Basal Cell Carcinoma (BCC): Your GoodRx Guide

What is a basal cell carcinoma?

Basal cell carcinoma (BCC) is the most common type of skin cancer. It’s much more common than melanoma, and it looks pretty different. In fact, a basal cell cancer doesn’t look like what most people expect a skin cancer to look like. It can look like a crust, a sore, a scar, or a rough patch of skin. 

BCC affects about 3.5 million people in the U.S every year. Anyone can develop a BCC, but it’s more common in people with lighter skin and lighter hair. BCC is most likely to develop on skin that gets a lot of sun, like your face or ears.

Most BCCs grow slowly, and they’re easy to cure when caught early. In very rare situations, a BCC can be more aggressive and spread to other parts of the body. The longer you wait to treat BCC, the harder it can be to treat and the more likely it is to come back.

What does BCC look like?

BCCs can look different from one person to the next. Basal cell carcinoma can look like:

• An open sore that doesn’t heal or one that bleeds or is crusty

• A flat, scar-like area that’s smooth and shiny

• A red or brown patch that looks like eczema or psoriasis — but doesn’t go away

• A smooth, pink or brown skin bump with a raised edge   

You can get a BCC anywhere on your skin, but they’re much more likely on skin that’s been exposed to the sun. This includes areas like your face, neck, ears, and chest.

Most BCCs don’t have symptoms, but sometimes they can itch or hurt. 

Here are some images of how different BCCs look in different people. 

Photo credit: Jorge Garcia, MD	Photo credit: Maria Robinson, MD
Photo credit: Maria Robinson, MD

What Do Different Types of Skin Cancer Look Like?

Written by Maria Robinson, MD, MBA

What causes BCC?

BCC starts when basal skin cells grow out of control. Basal cells are the skin cells at the bottom of the outer skin layer.

The main cause for this is too much ultraviolet (UV) exposure from the sun or tanning beds — or both. When UV light hits the skin, it damages the DNA (genetic instruction code) of basal cells. 

At first, the body can repair this damage. But, over time, the damage is more than the body can repair. When this happens, BCC can start to grow. 

Some things make it more likely that you may develop a BCC. It may be a good idea to get a skin screening with a dermatologist if you have any of these risk factors:

• Frequent unprotected UV light exposure (from sun or tanning beds)

• Light skin that freckles or burns easily

• Blond or red hair, or blue or green eyes

• Age over 50 or being male 

• Certain inherited genetic conditions (like nevoid basal cell carcinoma syndrome)

• Exposure to X-rays or radiation

• History of skin cancer

Some genetic mutations have been found in certain people with BCC. These mutations are in the so-called PTCH1 and PTCH2 genes. Gene mutations are important because some medications work by targeting them. Scientists will likely discover many more gene mutations.  

Do People of Color Need to Wear Sunscreen?

Written by Venus Sánchez

Diagnosing BCC

A BCC is usually diagnosed with a skin check followed by a skin biopsy. Typically, a dermatologist does this, but some primary care providers can, too.  

Here’s what you can expect:

• Skin exam: Your provider will check your skin for signs of BCC. If there’s a concerning spot, they’ll usually do a skin biopsy to confirm the diagnosis.

• Skin biopsy: This is a minor surgical procedure done in your provider’s office. They numb your skin with a small needle and then use a surgical blade to remove the spot. You may get stitches after the procedure. Your provider then sends the tissue to a lab where a pathologist evaluates it for skin cancer. It usually takes 2 to 5 days to get the results.

Treating BCC

Treatment for a BCC depends on a few factors, like where it is on the body and how big or small it is. Here are some common treatment options:  

• Surgical treatment: This works by cutting out the cancer and can be done with an excision or Mohs surgery (a special type of excision that spares normal skin).

• Destruction: This means removing the cancer by freezing it (cryosurgery) or scraping it off (curettage and electrodesiccation).

• Photodynamic therapy (PDT): This uses a special medication and light to target skin cancer cells.

• Topical chemotherapy: This uses imiquimod and 5-fluorouracil creams to kill cancer cells.

• Radiation: This uses high-energy waves or particles (like X-rays) to kill cancer cells. This is usually used when surgical treatments aren’t possible.   

Sometimes a BCC will grow very deep or spread to other parts of the body (advanced basal cell carcinoma). When this happens, it may need additional treatment with medications that work throughout the body, like vismodegib (Erivedge) or sonidegib (Odomzo). 

How Much Does Skin Cancer Treatment Cost?

Written by Margot Lester

Preventing BCC

You can’t entirely prevent BCC, but there are steps you can take to lower your chances of developing it. The most important things you can do are to protect your skin from UV rays and check your skin regularly.

Here are some more ways to prevent BCC:

• Use sunscreen every day.

• Find shade between 10AM and 4PM.

• Don’t tan or use tanning beds.

• Wear sun-protective clothing.

• See a dermatologist for regular checkups if you have risk factors.

• Trust your gut if you’re worried about a skin spot.

Where to Get Free Cancer Screenings Without Insurance

Written by Lorraine Roberte