LIVING WITH BASAL CELL CARCINOMA:
SECONDARY PREVENTION

After the initial surgical procedure or other treatment for your basal cell carcinoma (BCC), you can take proactive measures to prevent additional tumors from forming (secondary prevention). These preventive steps include keeping an appropriate follow-up medical appointment schedule, conducting skin self-examinations, and practicing sun safety.*

Follow-Up

Appointments

After you have completed your treatment for BCC, it is important to keep all follow-up medical appointments, because you are at risk of your BCC returning (recurring) as well as for developing a new BCC. Of all patients with BCC, thirty to fifty percent will develop another BCC within five years. You are also at risk of developing other skin cancers, such as melanoma, so it is important to be followed closely by your dermatologist. Ideally, you should see your dermatologist at least every 6-12 months after a BCC diagnosis for the first two years, and then yearly after that if no new tumors occur.

30%-50%

Proportion of patients with BCC who
will develop another BCC within five years

Skin Self-Examination

It’s important that you conduct skin self-examinations on a regular basis. These exams are an important aspect of early detection for BCC and other skin cancers. If you’re unsure how to perform a skin self-exam, click here for a pictorial tutorial. If you find anything suspicious during your exam, call your dermatologist’s office and tell them that you’ve been treated for BCC.

Protect Your Skin

Patients with a history of BCC need to practice meticulous sun protection. You can review guidelines for protecting yourself from UV radiation in the SUN SAFETY section. The main points are:

Protect your skin from the sun’s UV radiation. Allow your body to repair existing damage and to prevent further damage
- Avoid the sun whenever possible. If you are outside during the day, seek shade
- Wear sunscreen every day. Regardless of the weather, wear a sunscreen that offers broad-spectrum protection of SPF 30 or higher and water resistance
- Wear protective clothing every day. Put on a wide-brimmed hat and sunglasses before going outside. Also, whenever possible, wear a long sleeve shirt, long pants, shoes, and socks
Never use a tanning bed or other type of indoor tanning device. Indoor tanning is never safe. In fact, the UV radiation from tanning beds and other indoor-tanning equipment is generally stronger than the UV radiation from the sun. Treat indoor tanning equipment like a carcinogen—and stay away.

Chemoprophylaxis—A Controversial Area

Chemoprophylaxis, the use of a chemical agent or drug to prevent the development of a disease, has an unclear role in BCC. Oral retinoids, which have a limited role in squamous cell skin cancer, are not recommended for use in patients with BCC. Experts disagree about the role of nicotinamide, a vitamin B3 supplement, to prevent the development of BCCs in patients who have already had one. If you are in a high-risk group (e.g., you have a genetic syndrome), it’s worth having a conversation about chemoprophylaxis with your doctor.

Fact vs Fiction:

I should take antioxidant supplements to reduce my risk of skin cancer.

FICTION. Some laboratory studies suggest that antioxidants might be protective against skin cancer because they decrease the damage to DNA caused by UV radiation. However, in clinical studies, vitamin A, selenium, and other antioxidant supplements did not reduce the number of skin cancers that people developed. In addition, these supplements might cause side effects—for example, large doses of vitamin A can turn your skin yellow. Selenium can upset your stomach. Finally, recent studies have suggested that antioxidant supplements may actually accelerate the growth of tumor cells and make cancer more invasive. Therefore, don’t take antioxidant supplements. Simply eat a well-balanced diet rich in antioxidant-rich fruits and vegetables.

*In this section, we refer to follow-up and other secondary prevention strategies. We consulted the American Academy of Dermatology (AAD) and the National Comprehensive Cancer Network (NCCN) guidelines on these topics. These professional groups are the foremost authorities on skin cancer management. To consult these guidelines, please see RESOURCES.

LIVING WITH BASAL CELL CARCINOMA: SECONDARY PREVENTION