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How to Tell Basal Cell vs. Squamous Cell Carcinoma Apart

Basal cell carcinoma and squamous cell carcinoma are the most common skin cancers in the United States. These malignant (cancerous) diseases begin in the cells that cover or line human organs. Both under the nonmelanoma skin cancer category, they affect more than 9,500 Americans every day.

In this article, our goal is to explain the differences between basal cell and squamous cell skin cancers, as well as provide an overview of our approach to treating nonmelanoma. Equipping yourself with knowledge about skin cancer can be useful for early detection and survivorship, whether the disease affects you or a loved one.

Basal Cell vs. Squamous Cell Skin Cancers: What’s the Difference?

Basal cell carcinoma (BCC) accounts for 3.6 million skin cancer diagnoses each year, according to the Skin Cancer Foundation. It begins in your body’s basal cells, which are responsible for producing new skin cells to replace dead ones. BCC occurs most often in areas that receive frequent sun exposure, such as the skin on your head and neck. As a slow-growing malignancy, it rarely metastasizes (spreads) to other areas of the body.

Squamous cell carcinoma (SCC), also called cutaneous squamous cell carcinoma, begins in the squamous cells, which are flat cells situated near the surface of the skin that shed constantly as new ones develop. Adding the word “cutaneous” identifies SCC as a skin cancer, differentiating it from squamous cell carcinomas that form inside the body, such as the mouth, throat, or lung area. SCC rarely spreads, but it has a higher chance of doing so compared to BCC.

What Is Actinic Keratosis?

An early warning sign of skin cancer is the development of a precancerous skin condition known as actinic keratosis, which results from excessive or chronic sun exposure. These skin lesions are usually pink or red in color and have a rough or scaly texture. They form on sun-exposed skin areas, including in the scalp, face, ears, and backs of hands or forearms.

Actinic keratosis may appear as small, red, flat spots. If untreated, the spots may grow larger and become thick or rough. Sometimes, they are easier to feel than see, and there may be multiple lesions next to one another.

Importance of Treating Actinic Keratosis Early

Early treatment of actinic keratoses may prevent them from developing into skin cancer. These precancerous lesions affect 10 percent of men and women aged between 20 and 30 years, and over 90 percent of people over 80 years old. Historically, those with a single actinic keratosis develop more over time. Up to 10 percent of these lesions can progress into squamous cell carcinoma.

Levulan photodynamic therapy is a powerful treatment option for actinic keratoses. Read about this breakthrough treatment’s capabilities and benefits here.

Signs and Symptoms of Basal Cell vs. Squamous Cell Carcinoma

Generally, skin cancer’s most common indicator is a change in your skin, which is why dermatologists recommend getting new moles, growths, or persistent sores checked as soon as you can. The disease may begin as a small, smooth, pale, or waxy lump. It also may appear as a firm red lump or a multicolored mole. In some cases, the growth bleeds or develops a crust.

While basal and squamous cell cancers arise mainly in areas that receive regular sun exposure, note that skin cancer can occur anywhere. Let’s discuss the signs and symptoms of each malignancy to help you differentiate between BCC and SCC.

BCC often appears as pink bumps with the following features:

  • Waxy or pearly appearance
  • Irregular blood vessels on surface
  • Sunken center
  • Bleeds easily following an injury

Squamous cell cancer is the second most common skin malignancy after basal cell. Though its likelihood of becoming fatal is rare, it may spread or recur if not caught early. Its characteristics include:

  • Raised, dull-red skin lesions
  • Thick, scaly, and crusted
  • Ulcerated appearance

Related: Check out our previous article, How to Spot Skin Cancer, for step-by-step instructions on how to perform a skin self-exam.

How to Diagnose Squamous Cell and Basal Cell Cancers

Medical practitioners diagnose and address SCC and BCC in similar ways. When an area of skin does not look normal, your doctor may remove all or some of the growth. This procedure is what the scientific and medical community refer to as a biopsy, and it is the only way to ascertain cancer’s presence and its current stage.

Doctors divide skin cancer into two stages:

  • Local, in which the cancer remains confined to the skin
  • Metastatic, meaning cancer has spread beyond the skin

If the growth is large or has been present for a significant amount of time, your doctor will also check the lymph nodes in the area. In suspicion that your cancer has spread to another organ or area of the body, your doctor may require additional tests, such as X-rays, MRI, CT, or PET scans.

Identifying the type of skin cancer you have will help your oncologist plan your treatment, which will also depend on the tumor’s location, size, and aggressiveness.

How We Approach Basal Cell and Squamous Cell Skin Cancer

Buckeye Dermatology AZ provides superior, proven care to prevent, treat, and manage basal cell and squamous cell carcinomas by tailoring cutting-edge treatment plans for your unique diagnosis. The collective goal of our dermatologists, surgical oncologists, radiation specialists, and medical staff members is to provide the best treatment options and cure rates for skin cancer, all while giving outstanding cosmetic results.

Some of our treatments for nonmelanoma skin cancer include Mohs surgery, which removes the smallest amount of tissue to minimize scarring and preserve skin function; and superficial radiation therapy, which uses a precise beam to target the area beneath the skin where cancer cells form. Our practice also grants each patient access to educational resources to better equip them for the journey toward healing and remission.

If you have basal cell or squamous cell carcinoma, contact one of our information specialists at 602-754-6075 to discuss your treatment options and schedule a consultation. While waiting for your appointment, you can learn more about your potential treatments here.