun-exposed areas, timely medical evaluation can prevent unnecessary tissue damage and ensure effective treatment.