DERMADEX
ConditionsFebruary 11, 20269 min read

Basal Cell Carcinoma: Signs, What It Looks Like, and Treatment

Basal cell carcinoma is the most common skin cancer and one of the most curable. A DermaDex dermatologist explains what BCC looks like, why it develops, how it is diagnosed, and the treatment options available in Canada.

Mohsen Khoddami

Mohsen Khoddami

MD, Dermatologist

Basal Cell Carcinoma: Signs, What It Looks Like, and Treatment

As of February 10, 2026.

Basal cell carcinoma (BCC) is the cancer dermatologists see most often, and it is also one of the most treatable. As a dermatologist and co-founder of DermaDex, I look at spots like these every week, and the same worries come up: Is it dangerous? How fast does it grow? Will I need surgery? This guide covers what BCC looks like, why it develops, how it is diagnosed, and the treatments available in Canada. It is general education, not a diagnosis. If you have a spot that bleeds, crusts, or will not heal, ask a clinician to examine it.

What is basal cell carcinoma?

Short answer: Basal cell carcinoma is a slow-growing skin cancer that begins in the basal cells at the base of the outer skin layer. It is the most common cancer in humans and makes up about 80 percent of all skin cancers, according to the American Academy of Dermatology (AAD).

BCC starts when basal cells, which sit in the lowest part of the epidermis, are damaged and begin dividing out of control. Most of that damage comes from ultraviolet (UV) light. Unlike melanoma, BCC very rarely spreads to distant organs. Its real risk is local. Left alone, it can grow wider and deeper into skin, cartilage, and even bone, which makes removal more involved later. The Centers for Disease Control and Prevention (CDC) groups BCC with squamous cell carcinoma as the two main forms of non-melanoma skin cancer.

What does basal cell carcinoma look like?

Short answer: Basal cell carcinoma often shows up as a pearly or waxy bump, a flat scaly patch, or a sore that bleeds, scabs over, seems to heal, and then comes back in the same place. It usually appears on sun-exposed skin: the face, nose, ears, scalp, neck, and the backs of the hands.

There is no single appearance, which is why BCC is missed so often. The classic sign is a small, shiny, skin-coloured or pink bump with fine blood vessels visible across the surface. Other forms include a flat reddish patch, a pale waxy scar-like area with blurry borders, or an open sore that will not close after several weeks. Some BCCs hold brown or black pigment and look like a mole. The AAD lists a sore that heals and returns as one of the most common warning signs.

BCC subtype Typical appearance Common location
Nodular (most common) Pearly, waxy bump with visible vessels and sometimes a central dip Face, nose, ears
Superficial Flat, scaly pink or red patch that can resemble eczema Trunk, shoulders, back
Morpheaform (sclerosing) Pale, waxy, scar-like patch with poorly defined edges Mid-face
Pigmented Brown, blue, or black bump that can mimic a mole Sun-exposed skin

If you are trying to tell a harmless growth from something that needs review, our guide on seborrheic keratosis vs melanoma compares the visual clues.

What causes basal cell carcinoma and who is most at risk?

Short answer: The main cause of basal cell carcinoma is ultraviolet radiation from the sun and from indoor tanning beds. People with fair skin, light eyes, a history of sunburns, and many years of accumulated sun exposure carry the highest risk.

UV light damages the DNA inside skin cells, and that damage adds up over a lifetime. The World Health Organization (WHO) classifies solar UV radiation as a proven human carcinogen, and both ultraviolet A (UVA) and ultraviolet B (UVB) wavelengths play a part. Known risk factors, summarized by the CDC, include:

  • Fair skin that burns rather than tans (Fitzpatrick types I and II)
  • Light hair and eye colour
  • Frequent sunburns or any indoor tanning
  • Older age and a high lifetime sun dose
  • A weakened immune system, for example after an organ transplant
  • Past radiation treatment or arsenic exposure
  • Rare inherited conditions such as basal cell nevus (Gorlin) syndrome

Canadian context matters here. Cold winters do not cancel UV risk. Snow can reflect a large share of UV back at the skin, and across much of the country the summer UV index reaches high or very high levels. Health Canada recommends sun protection whenever the UV index is 3 or higher.

How is basal cell carcinoma diagnosed?

Short answer: A clinician diagnoses basal cell carcinoma by examining the skin, often with a dermatoscope, and confirming it with a skin biopsy. The biopsy removes a small sample so a pathologist can study the cells under a microscope, which is the only way to be certain.

The visit usually starts with a close look at the spot and the surrounding skin. Many clinicians use dermoscopy, a handheld magnifier with polarized light that reveals patterns invisible to the naked eye. Our explainer on dermoscopy describes what those patterns show. If BCC is suspected, the clinician performs a shave or punch biopsy under local anesthetic. Pathology confirms the diagnosis and the subtype, which guides treatment. In Canada, access to a dermatologist can take months in many regions, so primary-care photos and triage tools, including artificial intelligence (AI) skin checks, can help sort which spots need faster review. StatPearls confirms biopsy as the diagnostic standard.

How is basal cell carcinoma treated?

Short answer: Most basal cell carcinomas are cured with a single outpatient procedure that removes the tumour. Options range from surgical excision and Mohs micrographic surgery to curettage, freezing, prescription creams, and, for advanced disease, radiation or targeted medication.

The right choice depends on the subtype, size, location, and whether the BCC has been treated before. Small, low-risk tumours on the trunk or limbs are often handled with simple in-office methods, while tumours on the face or near the eyes, nose, and ears usually call for tissue-sparing surgery.

Treatment How it works Best suited for
Surgical excision Cuts out the tumour with a margin of normal skin Most BCCs
Mohs micrographic surgery Removes thin layers, checking each under a microscope until clear Face, recurrent, large, or aggressive BCC
Curettage and electrodesiccation Scrapes the tumour, then seals the area with electric current Small, low-risk BCC on the trunk or limbs
Cryotherapy Freezes the tumour with liquid nitrogen Small, superficial BCC
Topical creams (imiquimod or 5-fluorouracil) Patient-applied medicine over several weeks Superficial BCC
Radiation therapy Targeted radiation given in repeated sessions When surgery is not suitable
Targeted drugs or immunotherapy Block the tumour growth pathway Advanced or rare metastatic BCC

The AAD reports that Mohs surgery cures up to 99 percent of basal cell carcinomas that have not been treated before, which is why it is favoured for the face and high-risk tumours. In Canada, medically necessary biopsy and skin-cancer surgery are insured under provincial health plans such as the Ontario Health Insurance Plan (OHIP) when you have a referral, so the out-of-pocket cost for treatment is usually minimal.

How soon should it be treated, and what about follow-up?

Short answer: Basal cell carcinoma is not a same-day emergency, but it should be removed within a few weeks to a few months of diagnosis. Because anyone who has had one BCC has a higher chance of developing another, ongoing skin checks afterward are important.

BCC grows slowly, so a short scheduling delay does not usually change the outcome. The reason not to wait indefinitely is that a larger tumour means a bigger procedure and a larger scar, especially on the face. After treatment, the Canadian Dermatology Association (CDA) and the AAD both recommend regular full-skin examinations, since a person treated for one BCC has a meaningfully higher chance of developing another within a few years. Daily sun protection lowers that risk: seek shade, cover up, and use a broad-spectrum sunscreen with a Sun Protection Factor (SPF) of 30 or higher. If you notice a new or changing spot, contact us or your own clinician promptly. You can read more about our team and approach on our about page.

What else do people ask about basal cell carcinoma?

Short answer: The most common questions are about how serious BCC is, how fast it spreads, how quickly it should be removed, and how it affects life expectancy. In short, BCC is highly treatable, spreads very rarely, should be removed within weeks to months, and almost never shortens life when caught early.

How serious is basal cell skin cancer?

Basal cell carcinoma is the least dangerous of the common skin cancers, but it is still a true cancer that needs treatment. It almost never spreads to other organs, and it is rarely life-threatening. The seriousness is local. If it is ignored for months or years, it can invade nearby skin, cartilage, nerves, and bone, which makes removal more complex and can cause disfigurement, especially on the face. Tumours near the eyes, nose, and ears deserve prompt attention. The good news is that when it is found early, BCC is one of the most curable cancers, with cure rates above 95 percent for small, previously untreated tumours. Take it seriously enough to treat, but it is not a reason to panic. A clinician can confirm whether a spot is BCC.

How fast does basal cell carcinoma spread?

Basal cell carcinoma usually grows slowly, over months to years rather than days or weeks. Most of that growth is local: the tumour widens and deepens in the skin where it started. Spread to lymph nodes or distant organs, called metastasis, is very rare and is reported in far less than 1 percent of cases in the medical literature summarized by StatPearls. Certain subtypes, such as the morpheaform (sclerosing) and infiltrative types, can extend further under the surface than they appear, which is one reason borders can be hard to judge by eye. Because it grows slowly, BCC is rarely an emergency, but slow growth is not the same as harmless. The longer it is left, the larger the area that must eventually be removed.

How soon should you get basal cell carcinoma removed?

There is no need to rush to surgery the same week, but most clinicians aim to treat a confirmed BCC within a few weeks to a few months. The timing balances two facts: BCC grows slowly, so a short wait is safe, and it does not stop growing on its own, so indefinite delay only enlarges the eventual procedure and scar. High-risk locations, such as the eyelids, nose, ears, and lips, and aggressive subtypes warrant faster scheduling. In Canada, wait times to see a dermatologist or surgeon can stretch to several months in some regions, so it helps to start the referral promptly and to use photo-based triage where available. If a spot bleeds repeatedly, grows quickly, or changes, tell your clinician so it can be moved up.

What is the life expectancy of someone with basal cell carcinoma?

For nearly everyone, basal cell carcinoma does not lower life expectancy. It is almost never fatal because it rarely spreads beyond the skin, and the large majority of cases are cured with a single outpatient treatment. Death from BCC is extremely uncommon and is mostly limited to neglected tumours that were allowed to invade deeply over many years, or to the rare advanced cases in people with weakened immune systems. The more realistic long-term issue is recurrence: having one BCC raises the odds of developing another, which is why ongoing skin checks and sun protection matter. With early diagnosis and standard treatment, the outlook is excellent, and people go on to live a normal lifespan. This is general information, not a personal prognosis, so discuss your situation with your own clinician.

Sources

Frequently Asked Questions

You might also like

Conditions

Squamous Cell Carcinoma of the Skin: Symptoms and Treatment

Conditions

Hives (Urticaria): Common Causes and How to Stop the Itch

Prevention

Mole Mapping and Total Body Photography: Who Actually Needs It

Start Your Journey

Ready to Take Control of Your Skin Health?

Join Canadians who are already using DermaDex for instant skin analysis and access to certified dermatologists.

Get Started FreeContact Us

Free AI Analysis

No credit card required

HIPAA Compliant

Your data is secure

Instant Results

Get answers in seconds