Basal cell carcinoma is the most common form of skin cancer. It grows slowly and rarely spreads, but it can damage the skin and tissue around it if left untreated, which is why finding and treating it early matters.
Basal cell carcinoma, usually shortened to BCC, develops in the basal cells that sit in the lower part of the outer layer of your skin. Cancer Council Australia reports that BCC accounts for around 70% of non-melanoma skin cancers, and that around two in three Australians will be diagnosed with some form of skin cancer in their lifetime.
Unlike some other skin cancers, BCC very rarely spreads to other parts of the body. The reason it still needs treating is local: left alone, it keeps growing into the tissue around it.
What is basal cell carcinoma?
Basal cells sit at the base of the epidermis, the outer layer of your skin, and continually divide to replace the cells above them. Long-term exposure to ultraviolet radiation can damage the DNA in these cells, and over time that damage can lead to uncontrolled growth.
BCC is generally slow growing and is usually painless, which is part of why it can go unnoticed for a long time. It causes harm by growing into surrounding tissue rather than by spreading through the body.
BCC most often appears on skin that has had regular sun exposure, particularly the face, nose, ears, neck, scalp, shoulders and back. It can develop almost anywhere, though it is rare on the palms and soles.
If you are trying to work out how BCC differs from other skin cancers, our guide to melanoma vs non-melanoma skin cancer sets out the differences, and you can read more about melanoma on its own page.
What does basal cell carcinoma look like?
BCC does not usually look the way people expect a skin cancer to look. It is often small, subtle and painless. Common appearances include a:
- pearly or shiny pink bump, sometimes with tiny visible blood vessels across it
- sore that does not heal, or that scabs over, appears to heal, then returns
- pink patch that slowly gets bigger
- pale, waxy or scar-like area that may look slightly sunken or indented
- spot that bleeds easily after minor knocks or while drying with a towel
The scar-like type is the easiest to overlook, because it does not look like a lump or a sore at all.
The most useful thing to watch for is persistence. A spot that has been there for weeks and is not settling is worth having looked at, even if it seems minor.
Types of basal cell carcinoma
BCC subtypes behave differently, and the subtype influences which treatment is suitable:
Nodular BCC: the most common type. Appears as a raised, pearly lump, often on the face, and may develop a central dip or ulcer as it grows.
Superficial BCC: a flat, pink, sometimes slightly scaly patch that stays within the top layer of the skin. More often found on the trunk and limbs.
Infiltrative and morphoeic BCC: flatter and paler, resembling a small scar. These extend further under the skin than they appear on the surface, so they generally need wider treatment.
What increases your risk of BCC?
Risk factors include:
- cumulative sun exposure over many years
- a history of sunburn, particularly in childhood
- fair skin that burns easily, light-coloured eyes, blonde or red hair
- outdoor work or regular outdoor recreation
- use of solariums
- increasing age, with BCC becoming more common after 40
- a previous BCC or any other skin cancer
- a weakened immune system, from illness or medication
- previous radiation treatment to an area of skin
- certain rare inherited conditions affecting the skin
Having had one BCC makes another more likely, which is why ongoing skin checks are usually recommended after a first diagnosis.
Why treating BCC early matters
Because BCC rarely spreads, it is sometimes dismissed as not worth acting on. The argument for treating it early is about what it does locally.
A BCC left untreated continues to grow outwards and downwards into the surrounding tissue. A small lesion treated early usually means a smaller procedure and a smaller scar. The same lesion left for a year or two can require a considerably larger excision.
This matters most on the face. BCC has a particular tendency to appear on the nose, the inner corners of the eyes, the eyelids and the ears, where there is little spare tissue and where reconstruction becomes more complex as the lesion grows.
What happens at a skin check
A skin check is a thorough, methodical examination of your skin by a doctor. Your doctor will use a dermatoscope, a specialised magnifier using polarised and non-polarised light, to see colours and structures beneath the skin surface that are not visible to the naked eye. Many BCCs have characteristic patterns under dermoscopy that are not apparent otherwise. Where the diagnosis is clear, treatment can often be discussed straight away. Where there is uncertainty, or where knowing the subtype will change the treatment plan, a biopsy confirms both the diagnosis and the subtype. You can read more about our full body skin check and what to expect on the day.
How basal cell carcinoma is treated
Treatment depends on the size, location and subtype of the BCC, along with your general health and history. Options may include:
- Surgical excision, the most commonly recommended treatment, where the lesion is removed along with a margin of surrounding skin and sent for pathology
- Curettage and cautery for selected low-risk lesions, generally on the trunk or limbs
- Cryotherapy for carefully selected superficial lesions, used less often
- Prescription topical treatments applied to the skin over several weeks, which may suit some superficial BCCs in appropriate sites
- Radiotherapy in specific circumstances, usually where surgery is not suitable
- Mohs micrographic surgery, a specialist technique where tissue is examined during the procedure to confirm clear margins. Referral may be considered for higher-risk BCC in cosmetically sensitive areas such as the nose, eyelids, lips and ears.
Your doctor will talk through which options are appropriate for your lesion, including the likely outcome, the recovery and the expected scar.
When to book a skin check
Consider booking if you notice:
- a spot or sore that has not healed within a few weeks
- a sore that heals and then breaks down again in the same place
- a shiny or pearly bump, particularly on the face, ears or neck
- a pink patch that is slowly getting larger
- a pale, scar-like area on skin that has not been injured
- a spot that bleeds easily with minor contact
How often you need a skin check is individual. It depends on your risk factors, your skin cancer history and your doctor's advice.
Skin checks at Solvera
Solvera Skin Cancer Institute is led by three doctors who work exclusively in skin cancer medicine, with postgraduate qualifications including a Master of Medicine (Skin Cancer) alongside their general practice training.
We provide total body photography and digital dermoscopy monitoring for patients at higher risk, and manage diagnosis, excision and pathology in one place, so if something needs treating, your care continues with the doctor who found it.
Book a skin check online
Or call our reception team on (02) 8806 2207.
Book a skin cancer check
Frequently asked questions
Is basal cell carcinoma dangerous?
BCC very rarely spreads to other parts of the body, and Cancer Council Australia notes that most non-melanoma skin cancers are not life-threatening. It does still need treatment, because it continues to grow into the surrounding tissue and becomes harder to treat the longer it is left.
Does BCC spread to other parts of the body?
It is very uncommon for BCC to spread beyond the skin. The concern with BCC is local growth rather than distant spread.
Will treatment leave a scar?
Any procedure that removes tissue leaves some mark. How noticeable it is depends on the size and location of the lesion and the technique used. Treating a BCC when it is small generally means a smaller procedure. Your doctor will discuss what to expect before treatment.
If I have had one BCC, will I get another?
Having had a BCC increases the likelihood of developing another, either nearby or elsewhere. This is why ongoing skin checks are usually recommended after a diagnosis.
How often should I have a skin check?
This varies between individuals. Your doctor will recommend an interval based on your skin type, history and risk factors.
Medically reviewed by: Dr Tim Scrivener, MBBS, FRACGP, MMed (Skin Cancer)
Last reviewed: August 2026
Sources: Cancer Council Australia -skin cancer types, incidence and mortality, Australasian College of Dermatologists, DermNet NZ
This page is general information only and is not a substitute for individual medical advice. If you are concerned about a spot on your skin, please see a doctor.
