Basal Cell Carcinoma

April 10, 2026

This page was reviewed under our medical and editorial policy by Gaurav Singh, M.D., M.P.H., F.A.C.M.S., Mohs Micrographic Surgeon and Dermatologist, City of Hope^® Cancer Center Chicago.

Basal cell carcinoma is the most common type of skin cancer in the United States, accounting for 8 of 10 nonmelanoma skin cancer diagnoses. Although basal cell carcinoma is slow-growing and responds very well to treatment, rates for this skin cancer type have increased over the past few decades. Recognizing any type of skin cancer early is the key to effective treatment.

Facts About Basal Cell Carcinoma

• Basal cell skin cancer is the most common type of skin cancer, accounting for nearly 80% of all skin cancer diagnoses.
• The other two main types of skin cancer are squamous cell carcinoma and melanoma.
• Basal cell skin cancer is slow-growing and very rarely spreads to other parts of the body.
• Between 1% and 10% of patients with basal cell carcinoma experience recurrence after cancer treatment. 

“Basal cell carcinoma is the most common skin cancer in the world and, importantly, one of the most treatable,” says Gaurav Singh, M.D., M.P.H., F.A.C.M.S., Mohs micrographic surgeon and dermatologist at City of Hope^® Cancer Center Chicago. “It very rarely metastasizes or becomes life-threatening when addressed in a timely manner.”

What Are Basal Cells?

The epidermis is the outermost layer of the skin. It’s made up of three main types of skin cells, including basal cells, which are located on the bottom of the epidermis, the skin’s outermost layer. Basal cells shed over time and are replaced by new ones.

What Is Basal Cell Carcinoma?

Basal cell carcinoma is a type of cancer that develops when basal cells grow abnormally and form a tumor or lesion. These lesions cause changes in the appearance of the skin, such as patches, lumps or scar-like tissue that may be red, pink, skin-colored or translucent and may ulcerate or bleed. Less often, basal cell carcinoma may be referred to as basilioma or rodent ulcer, which are outdated terms for this disease.

Basal Cell Carcinoma Versus Squamous Cell Carcinoma

Basal cell and squamous cell carcinomas are the two most common types of skin cancer. Basal cell carcinoma accounts for about 80% of all nonmelanoma skin cancers, while about 20% are squamous cell carcinomas. Both form in the outer layer of the skin, but in different types of cells, as detailed below.

Basal cell carcinoma: This type of cancer begins in the basal cells, which are at the bottom of the epidermis. Basal cells are always growing, making new cells that push the old ones off the skin. Basal cell carcinoma rarely spreads to other parts of the body.

Squamous cell carcinoma: This type of cancer starts in the skin’s squamous cells, which are flat cells that shed off of the skin constantly. Squamous cell carcinoma sometimes spreads to other parts of the body.

Both basal cell and squamous cell skin cancer are caused in large part by exposure to ultraviolet (UV) light from the sun. This is why they are often found on areas of the body that are most exposed to the sun. However, squamous cell carcinoma may also grow in scars or skin sores that don’t heal on other parts of the body, including harder-to-examine areas such as between the toes or around the genitals.

Comparison of what squamous and basal cell carcinoma look like.

Basal Cell Carcinoma Versus Melanoma

Basal cell carcinoma and melanoma are both types of skin cancer. Basal cell carcinoma is common and not very aggressive. Melanoma is much rarer, accounting for only 1% of all skin cancer diagnoses. However, it is more likely to spread to other parts of the body. It may appear on sun-exposed areas or in areas of the body that are usually covered.

Basal Cell Carcinoma Versus Actinic Keratosis

Basal cell carcinoma is a form of skin cancer. Actinic keratosis is not cancer, but it is a kind of precancerous skin lesion. Actinic keratosis often appears in the form of changes to the skin, resulting in:

• A thick, rough scaly path that may be red, pink or brown
• Flat and raised areas of the skin
• A chapped or peeling area on the lower lip that doesn’t heal with lip balm or petroleum jelly

Actinic keratosis tends to develop in parts of the body exposed to the sun, specifically the face and the tops of the hands. Actinic keratosis can transform into squamous cell carcinoma, but does not transform into basal cell carcinoma.

What Do the Types of Basal Cell Carcinoma Look Like?

There are at least four different types of basal cell carcinoma. Each type has a slightly different appearance, as detailed below.

Nodular basal skin cell cancer: This type of cancer may look like a pimple that is raised from the skin. It may be flesh-colored, pink, pearly or shiny. It also may have little red blood vessels inside and a slightly raised edge. Slow-growing, this type of basal cell carcinoma may turn into an open sore and bleed.

Superficial spreading basal cell carcinoma: This appears like a scaly patch of skin that is pink or red and may develop a crust. It is flat against the skin. The outer edge may look pearl-colored with small white bumps.

Sclerosing or infiltrating basal cell carcinoma: Also called morpheaform basal cell carcinoma, this may appear as a lighter-colored patch on the skin that is shiny, smooth or looks like scar tissue. It may be more difficult to see and have ill-defined borders. It may also have indentations, little red blood vessels and open sores or a crust.

Pigmented basal cell skin carcinoma: This is often a different color to the surrounding skin, appearing brown, blue, black or red.

What Causes Basal Cell Carcinoma?

Basal cell carcinoma is the result of changes to the genetic material in the skin’s basal cells. These genetic changes are usually caused by environmental factors such as exposure to UV light from the sun or indoor tanning. However, there are some genetic factors that may play a role for a small number of patients.

Risk Factors

The single most significant risk factor for developing any kind of skin cancer is exposure to the UV light from the sun or from artificial tanning. In addition to a history of exposure to the sun or other UV light, other risk factors for developing basal cell skin cancer include:

• Being over age 50
• Having experienced multiple sunburns as a child
• Having a light skin tone or freckled skin
• Having blonde or red hair
• Having blue, green or gray eyes
• Having multiple moles on the skin
• A family history of skin cancer
• Being immunocompromised
• A history of other skin diseases, such as nevoid basal cell carcinoma syndrome, a hereditary condition characterized by multiple basal cell skin cancers
• A history of photodynamic therapy, which uses special drugs along with a light source to kill cancer cells
• A history of smoking

Where Does Basal Cell Carcinoma Form?

Most basal cell skin cancers occur on parts of the body that have been exposed to direct sunlight, such as the the neck, scalp, chest, shoulders and back. However, it may also be found on parts of the body that are usually kept out of the sun, such as between the toes, on the feet or around the genitals.

Basal Cell Carcinoma Symptoms

The key to detecting any form of skin cancer early is to perform a self-exam to look for changes to the skin that may be a sign of skin cancer. Some common symptoms of basal cell skin cancer include:

• An open sore that doesn’t heal fully and may bleed, ooze or crust over
• A shiny or pearly bump that is pink, red or flesh-colored
• A raised spot on the skin that has a rolled edge and a crusty indentation at its center
• A white, waxy or yellow area of skin that may look like a scar

In some cases, these changes to the skin may become sore or itchy. Any change in the appearance of a mole or spot on the skin should be examined by a dermatologist.

Basal Cell Carcinoma Stages

Staging cancer is the process of using tests and physical exams to determine how far cancer has spread. Because basal cell carcinoma is slow-growing and does not tend to spread from its original site, skin cancer experts usually stage the disease as either high risk or low risk, as follows.

High-risk basal cell carcinomas: These tend to be larger than 2 centimeters (cm) in diameter, have less well-defined borders, be located in harder-to-treat areas such as the face, ears or scalp or be a more aggressive subtype of the disease.

Low-risk basal cell carcinomas: These are usually smaller than 2 cm in diameter, are located in a more easily accessible and treatable area of the body and have well-defined borders.

Basal Cell Carcinoma Treatment

Patients with basal cell carcinoma may undergo one kind of treatment or several, depending on factors such as their overall health, the stage of their cancer and whether it is a recurrent cancer or a new one. In some cases, certain treatments are combined to make a more effective treatment plan.

Surgery

Surgery is the most common treatment for basal cell carcinoma. Some of the common surgical options for the disease include wide excision, Mohs micrographic surgery and laser surgery. Each skin cancer surgery procedure works differently, but the goal is to completely remove skin cancer from the body. Surgery is often the only treatment needed for early-stage basal cell carcinoma.

Mohs surgery has the highest cure rate and least possible scarring for basal cell carcinoma. Your surgeon removes the cancer with a narrow margin of normal skin and assesses for the absence or presence of tumor under the microscope while you wait in the office. Reconstruction is then performed to give an optimal outcome.

“Mohs micrographic surgery is considered the gold standard treatment for basal cell carcinomas located on high-risk areas such as the face, scalp, ears and nose, offering cure rates greater than 99% for primary tumors while preserving the maximum amount of healthy surrounding tissue,” Dr. Singh says. “It can also be performed on the arms, legs and back. It is helpful to acknowledge that certain features such as tumor size, location, histologic subtype (particularly morpheaform or infiltrative patterns) and the patient's immune status can influence the overall risk profile and surgical approach.”

Radiation Therapy

Radiation therapy is the use of high-powered beams of radiation to target and destroy skin cancer. Radiation therapy may be used to treat basal cell carcinoma that may not be treated surgically or to kill any remaining cancer cells left behind after surgery to remove a basal cell carcinoma tumor.

Cryotherapy

Cryotherapy, sometimes called cryosurgery, is used to treat early-stage basal cell carcinomas. A doctor applies liquid nitrogen to the site of a tumor to freeze it. The skin cancer lesion then falls off, leaving healthy tissue behind.

Photodynamic Therapy

Photodynamic therapy (PDT) uses medications injected into the bloodstream, where they bind to cancer cells. A specialized kind of laser is then shone at the site of the cancer, activating the medications so that they kill cancer cells. It is sometimes used to treat basal cell carcinoma at its earliest stages.

Topical Skin Cancer Treatments

Topical skin cancer treatments are creams, ointments or gels applied to the skin at the site of a skin lesion to destroy precancerous or cancer cells on the skin’s surface. Sometimes, these medications are referred to as “chemo cream.”

Treatment of Advanced or Metastatic BCC

Although it is very rare, basal cell carcinoma may spread to other parts of the body. For patients with advanced basal cell carcinoma, there are some newer chemotherapy treatment options, including Erivedge® (vismodegib) and Odomzo® (sonidegib), which block a key signaling pathway that encourages basal cell skin cancers to grow and spread.

Basal Cell Carcinoma Survival Rates

Basal cell carcinoma is extremely common and highly treatable. Because of this, survival statistics are not reported and tracked in the same way as many other cancers. The American Cancer Society estimates that only around 2,000 out of the 5 million Americans who are diagnosed with either basal cell or squamous cell carcinoma each year will die as a result of their cancer. Patients who have worse outcomes related to basal cell carcinoma are those who:

• Are older than 70
• Don’t seek care until their cancer is very advanced
• Have a weakened immune system

Healthy people who develop basal cell carcinoma typically have a very positive prognosis, with early-stage basal cell cancers routinely being cured after initial treatment via surgery or other treatment options.