Quick answer. Basal cell carcinoma (BCC) is the most common form of skin cancer. It arises from the basal cells at the bottom of the outer skin layer, usually on sun-exposed areas such as the face, nose, ears and neck. A BCC is typically slow-growing and very rarely spreads to other parts of the body, so it is almost always curable – but left untreated it can keep enlarging and destroy nearby skin, cartilage and bone. It often looks like a pearly or waxy bump, a persistent non-healing sore, or a flat scaly patch that may bleed or scab and never quite heals. Any new, changing or non-healing spot should be checked by a doctor.
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The message that matters most: a sore or spot that does not heal within a few weeks, or that bleeds and scabs over and over, is the classic clue to a BCC – and the earlier it is treated, the smaller and simpler the treatment.
What basal cell carcinoma is
BCC develops from basal cells in the epidermis (the outermost layer of skin). It is strongly linked to long-term sun exposure and ultraviolet (UV) damage accumulated over many years, which is why it usually appears on areas that catch the most sun. Because Singapore sits almost on the equator with intense year-round UV, cumulative sun exposure is a real local risk factor.
BCC is one of several skin cancers. Unlike melanoma, which can spread and be life-threatening, BCC almost never metastasises. That is reassuring – but it is still a cancer, and it will not go away on its own.
What a BCC looks like
BCCs vary in appearance, which is part of why they are missed. Common patterns include:
- a pearly, shiny or waxy bump, sometimes with tiny visible blood vessels across it;
- a flat, firm, pale or scaly patch that can resemble a scar;
- a sore that bleeds, oozes or crusts, heals partly, then breaks down again – the “non-healing ulcer”;
- a pink or skin-coloured lump that slowly grows over months.
They are usually painless, which is exactly why people delay. On the face, common sites are the nose, forehead, cheeks, around the eyes and the ears.
Who is at higher risk
Risk rises with cumulative UV exposure, fair skin that burns easily, older age, a history of frequent sunburn or tanning, outdoor work or hobbies, previous skin cancer, and a weakened immune system (for example after an organ transplant). BCC can, however, occur in people of any skin tone. Having had one BCC raises the chance of developing another, so ongoing skin checks matter.
How it is diagnosed
A doctor – a GP or a dermatologist – examines the spot, often using a handheld magnifier called a dermatoscope. The diagnosis is confirmed with a skin biopsy, where a small sample (or the whole lesion) is removed and examined under a microscope. This also tells the doctor the BCC subtype, which guides treatment.
How BCC is treated
Because BCC rarely spreads, treatment focuses on completely removing or destroying the local tumour. Options depend on the size, type and site:
- Surgical excision – cutting out the BCC with a margin of normal skin; the mainstay for most lesions.
- Mohs micrographic surgery – a precise, tissue-sparing technique that checks margins under the microscope during the operation, often used on the face or for recurrent or ill-defined tumours.
- Curettage and electrodessication – scraping and cauterising, suitable for some smaller, low-risk BCCs.
- Cryotherapy (freezing), topical creams (such as imiquimod or 5-fluorouracil) or photodynamic therapy for certain superficial BCCs.
- Radiotherapy where surgery is not suitable, and specialist medication for the very rare advanced case.
Cure rates are high, especially when BCCs are found and treated early and small. Your doctor will advise which option best balances cure, function and cosmetic outcome for the site involved.
Prevention and follow-up
Sun protection is the single most useful preventive step: seek shade in the midday sun, wear a broad-brimmed hat and covering clothing, and use a broad-spectrum sunscreen of SPF 30 or higher, reapplied regularly – sensible advice year-round in Singapore. Avoid tanning. After a BCC, keep up regular skin self-checks and attend follow-up, because new skin cancers are more likely once you have had one.
When to see a doctor
See a doctor about any spot that is new, changing, or has not healed within a few weeks, any sore that repeatedly bleeds or crusts, or any lump that is slowly growing. Getting a non-urgent-looking spot checked early is exactly what keeps treatment small and simple. A dermatologist can assess, biopsy and treat skin cancers.
Related skin & dermatology topics
- Squamous cell carcinoma
- Sun damage & photoaging
- Sunburn
- Prickly heat (heat rash)
- Intertrigo (skin-fold rash)
- Milia (milk spots)
- Ingrown hairs
- Lichen planus
- Dry skin (xerosis)
- Skin cancer
- Eczema
- Dermatologists in Singapore
Sources
- DermNet — Basal cell carcinoma: commonest skin cancer, appearance, subtypes, rarely metastasises, treatment options.
- American Academy of Dermatology (AAD) — BCC signs, risk factors, Mohs surgery and other treatments.
- NHS — Non-melanoma skin cancer: symptoms (non-healing sore), diagnosis by biopsy, surgery and other treatments.
- National Skin Centre / National Cancer Centre Singapore — local skin-cancer context and specialist assessment.