Basal Cell Carcinoma

A basal cell carcinoma (also known as rodent ulcer or BCC) is a very common, low grade type of skin cancer which does not spread elsewhere but grows very slowly over time. If left, it will not resolve by itself and will eventually cause symptoms such as bleeding or soreness. If near a vital structure such as the eye of nose, it can cause more significant damage to sight or breathing. 

In most cases, this type of skin cancer can you cured once it has been fully removed either with surgery or a chemotherapy cream if very thin.  

There are different types of Basal Cell Carcinoma:

1) Nodular - the most common type. This is a lump on the skin, sometimes with a central ulcer when there skin has broken down and is typically shiny or pearly around edges where light is reflected. 

2) Morphoeic - can look like a white firm scar which feels thickened when pinched and will gradually increase in size over time. 

3) Pigmented - can be confused with melanoma as there is some brown (pigmented) colour within it. Usually this can be determined by the Consultant using a Dermatoscope.

4) Superficial - this means the cancer is only in the top layer of the skin. This presents as a red mark which might bleed when rubbed e.g. with a towel. This type of BCC can often by treated with a cream called Aldara (imiquimod), liquid nitrogen or a curettage procedure. 

Treatment for Basal Cell Carcinoma depends on the type. Nodular, Morphoeic and Infiltrative subtypes usually need to be removed surgically with a margin under local anaesthetic. 

Your dermatologist can arrange this for you and in most cases this is a minor procedure performed whilst you are awake under local anaesthetic. Dr Aaron Wernham is a specialist skin surgeon who has trained to provide high cure rates for Basal Cell Carcinoma with excellent cosmetic outcomes. 

In some cases, you will be advised to have a special surgical technique call Mohs Micrographic Surgery. This allows the tumour to be checked under the microscope whilst you wait to ensure the margins are clear before reconstructing the defect and bringing the skin back together. This is a technique Dr Wernham has undertaken specialist training in to ensure he can provide gold standard treatment to patients who need it. Mohs is typically required when the margins of the skin cancer are not clear or on cosmetically sensitive sites such as the face. 

If your basal cell carcinoma is very thin (superficial type) then other treatments can be considered. For further information visit the minor procedures page. These include:

• Liquid nitrogen therapy. 
• Curettage and Cautery. 
• Aldara or Efudix creams.