Basal or Squamous Cell Carcinoma? The Similarities and Differences

What are basal and squamous cell cancers? Nonmelanoma skin cancer (including basal and squamous cell) impacts over three million people in the United States annually, according to the American Academy of Dermatology (AAD). Whether you’ve had a recent diagnosis or just want more information, take a look at the differences between the two major nonmelanoma skin cancers.

The Skin Location

Where do each of these nonmelanoma cancers originate? While both basal and squamous cell cancers start in the epidermis, or top layer of the skin, they have different locations.

Like the name implies, basal cell cancer starts in the basal cell layer. This lower layer of the epidermis is below the squamous cell layer. The squamous cell layer is the outer or top area of the epidermis. You constantly shed these cells, which leaves the basal layer to repopulate it. As squamous cells shed, basal cells move upward to the top of the skin (and change into squamous cells) to replace this layer.

Even though basal cells eventually become squamous cells, basal cell cancer starts in the lower layer of the skin — before the cells flatten, change, and move upward. In comparison, squamous cell cancer starts in the top layer (after the basal cells have already changed into the squamous variety).

The Symptoms

What are the symptoms of each cancer? The appearance of each type of cancer may look similar to the untrained eye. This makes a doctor’s diagnosis essential.

Basal cell carcinoma can have a pearly white, skin-colored, or pink bump–like appearance. It can also appear as a brown, blue, or black raised lesion with spots or a flat, scaly, red patch. Some patients develop a white, waxy lesion. This type of cancer is most commonly seen on areas exposed to the sun often and may seem like a wound that won’t heal.

Squamous cell cancers may also look red and scaly or appear as rough, open sores. Patients may have wart-like areas or raised growths with a depression in the center. A squamous cell carcinoma may itch, bleed, or form a crusty covering. Like basal cell cancers, this type of carcinoma is also more likely to appear on areas exposed to the sun.

The Risk Factors

How do the risk factors of each type of skin cancer compare to one another? As epidermal cancers, both basal and squamous cell carcinomas share many risk factors. These include chronic unprotected sun exposure, age (older adults are more likely to experience both of these cancers), family history of skin cancer, weakened immune system or immunosuppressing drugs, and fair skin.

The Preventive Strategies

Are there different strategies used to prevent each type of skin cancer? With sun exposure as a primary risk factor, the main way to protect yourself against either basal or squamous cell carcinoma is to avoid UV exposure.

Wear sunscreen outdoors year-round to decrease the possibility of exposure — even if you don’t plan to stay outside all day long. Apply a broad-spectrum (UVA and UVB), water- and sweat-resistant sunscreen liberally before outdoor activity. Reapply during periods of heavy sweating or after swimming.

If you only go outside for small or moderate periods of time, choose a sunscreen-containing moisturizer or cosmetic product, and cover exposed areas with a hat and clothing for added protection.

Along with sunscreen, sun avoidance, and protective clothing, regular dermatologist checkups help catch these cancers before they grow into a more serious issue — especially if you have fair skin, are over age 50, or have a family history of skin cancer. Not only can the dermatologist spot a basal or squamous cell cancer early during a regular checkup, they can create and implement a treatment plan.

Do you have a suspected basal or squamous cell cancer? Contact Countryside Dermatology & Laser Center for more information.

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