Overview

Basal cell carcinoma is a type of skin cancer that occurs most commonly on the face or neck, often near an eyelid or on the nose.  The tumor cells are thought to originate from the basal, or innermost, layer of the skin. 
Basal cell carcinoma is the most common type of skin cancer in the United States.  Fair-skinned people over age 50 are most commonly affected; it is rare among those with dark skin.  The incidence increases significantly with sun exposure.  Those who work outdoors or live in sunny climates or areas with high sun exposure are at greater risk. 
The ultraviolet radiation in sunlight is believed to be the cause in most cases.  People with dark complexions have more melanin in their skin and are able to absorb higher amounts of the damaging ultraviolet rays.  Since those with fair skin have less melanin, they are less able to withstand the effects of UV exposure. 

Signs and Symptoms

• Typically appears on the eyelid (the lower lid is more common than the upper)
• Begins as a small, raised growth
• Classic appearance is a nodule with a pitted center 
• Tumor edges may have a “pearly” appearance
• Does not cause discomfort, but if advanced, may cause lid to turn in or out

Detection and Diagnosis

If left untreated, the growth may gradually invade the surrounding tissue.  Fortunately, basal cell carcinomas rarely metastasize (spread to other parts of the body).  Diagnosis is made by microscopic examination of the tumor cells.

Treatment

Basal cell can be removed surgically or with radiation.  As with any type of cancer, early detection is important.  Consult with an ophthalmologist or dermatologist about any suspicious growth appearing on the eyelids or skin. 

Prevention

Individuals at risk, especially the fair-skinned, should avoid overexposure to sunlight.  Wear sunglasses to protect the delicate skin around the eyelids from UV light.  Protective clothing, headgear, and sunscreen are also advisable when spending time outdoors.