Watch Out! Persistent Bumps on Head or Face After 40 Could Be This Skin Cancer.

As we age, many people may notice a quiet appearance of a “little bump” on the face, nostrils, temples, or near the ears.“small bump”.

It is painless and itchless, grows very slowly,yet never seems to recede,sometimes it scabs and bleeds repeatedly, and even with medication, there is no improvement. There is no need to worry too much, as most of these skin changes arebenign.

However, we must remain vigilant because there is a relatively common skin tumor in the elderly population that may look very similar. This tumor is “Basal Cell Carcinoma”（BCC for short）.

Don’t be frightened by the word “cancer”.BCC has a low level of malignancy overall, and almost all can be cured if treated early.The problem lies in the fact that many friends always want to “put it off, wait a bit”.

The most dangerous aspect of BCC is not metastasis, but thedestructive impact on the face after long-term neglect, such as nasal collapse, eyelid eversion, and scar deformities.

What is Basal Cell Carcinoma?

BCC is a type of skin cancer that originates fromthe basal cells of the epidermis, as shown in the figure below:

It often appears on:the head, face, and upper trunk, such as the neck, cheeks, nose, ears, around the eyes, and scalp.

It manifests as a slowly enlarging shiny nodule,which may be skin-colored, pink, or a darker brownish-black, sometimes ulcerating and bleeding, but usually painless.

The most common types include:

It manifests as a round, translucent “little pearl-like nodule”,smooth surface with visible fine blood vessels,over time, the center may ulcerate or scab over.

Manifests as a hard plaque with a texture that is firm to the touch and a color close to normal skin, often mistaken for a scar or scleroderma.

Darker in color, presenting as brown or black nodules, sometimes resembling “moles”, and can be easily misdiagnosed as melanoma.

Why is it “can’t be delayed” or “can’t wait”?

BCC grows slowly and seems unchanged, which can easily let people let their guard down. In fact,it continuously erodes the surrounding skin and tissue.If delayed for too long, it may involve cartilage, muscle, and even orbital structures.

In addition, the scope of surgery in the later stages is larger, which may leave obvious scars
.Moreover, in severe cases,tumor cells can also metastasize.

On the contrary, the cure rate in the early stage is close to 99%, and most cases only require one surgery to resolve.The cosmetic effect is most ideal in the early treatment(can be understood as minimizing scars and maximizing the preservation of organ shape and function).

Who is more likely to develop BCC?

Age:
More common in people over 40, especially middle-aged and elderly people aged 50-70;

Skin color:
People with fair skin;

Sun exposure:
People who work outdoors for a long time, or those who enjoy sunbathing;

Electromagnetic radiation:
A history of long-term exposure to ultraviolet rays, contact with radiation;

Immune status:
Those with weakened immune functions or who are on long-term immunosuppressive medications;

Predisposition:
BCC has a familial predisposition, such as Gorlin syndrome(nevoid basal cell carcinoma syndrome); a history of skin cancer.

Which “little bumps” need special attention?

Scalp, face, neck, hands, feet, etc.

• Growing faster(significantly larger in 2-3 months)

• Recurrent ulceration and bleeding

• Irregular borders

• Diverse colors, changes, or increased blood vessels

Such individuals are at higher risk of recurrence and require close follow-up.

How to diagnose?

Diagnosing basal cell carcinoma, in addition to clinical examination, mainly relies on the following examinations:

• Dermoscopy:
  Observing vascular morphology, pigment distribution, and other characteristics; the most common and non-invasive method for skin tumor screening,
  the diagnostic rate for BCC can be over 90%;

• Histopathological examination:
  Biopsy of a small amount of tissue, the “gold standard” for diagnosis;

• Imaging studies (CT/MRI) if necessary:
  To assess whether there is deep invasion. These examinations are safe, fast, and do not exacerbate the condition.

How to treat?

The goal of treatment is to completely remove the tumor, preserve normal tissue, and reduce recurrence.

This is the most common treatment method. Ordinary lesions can be completely removed in one surgery, but the scope of resection needs to be determined based on the specific situation of the tumor.

Suitable for facial or recurrent cases, doctors remove the lesion tissue layer by layer under the microscope, ensuring cleanliness while minimizing tissue damage.

Suitable for superficial types or adjuvant therapy after surgery, with good cosmetic effects and minimal trauma.

Such as imiquimod or 5-fluorouracil cream, which can be used for superficial lesions.

For cases that cannot be operated on or for multiple lesions, oral medications such as sonidegib can be used to control the condition.

After treatment, it is generally necessary to follow up every 3-6 months to monitor for recurrence or new lesions.

How to prevent?

Sun protection is the most effective preventive measure.

• Avoid strong UV hours from 10 am to 4 pm;

• Use sunscreen with SPF≥30 and reapply regularly;

• Wear hats and sunglasses when going out to reduce direct exposure;

• Regularly self-examine the skin, especially the elderly and those who like to sunbathe for a long time.