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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Skin Cancer, Basal Cell

Ultraviolet radiation can damage basal cells in the epidermis. These cells may surface and produce a growth characteristic of skin cancer.

What is it?

Basal cell skin cancer is by far the most common form of skin cancer in the United States. It is believed to occur when ultraviolet radiation (usually sunlight) damages the genetic material of the basal cells located in the thin, top layer of the skin (epidermis) or hair follicles. The most common site for basal cell skin cancer is the face (typically the nose or ears), although it may appear anywhere. It is a painless, slow-growing cancer and very rarely, if ever, spreads to other parts of the body. Left untreated, however, it can slowly invade and even destroy the entire nose or an ear. Fortunately, with early detection and treatment, basal cell carcinoma is cured in 95 percent of cases, with only 5 percent of cases showing local recurrence.

What Causes It?

  • Skin cells are damaged by cumulative exposure to ultraviolet radiation from the sun or from artificial sources (such as sunlamps). Although the risk of skin cancer increases steadily with age, even teenagers with excess sun exposure can develop skin cancers.
  • People who sunburn easily, especially those with fair skin, blue eyes, or red or blond hair are most at risk, because they have relatively little natural pigment protection (melanin).
  • Risk is greater in year-round sunny climates, where the sun's radiation is most constant and intense.

Prevention

  • As much as possible, avoid exposure to direct sunlight between 10 a.m. and 3 p.m.
  • Block the sun's rays with protective clothing such as hats and long sleeves.
  • Before going outside, apply (and reapply often) a waterproof sunscreen lotion with a sun protection factor (SPF) of at least 15 to 30. (The way most people sparingly apply sunscreen, an SPF of 30 really provides only about an SPF of 15.)
  • Avoid sunlamps and tanning booths.
  • Perform regular skin self-examinations, looking for any new growths or changes in existing lesions.
  • People who have had one basal cell skin cancer have an approximately 50 percent chance of having a second nonmelanoma (basal or squamous cell) skin cancer within five years. For this reason, preventive measures are especially important after initial diagnosis.

Diagnosis

  • A biopsy (removal of a tissue sample for examination by a pathologist) will be performed.

How to Treat It

  • To remove cancerous cells, surgery or radiation therapy may be used.

When to Call a Doctor

  • Make an appointment with your doctor when you notice a new growth, particularly on sun-exposed sites. Just about everyone has some skin growths; most are harmless. Nonetheless, an examination is wise and a biopsy may be needed.
  • Schedule a skin examination at least once a year following an episode of basal cell skin cancer.