The Major Cause
Both long-term sun exposure over your lifetime and occasional extended, intense exposure (typically leading to sunburn) combine to cause damage that can lead to BCC. Almost all BCCs occur on parts of the body excessively exposed to the sun — especially the face, ears, neck, scalp, shoulders, and back. On rare occasions, however, tumors develop on unexposed areas. In a few cases, contact with arsenic, exposure to radiation, open sores that resist healing, chronic inflammatory skin conditions, and complications of burns, scars, infections, vaccinations, or even tattoos are contributing factors. It is not possible to pinpoint a precise, single cause for a specific tumor, especially one found on a sun-protected area of the body or in an extremely young individual.
Who Gets It?
Anyone with a history of sun exposure can develop BCC. However, people who are at highest risk have fair skin, blond or red hair, and blue, green, or grey eyes. The tendency to develop BCC may also be inherited. Those most often affected are older people, but as the number of new cases has increased sharply each year in the last few decades, the average age of patients at onset has steadily decreased. The disease is rarely seen in children, but occasionally a teenager is affected. Dermatologists report that more and more people in their twenties and thirties are being treated for this skin cancer.
Men with BCC have outnumbered women with the disease, but more women are getting BCCs than in the past. Workers in occupations that require long hours outdoors and people who spend their leisure time in the sun are particularly susceptible.
Risk of Recurrence
People who have had one BCC are at risk for developing others over the years, either in the same area or elsewhere on the body. Therefore, regular visits to a dermatologist should be routine so that not only the site(s) previously treated, but the entire skin surface can be examined.
BCCs on the scalp and nose are especially troublesome, with recurrences typically taking place within the first two years following surgery.
Should a cancer recur, the physician might recommend a different type of treatment. Some methods, such as Mohs micrographic surgery, may be highly effective for recurrences.