Prevention & care

Common non-melanoma skin cancers: basal and squamous cells, biopsy, and treatment choices

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Basal cell carcinoma and cutaneous squamous cell carcinoma are the main cancers grouped under “non-melanoma skin cancer.” They arise in different cells of the skin’s outer layer. This page focuses on those two common diseases; rarer skin malignancies require their own explanations.[1]

Names that describe different findings

Names that describe different findings
Finding	Meaning
Basal cell carcinoma	Cancer beginning in basal cells.[2]
Squamous cell carcinoma	Cancer beginning in squamous cells.[2]
Actinic keratosis	A precancerous growth that sometimes becomes squamous cell cancer.[4]
Squamous cell carcinoma in situ	Cancer confined to the top skin layer; also called Bowen disease.[4]

Appearance varies across skin tones

AAD describes basal cell cancers as possible bumps, patches or sores; color can vary with skin tone. Squamous cell cancers may look scaly, crusted or dome-shaped, and may bleed, hurt or cause no sensation. Some develop in scars or persistent wounds. Similar-looking marks can have different causes.[3][4]

A persistent or changing lesion deserves assessment

NHS advises assessment for a changing growth, lump or skin area. A sore that does not heal or repeatedly bleeds also merits attention. A clinician can examine the area and decide whether specialist evaluation is needed. Comparing a mark with online pictures cannot supply a tissue diagnosis.[5]

Biopsy and spread testing answer different questions

NHS describes specialist examination and removing tissue for laboratory analysis. Further tests assess spread when appropriate. Many basal cell cancers do not require spread imaging because distant spread is rare; selected squamous cell cancers may need additional investigation. Fewer tests do not necessarily mean that the diagnosis was overlooked.[6]

The same type can have different risk features

AAD explains that depth, differentiation, recurrence and immune status affect concern about squamous cell cancer. People taking immune-suppressing medication after an organ transplant have a higher risk of aggressive disease. “Invasive” means growth beyond the top skin layer; it does not automatically mean distant spread.[4]

Surgery is tailored to the lesion and its site

NHS describes surgery as the main treatment, sometimes with a skin graft or reconstruction. Location, size and disease findings affect the approach. Other options can include radiation or medicines in appropriate settings. A discussion should address removal, recurrence, tissue function, appearance and wound care.[7]

Mohs surgery checks the margins during removal

AAD describes Mohs surgery as removing a visible tumor and a thin surrounding layer, examining the edges under a microscope, and removing further tissue where cancer remains. This can spare uninvolved tissue. It is used in selected settings and is not the appropriate operation for every skin cancer.[3]

A cream or light-based treatment has a specific scope

NHS describes local chemotherapy creams and photodynamic therapy for selected skin cancers. Photodynamic therapy combines a light-sensitive drug with directed light. These approaches are not interchangeable with surgery for every depth or type of disease, nor evidence that general red-light wellness devices treat an undiagnosed growth.[7]

Screening, surveillance and diagnosis have different purposes

NCI reports that population evidence has not established whether skin-cancer screening reduces mortality. That does not cancel evaluation of a concerning lesion. Follow-up after an established skin cancer is another setting: prior disease can affect later risk and the appropriate checking plan.[8]

Risk reduction does not make new changes harmless

NCI identifies UV exposure, sunbeds, prior radiation and immune suppression among relevant risks. Sun protection is useful without guaranteeing that cancer will never occur. A diagnosis should prompt discussion of future skin checks and exposure reduction. These pages do not identify a lesion or choose its treatment.[2]

Evidence & uncertainty

These cancers are often treatable, but behavior varies. Basal cell cancer rarely spreads elsewhere, yet can damage nearby tissue. Squamous cell cancer can sometimes spread. A familiar label, slow growth or reassuring photograph does not establish the risk of a particular lesion.[2][4]

Selected-source overview · Independent review pending

Published questions

Are basal cell and squamous cell skin cancers the same disease?

Selected-source overview · Independent review pending. Read the evidence context.

They begin in different skin cells and can behave differently.[2]

Evidence behind this answer

Skin Cancer Treatment (PDQ), Patient Version
agency condition or prevention explanation · Date not stated
Selected relevant original official page passages inspected · Skin-cell origins, spread, actinic keratosis and risk factors