{"id":27062,"date":"2026-02-27T11:34:44","date_gmt":"2026-02-27T11:34:44","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=27062"},"modified":"2026-04-15T09:13:16","modified_gmt":"2026-04-15T08:13:16","slug":"basal-cell-carcinoma","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/basal-cell-carcinoma\/","title":{"rendered":"Basal Cell Carcinoma"},"content":{"rendered":"\n<p>BCC is the most common type of skin cancer (around 75% of all skin cancers diagnosed). It develops from basal cells, found in the deepest part of the outer layer of the skin (the epidermis).<\/p>\n\n\n\n<p>They are typically found in areas of chronic sun exposure, such as the head and neck. It is rare for basal cell skin cancer to metastasise. However, they can cause significant destruction and disfigurement if neglected or inadequately treated.<\/p>\n\n\n\n<p>Patients who have had a BCC are prone to developing further skin cancer (estimated clinical risk of 50% over 5 years).<\/p>\n\n\n\n<p><strong>Risk factors for all skin cancers<\/strong> include:<\/p>\n\n\n\n<p>Excessive sunlight exposure and sun bed use (UV radiation) and is highest in people with fair skin colour and a susceptibility to burn.<\/p>\n\n\n\n<p><strong>Suspect a BCC<\/strong> if a skin lesion has one or more of the following characteristics:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Slow-growing lesion<\/li>\n\n\n\n<li>An ulcer with a raised rolled edge, a nodule on the skin (waxy or pearly), a reddish plaque, scar-like with tethering or contraction<\/li>\n\n\n\n<li>Prominent fine blood vessels within the lesion<\/li>\n\n\n\n<li>History of spontaneous bleeding<\/li>\n\n\n\n<li>May contain pigmented areas<\/li>\n\n\n\n<li>Itchy<\/li>\n\n\n\n<li>Rarely painful<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n<style>.wp-block-kadence-advancedgallery .kb-gallery-type-grid.kb-gallery-id-27062_1b2870-2a{margin:-5px;}.kb-gallery-type-grid.kb-gallery-id-27062_1b2870-2a .kadence-blocks-gallery-item{padding:5px;}.kb-gallery-id-27062_1b2870-2a .kadence-blocks-gallery-item .kb-gal-image-radius, .kb-gallery-id-27062_1b2870-2a .kb-slide-item .kb-gal-image-radius img{border-radius:0px 0px 0px 0px;;}.kb-gallery-caption-style-bottom.kb-gallery-id-27062_1b2870-2a .kadence-blocks-gallery-item .kadence-blocks-gallery-item-inner .kadence-blocks-gallery-item__caption, .kb-gallery-caption-style-bottom-hover.kb-gallery-id-27062_1b2870-2a .kadence-blocks-gallery-item .kadence-blocks-gallery-item-inner .kadence-blocks-gallery-item__caption{background:linear-gradient(0deg, rgba(0, 0, 0, 0.8) 0, rgba(0, 0, 0, 0) 100%);}<\/style><div class=\"kb-gallery-wrap-id-27062_1b2870-2a alignnone wp-block-kadence-advancedgallery\"><ul class=\"kb-gallery-ul kb-gallery-non-static kb-gallery-type-grid kb-gallery-id-27062_1b2870-2a kb-gallery-caption-style-bottom kb-gallery-filter-none\" data-image-filter=\"none\" data-item-selector=\".kadence-blocks-gallery-item\" data-lightbox-caption=\"true\" data-columns-xxl=\"2\" data-columns-xl=\"2\" data-columns-md=\"2\" data-columns-sm=\"2\" data-columns-xs=\"1\" data-columns-ss=\"1\"><li class=\"kadence-blocks-gallery-item\"><div class=\"kadence-blocks-gallery-item-inner\"><figure class=\"kb-gallery-figure kb-gallery-item-has-link kadence-blocks-gallery-item-has-caption\"><a href=\"https:\/\/dermnetnz.org\/topics\/basal-cell-carcinoma\" class=\"kb-gallery-item-link\" target=\"_blank\" rel=\"noopener noreferrer\"><div class=\"kb-gal-image-radius\"><div class=\"kb-gallery-image-contain kadence-blocks-gallery-intrinsic kb-gallery-image-ratio-land43 kb-has-image-ratio-land43\" ><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Superficial-1.png\" width=\"602\" height=\"402\" alt=\"BCC Superficial\" data-full-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Superficial-1.png\" data-light-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Superficial-1.png\" data-id=\"27067\" class=\"wp-image-27067\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Superficial-1.png 602w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Superficial-1-300x200.png 300w\" sizes=\"auto, (max-width: 602px) 100vw, 602px\" \/><\/div><div class=\"kadence-blocks-gallery-item__caption\">BCC Superficial &#8211; DermNetNZ<\/div><\/div><\/a><\/figure><\/div><\/li><li class=\"kadence-blocks-gallery-item\"><div class=\"kadence-blocks-gallery-item-inner\"><figure class=\"kb-gallery-figure kb-gallery-item-has-link kadence-blocks-gallery-item-has-caption\"><a href=\"https:\/\/dermnetnz.org\/topics\/basal-cell-carcinoma\" class=\"kb-gallery-item-link\" target=\"_blank\" rel=\"noopener noreferrer\"><div class=\"kb-gal-image-radius\"><div class=\"kb-gallery-image-contain kadence-blocks-gallery-intrinsic kb-gallery-image-ratio-land43 kb-has-image-ratio-land43\" ><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Pearly.png\" width=\"317\" height=\"480\" alt=\"BCC Pearly\" data-full-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Pearly.png\" data-light-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Pearly.png\" data-id=\"27066\" class=\"wp-image-27066\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Pearly.png 317w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Pearly-198x300.png 198w\" sizes=\"auto, (max-width: 317px) 100vw, 317px\" \/><\/div><div class=\"kadence-blocks-gallery-item__caption\">BCC Pearly &#8211; DermNetNZ<\/div><\/div><\/a><\/figure><\/div><\/li><li class=\"kadence-blocks-gallery-item\"><div class=\"kadence-blocks-gallery-item-inner\"><figure class=\"kb-gallery-figure kb-gallery-item-has-link kadence-blocks-gallery-item-has-caption\"><a href=\"https:\/\/dermnetnz.org\/topics\/basal-cell-carcinoma\" class=\"kb-gallery-item-link\" target=\"_blank\" rel=\"noopener noreferrer\"><div class=\"kb-gal-image-radius\"><div class=\"kb-gallery-image-contain kadence-blocks-gallery-intrinsic kb-gallery-image-ratio-land43 kb-has-image-ratio-land43\" ><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Nose.png\" width=\"480\" height=\"480\" alt=\"BCC Nose\" data-full-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Nose.png\" data-light-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Nose.png\" data-id=\"27065\" class=\"wp-image-27065\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Nose.png 480w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Nose-300x300.png 300w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Nose-150x150.png 150w\" sizes=\"auto, (max-width: 480px) 100vw, 480px\" \/><\/div><div class=\"kadence-blocks-gallery-item__caption\">BCC Nose &#8211; DermNetNZ<\/div><\/div><\/a><\/figure><\/div><\/li><li class=\"kadence-blocks-gallery-item\"><div class=\"kadence-blocks-gallery-item-inner\"><figure class=\"kb-gallery-figure kb-gallery-item-has-link kadence-blocks-gallery-item-has-caption\"><a href=\"https:\/\/dermnetnz.org\/topics\/basal-cell-carcinoma\" class=\"kb-gallery-item-link\" target=\"_blank\" rel=\"noopener noreferrer\"><div class=\"kb-gal-image-radius\"><div class=\"kb-gallery-image-contain kadence-blocks-gallery-intrinsic kb-gallery-image-ratio-land43 kb-has-image-ratio-land43\" ><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Ear-1.png\" width=\"362\" height=\"482\" alt=\"BCC Ear\" data-full-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Ear-1.png\" data-light-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Ear-1.png\" data-id=\"27064\" class=\"wp-image-27064\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Ear-1.png 362w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/BCC-Ear-1-225x300.png 225w\" sizes=\"auto, (max-width: 362px) 100vw, 362px\" \/><\/div><div class=\"kadence-blocks-gallery-item__caption\">BCC Ear &#8211; DermNetNZ<\/div><\/div><\/a><\/figure><\/div><\/li><\/ul><\/div>\n\n\n<p>All images on this page are sourced from&nbsp;<a href=\"https:\/\/dermnetnz.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">DermNet | Dermatology Resource (dermnetnz.org)<\/a><\/p>\n\n\n\n<p><strong>Other skin lesions that are concerning for malignancy<\/strong><\/p>\n\n\n\n<p>The following skin changes should raise concern for a different malignant lesion (including Merkel&#8217;s cell carcinoma, sarcoma, or amelanotic melanoma):<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Nodule grows quickly (over weeks)<\/li>\n\n\n\n<li>A new change (growth, pigmentation, or pain) in a long-standing ulcer, scar, traumatic or inflamed area of skin<\/li>\n\n\n\n<li>Non-healing and\/or destructive atypical ulcer<\/li>\n\n\n\n<li>Progressive unexplained scar-like area<\/li>\n\n\n\n<li>An unexplained skin lesion with loco-regional lymphadenopathy<\/li>\n<\/ul>\n\n\n\n<p>Please refer these USOC via the Melanoma pathway.<\/p>\n\n\n\n<p><strong>B. C, C. L &amp; P. O &#8211; 16-03-26<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>Refer <strong>high risk BCCs<\/strong> (those invading a potentially dangerous area e.g. eyelid margin, auditory meatus, nerve or major blood vessel of the face) USOC via Sci Gateway: Lauriston\/SJH&gt;Dermatology&gt;LI Suspected High risk BCC.<\/p>\n\n\n\n<p>Refer <strong>other BBCs on the head and neck<\/strong> urgently via Sci Gateway:<\/p>\n\n\n\n<p>Refer <strong>BCCs on the trunk and limbs<\/strong> routinely via Sci Gateway: Lauriston\/SJH&gt;Dermatology&gt;LI Dermatology Lesions.<\/p>\n\n\n\n<p>Please use the&nbsp;<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/using-the-consultant-connect-app\/\" target=\"_blank\" rel=\"noreferrer noopener\">Using the Consultant Connect App \u2013 RefHelp<\/a>&nbsp;to take photos of the lesion(s) and then attach these to your Sci Gateway referral.<\/p>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dermatology\/attaching-photos-to-referrals\/\" target=\"_blank\" rel=\"noreferrer noopener\">Attaching photos to referrals \u2013 RefHelp<\/a><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>Low risk BCC can be removed in primary care where an appropriate service is available.<\/p>\n\n\n\n<p><strong>Criteria <\/strong>for removal in Primary Care (BCC):<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Send all specimens to pathology<\/li>\n\n\n\n<li>Diagnosis certain<\/li>\n\n\n\n<li>Well defined margins<\/li>\n\n\n\n<li>BCC should be excised with a 4 mm lateral margin and a cuff of fat in depth<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><strong>For Patients<\/strong><strong><\/strong><\/p>\n\n\n\n<p>The BAD (British Association&nbsp;of Dermatologists) has a PIL on BCC. This can be found at: <a href=\"https:\/\/www.skinhealthinfo.org.uk\/a-z-conditions-treatments\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.skinhealthinfo.org.uk\/a-z-conditions-treatments\/<\/a>&nbsp;&amp; search for \u201cbasal cell carcinoma\u201d.<\/p>\n\n\n\n<p><strong>For Healthcare Professionals<\/strong><\/p>\n\n\n\n<p>Primary Care Dermatology Society \u2013&nbsp;<a href=\"https:\/\/www.pcds.org.uk\/clinical-guidance\/basal-cell-carcinoma-an-overview\" target=\"_blank\" rel=\"noreferrer noopener\">Basal cell carcinoma<\/a><\/p>\n\n\n\n<p>Scottish Referral Guidelines for suspected Cancer &#8211; &nbsp;<a href=\"https:\/\/www.gov.scot\/binaries\/content\/documents\/govscot\/publications\/advice-and-guidance\/2025\/08\/scottish-referral-guidelines-suspected-cancer-2025\/documents\/scottish-referral-guidelines-suspected-cancer-2025\/scottish-referral-guidelines-suspected-cancer-2025\/govscot%3Adocument\/scottish-referral-guidelines-suspected-cancer-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Referral Guidelines for Suspected Cancer 2025<\/a><\/p>\n\n\n\n<p>Dermnet nz \u2013&nbsp;<a href=\"https:\/\/dermnetnz.org\/topics\/basal-cell-carcinoma\" target=\"_blank\" rel=\"noreferrer noopener\">Basal Cell Carcinoma:&nbsp;Symptoms, Causes, and Treatment \u2014 DermNet<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>BCC is the most common type of skin cancer (around 75% of all skin cancers diagnosed). It develops from basal cells, found in the deepest part of the outer layer of the skin (the epidermis). They are typically found in areas of chronic sun exposure, such as the head and neck. It is rare for<\/p>\n","protected":false},"author":20,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[1371,93],"class_list":["post-27062","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-basal-cell-carcinoma","category-dermatology"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"mariamazoysaavedra","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/mariamazoysaavedra\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/dermatology\/https-apps-nhslothian-scot-refhelp-basal-cell-carcinoma\/\" rel=\"tag\">Basal Cell Carcinoma<\/a><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/dermatology\/\" rel=\"tag\">Dermatology<\/a>","rttpg_excerpt":"BCC is the most common type of skin cancer (around 75% of all skin cancers diagnosed). It develops from basal cells, found in the deepest part of the outer layer of the skin (the epidermis). They are typically found in areas of chronic sun exposure, such as the head and neck. It is rare for","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27062","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=27062"}],"version-history":[{"count":12,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27062\/revisions"}],"predecessor-version":[{"id":27275,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27062\/revisions\/27275"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=27062"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=27062"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}