Basal Cell Carcinoma: Types and Pictures

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Definition | Symptoms | Pictures | Types | Treatment | Causes | Prevention

Basal cell carcinoma is the most common type of skin cancer. Basal cell carcinomas (BCCs) are often confused with less significant skin lesions due to a lack of awareness. The general population tends to have a better awareness of melanoma which often involves dark pigmented lesions that cause concern. BCCs are often less dramatic in appearance but early detection remains important.

What Is Basal Cell Carcinoma?

Basal cell carcinomas are skin cancers that develop from the deepest cells of the outermost layer of skin, called the epidermis. Specifically, they arise from the basal cells which give them their name (¹). Given their origin, it is natural to wonder what basal cell carcinoma looks like.

They generally look like translucent (partly clear) bumps on the skin. However, basal cell cancer can also involve a brown, blue or black lesion. Less commonly they can involve flat red patches and rarer still, appear like white, waxy lesions that look like scars.

Basal Cell Carcinoma Pictures, Types and Symptoms

Basal skin cancer accounts for eighty percent of all skin cancers. As with all types of cancer, early detection is vital. Early stage basal cell carcinoma is usually easily treatable, often with minor surgery under local anaesthetic. In this article we consider the main basal cell cancer symptoms along with pictures of basal cell carcinoma types.

What Are the Signs and Symptoms of Basal Cell Carcinoma

Basal cell carcinomas (also known as basal skin cancer) can appear anywhere on the body but the most common sites are sun exposed areas such as the face and arms. It’s important to keep a close eye on your skin to try and identify early basal cell carcinoma, as it’s easier to treat if identified early on.

Typical Basal cell carcinoma symptoms are: (²) (³)

• New skin lesion
• Itching of a lesion
• Easy bleeding with shaving or abrasion
• Non-healing lesion
• Change in colour of a lesion

The typical lesions to watch out for are as follows:

• Pink or translucent, shiny bumps or pearly nodules, sometimes with dark spots or black, blue, or brown surface
• Growths, pink in color, with raised edges and sunken center, usually with irregular blood “spoke-wheel” vessels on its surface
• Pale or yellow scar-like areas
• Elevated reddish patches
• Oozing, crusted, scaly and open sores that don’t heal over time

Basal Cell Carcinoma Pictures

Below are basal cell carcinoma pictures of typical lesions on various sites of the body. These photos and images of basal cell carcinomas are not exhaustive but are examples of common lesions.

Images in this article were sourced from DermNet NZ, Waikato District Health Board, Raimo Suhonen and Dr Richard Ashton.

Basal Cell Carcinoma Types

Basal cell carcinoma types are generally classified in the following way:

• Nodular basal cell carcinoma
• Superficial basal cell carcinoma
• Pigmented basal cell carcinoma
• Morphoeic basal cell carcinoma
• Basosquamous cell carcinoma

Below are basal cell carcinoma pictures to illustrate the differences between the various types.

Nodular basal cell carcinoma

As stated, 80 percent of skin cancers are basal cell carcinomas. Around 70 percent of these are nodular basal cell carcinomas. These are lesions found most commonly on the head and generally consist of pearl-shaped nodules with telangiectasia on the surface. Some types of nodular bcc can resemble melanoma. Below are nodular basal cell carcinoma images and photos.

Superficial basal cell carcinoma

Around 20 percent of basal cell carcinomas are superficial basal cell carcinomas. Superficial BCCs involve a well-marked red plaque with a pearl-shaped edge and erosion in sections. They don’t tend to grow invasively. Below are superficial basal cell carcinoma photos.

Pigmented basal cell carcinoma

Pigmentation can be found in several types of basal cell carcinoma including the two most common ones mentioned above. Dark black/brown pigments are found in parts of the lesion. Below are pigmented basal cell carcinoma photos.

Morphoeic basal cell carcinoma

These are uncommon and have a poorly demarcated red plaque with a slightly shiny surface. Below are morpheaform basal cell carcinoma images.

Basosquamous cell carcinoma

Basosquamous carcinoma is fortunately quite rare. It is an aggressive cancer with features of both basal cell carcinoma and squamous cell carcinoma. It often recurs locally after removal but also has a strong tendency towards metastasising to distant sites. Below are basosquamous cell carcinoma photos.

Images in this article were sourced from DermNet NZ, Waikato District Health Board, Raimo Suhonen and Dr Richard Ashton.

Basal Cell Carcinoma Treatment and Diagnosis

Basal cell carcinoma diagnosis is a frequent and daily occurrence across the UK. Fortunately, the vast majority are very easy to cure and very few people diagnosed with BCC will see it spread from its starting site (metastasis) or suffer serious ill-health. However, this relies on early detection. As described and illustrated above most of these lesions are easy to notice and this usually prompts early medical review and treatment. This limits the number of people that present for basal cell cancer treatment at a late stage.

Diagnosis is often by inspection but sometimes confirmation is required by a simple skin biopsy which is then assessed under a microscope. Lesions in a single site are usually removed with minor surgical procedures. Basal cell carcinoma removal and surgery often only requires local anaesthetic. Some very small lesions can be treated with topical chemotherapy type creams.

Further details of basal cell carcinoma treatment can be found here.

Basal Cell Carcinoma Causes and Prevention

Several causes for basal cell carcinoma have been identified. BCC can, however, arise without any of these. They start with a single cell that becomes abnormal due to damage to its DNA. These cells then multiply, and as abnormal cells build-up, the skin lesion becomes visible.⁴

Basal cell carcinoma risk factors include: ⁵

• Ultraviolet light
  UV light from sunshine and commercial tanning beds can both cause damage to cells mentioned, ultimately resulting in abnormal skin lesions. More sun exposure from warm climates, excess suntanning and excess use of tanning beds all make BCC more likely. Severe sunburn can also be a factor.
  
• Fair skin
  Fair skin is a risk factor as there is less protection for the deeper skin layers from melanin.
  
• Age
  As detailed, BCC starts with damage to cells and as we get more damage over time, increasing age is a significant factor.
  
• Medical treatment
  Radiotherapy for other medical conditions and immunosuppressants drugs can increase the risks of basal carcinoma and must be taken into account when assessing skin lesions.

For more details of risks factors, see this article.

Basal cell carcinoma prevention

Avoiding or minimising these risk factors is the mainstay of basal cell carcinoma prevention. The most important preventable factor is sun exposure.

• Avoid the midday sun.
• Wear sunscreen as much as possible and with the highest skin protection factor available.
• Cover up. This alone can make a big difference to reducing sun exposure and associated damage.
• Avoid tanning beds. Despite advice on the risks, tanning beds remain popular. Sadly they are one of the main reasons that we see skin cancer in patients in their early 20s.

It is vital to monitor your skin for new lesions and to have new lesions assessed by a medical professional. A Skin check guide and Skin mapping guide are useful background information to help protect yourself. There are also specific skin apps that can make the process easier.

Tracking Skin Lesions

We all have various skin lesions across our body and tend to develop more as we get older. Fortunately the vast majority of them are entirely harmless.

However it is important to monitor new lesions and changing lesions and smartphone apps, specially designed to track changes in the skin, can be really helpful with this. You can take photos at regular intervals in order to track and assess any changes. In some cases photo tracking has helped to highlight changes that need review by a doctor. Read more on how smartphone apps can help with early skin cancer detection.

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