Basal Cell Carcinoma: Causes, Signs, and Treatment Options in Melbourne

Basal cell carcinoma (BCC) is the most common type of skin cancer in Australia — and in the world. While it is rarely life-threatening, untreated BCC can cause significant local damage, recur, and in uncommon cases spread to surrounding tissue. The good news is that basal cell carcinoma treatment is highly effective when the condition is caught early, and most cases can be resolved with a straightforward in-clinic procedure.

What Is Basal Cell Carcinoma?

Basal cell carcinoma is a type of non-melanoma skin cancer that develops in the basal cells — the deepest layer of the epidermis (the skin’s outermost layer). BCC grows slowly, usually on areas of skin that receive the most sun exposure, including the face, head, neck, ears, and hands.

Unlike melanoma, BCC very rarely spreads to other parts of the body (metastasises). However, if left untreated, it can grow into surrounding tissue, including muscle, bone, and nerves, making treatment more complex and recovery more difficult.

What Does Basal Cell Carcinoma Look Like?

BCC can appear in several different forms. Knowing what to look for means you can seek advice sooner:

BCC Type	Appearance	Common Location
Nodular BCC	Pearly or translucent bump with visible blood vessels; may have a central depression or ulcer	Face, nose, ears
Superficial BCC	Flat, reddish, scaly patch; may look like eczema or a scar	Trunk, shoulders, back
Morphoeic (Sclerosing) BCC	Pale, waxy, scar-like lesion with poorly defined edges; hardest to detect	Face
Pigmented BCC	Blue, brown, or black colouring — can resemble melanoma	Any sun-exposed area
Ulcerating BCC	Open sore that crusts, bleeds, heals, and then returns	Face, scalp

If you notice any skin lesion that doesn’t heal within a few weeks, appears shiny or pearly, bleeds without injury, or repeatedly forms a crust, you should have it assessed by a skin cancer doctor promptly.

What Causes Basal Cell Carcinoma?

The primary cause of BCC is cumulative damage to skin cells from ultraviolet (UV) radiation — primarily from the sun, but also from tanning beds. Australia’s intense UV levels put the entire population at elevated risk compared to most other countries.

Key Risk Factors for BCC

• Prolonged or repeated sun exposure over a lifetime
• A history of sunburn, particularly in childhood
• Fair skin, light hair, and light or blue eyes
• A personal or family history of skin cancer
• Use of tanning beds or solaria
• A weakened immune system (e.g. due to organ transplant medication)
• Exposure to radiation therapy or arsenic

Basal Cell Carcinoma Treatment Options

The right basal cell carcinoma treatment depends on the size, type, location, and depth of the lesion, as well as the patient’s general health and preference. Your doctor at Manningham Skin Cancer Clinic will discuss which approach best suits your individual situation.

Surgical Treatments

• Excision: The lesion is surgically removed under local anaesthetic along with a margin of healthy tissue. This is the most common and effective treatment for most BCC types.
• Mohs Micrographic Surgery: A specialist procedure where thin layers of tissue are removed and immediately examined under a microscope. Used for BCC on the face or in areas where preserving tissue is important.
• Curettage and Electrodesiccation: The tumour is scraped away with a curette, then the area is treated with an electric current to destroy remaining cancer cells. Suitable for small, superficial BCCs.

Non-Surgical Treatments for BCC

• Imiquimod cream: A topical immune response modifier applied directly to superficial BCCs. This is a well-established basal cell carcinoma treatment cream for low-risk, superficial cases.
• Fluorouracil (5-FU) cream: A topical chemotherapy agent that destroys abnormal skin cells, effective for superficial BCCs on the trunk or limbs.
• Photodynamic Therapy (PDT): A light-sensitive medication is applied to the skin, then activated with a specific wavelength of light to destroy cancer cells. Useful for superficial BCCs in cosmetically sensitive areas.
• Radiation Therapy: Used when surgery is not appropriate, for example in elderly patients or for BCCs in difficult locations.

Can Basal Cell Carcinoma Be Left Untreated?

BCC should not be left untreated. While it grows slowly and rarely spreads to other organs, it will continue to grow locally and can invade surrounding tissue — including cartilage, bone, and nerves in advanced cases. Treatment becomes more complex the larger the lesion grows, and outcomes are far better when BCC is caught and treated early.

If you have been diagnosed with BCC, or if you have a lesion you are concerned about, the doctors consulting at Manningham Skin Cancer Clinic are here to advise you on the most appropriate next steps.

Related reading:
When Did You Last Have a Skin Cancer Check?
Full Body Mole Mapping in Melbourne
Skin Cancer in Australia: Key Statistics
Melanoma vs Non-Melanoma Skin Cancer

Frequently Asked Questions About Basal Cell Carcinoma

What is basal cell carcinoma (BCC)?

Basal cell carcinoma is the most common type of skin cancer in Australia. It develops in the basal cells of the epidermis and is primarily caused by cumulative sun exposure. BCC grows slowly, rarely spreads to other organs, but can cause significant local damage if not treated.

Is basal cell carcinoma dangerous?

BCC is rarely life-threatening but should not be ignored. Without treatment, it can grow into surrounding tissue, including muscle, nerves, and bone, particularly when located on the face. Early treatment leads to excellent outcomes for the vast majority of patients.

Can basal cell carcinoma spread to other parts of the body?

BCC very rarely metastasises (spreads to other organs). This sets it apart from melanoma and squamous cell carcinoma. However, it does spread locally and can recur after treatment, which is why regular monitoring after treatment is important.

What is the best treatment for basal cell carcinoma?

The most appropriate treatment depends on the BCC type, size, and location. Surgical excision is the most commonly recommended treatment for most BCCs. For small superficial BCCs, topical creams such as imiquimod or 5-FU, or photodynamic therapy, may be suitable alternatives. Your doctor will recommend the best approach for your individual case.

Is there a basal cell carcinoma treatment without surgery?

Yes. Superficial BCCs may be treated with topical imiquimod cream, fluorouracil (5-FU) cream, or photodynamic therapy — all of which avoid surgery. These non-surgical options are typically suitable for low-risk, superficial BCCs on the trunk or limbs. Your doctor will determine whether non-surgical treatment is appropriate based on the characteristics of your BCC.

How long can basal cell carcinoma go untreated?

BCC grows slowly, and some patients live with undiagnosed BCC for months or years. However, delaying treatment allows the lesion to grow larger and invade deeper tissue, which makes treatment more extensive and recovery harder. There is no safe timeline for leaving BCC untreated — if you have a suspicious lesion, please book an assessment as soon as possible.

Do I need a referral to see a skin cancer doctor in Melbourne?

No. Manningham Skin Cancer Clinic does not require a GP referral. You can book directly to have any suspicious lesion assessed by an experienced skin cancer doctor at our Templestowe clinic.

Can basal cell carcinoma be cured?

Yes. When caught early, BCC is highly curable — the majority of cases treated by surgical excision or other appropriate methods achieve complete clearance. Recurrence can happen, particularly for certain subtypes or for lesions that were incompletely excised, which is why follow-up skin checks are important.

Published by Manningham Skin Cancer Clinic, 200 High Street (Level 4, Lower), Templestowe VIC 3107. This article is for general information only and does not replace professional medical advice.