Medically reviewed by Dr. Mary Alice Mina, MD, FAAD, board-certified dermatologist and Mohs surgeon | Last updated: August 4, 2026
Basal cell carcinoma is the most common cancer in the world, and most people have never heard of it until they are sitting in a dermatologist’s office hearing the word cancer for the first time. In a recent episode of The Skin Real, I walked through what these spots actually look like, how we confirm the diagnosis, and every treatment option on the table. Here is the short version.
The bottom line
Basal cell carcinoma is a common, slow-growing skin cancer that rarely spreads but does need treatment. It often shows up as a pink shiny bump that bleeds, or a scar-like or dry patch that will not heal. It is highly curable when caught early, and a biopsy is what confirms it before any treatment begins.
What is basal cell carcinoma?
Basal cell carcinoma is a cancer that starts in the basal cells at the bottom of the outer layer of your skin. It is the most common cancer on the planet, and it is usually caused by years of sun exposure and UV damage. The good news is that it grows slowly and almost never spreads to other parts of the body, so it is very treatable, especially when you catch it early.
What does it look like?
This is where a lot of people get tripped up, because basal cell carcinoma rarely looks like what they expect. Sometimes it is a pink or pearly bump that is shiny and bleeds without much reason. Other times it hides as a stubborn scar-like patch, or a dry, flaky spot that gets mistaken for eczema for months. The pattern I want you to remember is simple. A spot that is new, that bleeds, or that will not heal deserves to be checked.
How is it diagnosed?
Diagnosis starts with a close look, often using a handheld magnifying tool called a dermatoscope that lets me see patterns under the surface of the skin. If a spot looks suspicious, the next step is a biopsy, where a small sample is taken and sent to the lab. I almost never treat a spot without a biopsy first, because the biopsy confirms whether it is cancer and tells us the exact subtype, and that information shapes the whole treatment plan.
What are the treatment options?
There is no single treatment for basal cell carcinoma, and the right one depends on the lesion’s size, location, and subtype. Options I covered in the episode include Mohs surgery, topical chemotherapy creams, electrodesiccation and curettage (often called scrape and burn), vascular laser, radiation therapy, and oral systemic medications for more advanced cases. Not every basal cell needs surgery, and part of my job is matching the treatment to the spot rather than treating every one the same way.
Will it come back?
If you have had one basal cell carcinoma, your risk of developing another skin cancer is real. Research shows that 30 to 50 percent of people with a nonmelanoma skin cancer develop a second one within five years, which is why regular skin checks matter so much after a diagnosis. You can lower your risk with daily sunscreen and sun protection, treating sun-damaged areas, and in some cases a supplement called nicotinamide. A 2015 randomized controlled trial found that nicotinamide at 500 mg twice daily reduced new nonmelanoma skin cancers by about 23 percent in high-risk patients, a meaningful but modest benefit that is worth discussing with your dermatologist.
Quick answers (FAQ part)
Is basal cell carcinoma dangerous? Basal cell carcinoma is rarely life-threatening because it almost never spreads, but left untreated it can grow and damage nearby skin and tissue, so it should always be treated.
Do I need a scan or imaging? For most basal cell carcinomas, no imaging is needed. Scans are reserved for uncommon, advanced cases, which your dermatologist will discuss with you if relevant.
Can I wait and watch a suspicious spot? A spot that is new, bleeding, or not healing is worth getting checked promptly. Getting it looked at is never a waste of time.
The takeaway
Basal cell carcinoma is common, it is usually very curable, and the scariest part for most patients is simply not knowing what to expect. If you have a spot that is new, bleeding, or refusing to heal, get it checked. Early is always easier.
Want the full walkthrough, including what each treatment feels like and how I decide between them? Listen to the basal cell carcinoma episode of The Skin Real, and if you have a spot you are wondering about, you can book a Meet and Greet at The Skin Real Serenbe.