What Is Basal Cell Carcinoma?

Plenty of people live with a small, shiny spot on their skin for years, assuming that anything growing that slowly can't be serious. Sometimes they're right — and sometimes that spot is a basal cell carcinoma. It is a cancer that starts in the basal cells, the round cells deep in the outer layer of skin that constantly produce new skin cells. Because it tends to grow slowly and quietly, it collects myths. This article works through the common ones, because what basal cell carcinoma actually does — and doesn't do — decides how it should be handled. The short video at the top of this page, "Basal Cell Carcinoma Excision on the Leg" (about two and a half minutes), shows one being removed from a patient's leg, which is where several of these myths end up being settled in practice.

Myth: "If it doesn't hurt and grows slowly, it can't be cancer"

Fact: basal cell carcinoma is known for being painless and slow. It often appears as a pearly or translucent bump, a pink patch, or a sore that seems to heal and then comes back in the same place. Over months it can gradually enlarge, develop a crusted centre, or bleed after minor knocks such as towelling or shaving. Slowness is not reassurance — it is simply this cancer's usual pace. What matters more is change: a spot that is new, growing, repeatedly crusting, or not healing the way ordinary skin does deserves an examination, whatever it feels like. Our overview of skin cancers sits within the site's cancer condition hub, and basal cell carcinoma should not be confused with melanoma, a different skin cancer with different behaviour and its own warning signs.

Myth: "The doctor can always tell just by looking"

Fact: an experienced clinician can often suspect basal cell carcinoma from its appearance, sometimes helped by a handheld magnifier with a light (a dermatoscope) — but suspicion is not a diagnosis. Confirmation normally comes from a biopsy: a small piece of the spot, or the whole spot, is removed under local anaesthetic and examined in a laboratory. That is also how the exact type is pinned down, which guides how it is treated. If you want to see what the sampling itself involves, our guide to what a skin biopsy is walks through the shave and punch techniques step by step.

Myth: "It will have to be cut out with a big margin, whatever happens"

Fact: surgical removal is the most common treatment, and the anchor video shows the standard version — the growth on the leg is cut out (excised) along with a small rim of normal-looking skin, and the wound is closed. But it is not the only route, and the choice depends on the size, type and position of the cancer and on your general health. For some cancers in delicate areas such as the face, Mohs surgery may be used instead: the tissue is removed in thin layers and each layer is checked under a microscope during the same visit, so as little healthy skin as possible is taken. The site also hosts a longer video, "What is Mohs Surgery?", whose description explains that the technique removes skin cancers — most commonly basal and squamous cell carcinomas and melanoma — while preserving the maximum amount of healthy tissue. Other situations may be managed with freezing, scraping, creams, light-based treatment or radiotherapy; those decisions belong to the treating team after the biopsy result, not to a general guide.

Myth: "Once it's removed, skin checks are finished forever"

Fact: removal treats that one cancer, but skin that has produced one basal cell carcinoma can produce another, and a new spot elsewhere is a separate event rather than the old one returning. So follow-up usually includes keeping an eye on the scar, watching the rest of your skin, and going back promptly if a new or changing spot appears rather than waiting for a routine appointment. Protecting your skin from further sun damage — shade, clothing and sunscreen on exposed areas — is the standard advice after treatment, and your team will tell you how often, if at all, they want to see you again. The honest summary is this: basal cell carcinoma rarely spreads to other parts of the body, but it can keep growing into surrounding tissue if it is left, which is why a "minor" spot that won't heal is worth one appointment rather than another year of watching it.

References & further reading

• MedlinePlus — Basal cell skin cancer (Medical Encyclopedia): https://medlineplus.gov/ency/article/000824.htm
• MedlinePlus — Skin Cancer (summary): https://medlineplus.gov/skincancer.html
• National Cancer Institute — Skin Cancer Treatment: https://www.cancer.gov/types/skin/patient/skin-treatment-pdq
• Skin Cancer Foundation — Basal Cell Carcinoma: https://www.skincancer.org/skin-cancer-information/basal-cell-carcinoma/

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Frequently Asked Questions

What does basal cell carcinoma look like?
It varies. Common forms include a pearly or shiny bump, a pink or red patch, and a sore that crusts, bleeds, seems to heal, then returns in the same place. Because it can mimic harmless spots, a changing or non-healing area should be examined rather than judged by appearance alone.

Does basal cell carcinoma spread?
It rarely spreads to distant parts of the body. Its main risk is local: left alone, it can keep growing into the tissue around it, which can make later removal larger and more complicated. That is why prompt assessment matters even though it usually grows slowly.

How is basal cell carcinoma removed?
Often by excision — cutting out the growth with a small rim of normal skin under local anaesthetic, as the video at the top of this page shows. In some areas, Mohs surgery removes it layer by layer with microscope checks during the same visit. Other options exist for selected cases, and the biopsy result guides the choice.

Will I need stitches after excision?
Many excision wounds are closed with stitches, though small ones may heal in other ways depending on size and position. Your team will explain wound care and any stitch removal at the time.

Can basal cell carcinoma come back after removal?
The treated spot can occasionally regrow, and entirely new basal cell carcinomas can appear elsewhere on sun-exposed skin. Reporting any new, growing or non-healing spot promptly — rather than waiting — is the practical takeaway.

This article is for general education only and is not medical advice. It does not replace consultation with a qualified clinician. Any new, growing, bleeding or non-healing skin spot should be examined in person, since only an examination and, where needed, a biopsy can say what it is.

Dr. Mohamed Ibrahim, MD, PhD

Physician-scientist · Founder, MedicalVideos.com

Dr. Ibrahim founded MedicalVideos.com in 2007 to make medical and surgical education freely accessible to students, clinicians, and patients.

Last reviewed: 11/09/26