Basal Cell Carcinoma (BCC) Treatment in Mount Gravatt, Brisbane

BCCs usually appear on sun-exposed skin: the face, nose, ears, neck, shoulders and upper back. The four main subtypes look different.

• Nodular BCC, the most common type: a pink or pearly, shiny lump with fine blood vessels on the surface. It may break down into a crusted sore.
• Superficial BCC: a flat, pink or red scaly patch, often on the chest, back, arms or legs, and easily mistaken for eczema.
• Infiltrative or morphoeic BCC: a pale, firm, shiny area that looks like a scar. It grows in thin strands under the skin, so it's often bigger than it looks.
• Pigmented BCC: contains brown, blue-grey or black colour, so it can look like a mole or even a melanoma.

A typical BCC story: a spot bleeds when you dry your face, scabs over, seems to heal, then breaks down again weeks later. That's worth a skin cancer check.

For a biopsy-proven superficial BCC, and selected nodular BCCs, laser-assisted photodynamic therapy (PDT) treats the cancer without surgery. A dermatologist performs laser-assisted PDT in our Mount Gravatt clinic, and Dr Mitch uses this approach for many skin cancer cases.

How it works, step by step

1. Numbing and laser pass. We inject local anaesthetic directly into the BCC. Then a quick pass of a fractional laser, either our CO2 laser or the LaseMD ULTRA, makes tiny channels in the outer layer of skin.
2. Light-sensitising cream. The cream goes on and is covered for about an hour. The channels are designed to help more of it reach the abnormal cells.
3. Red light. Our Healite II LED panel shines red light on the area for about 30 minutes. The light activates the cream, and the BCC cells break down over the following days.
4. Second session. A BCC usually needs 2 sessions, 6 weeks apart, then close follow-up.

Who it suits: thin, low-risk superficial BCCs and selected nodular BCCs, especially where a scar or a slow-healing wound is a real concern. Suitability depends more on the BCC's type and depth than on where it is, and we decide case by case.

Who it doesn't suit: infiltrative or morphoeic BCCs, BCCs that have come back, and poorly defined BCCs. These usually need surgery. For a nodular BCC, we'll tell you whether yours is one that suits laser-assisted PDT.

PDT and surgery. Surgery has the highest cure rate for BCC, and the lab confirms the whole cancer is gone. PDT leaves no specimen, so follow-up visits do that job.

Published results. In a published UK series of 177 biopsy-proven BCCs, 97.1% were still clear an average of 32 months after CO2 laser-assisted PDT (Annals of Plastic Surgery, 2014), and the same unit reported 93.6% still clear at 5 years (Annals of the Royal College of Surgeons of England, 2021).

Recovery. Expect about a week of redness and crusting, a little more than after standard PDT. Avoid strong light, including sunlight, for about 48 hours. Colour change in the treated skin is possible. BCCs grow slowly, so treatment can often be timed around a wedding or holiday. Read more on our PDT page.

Australia's optimal care pathway for keratinocyte cancer recommends complete excision for most lesions. For a BCC, that means cutting it out with a margin of normal-looking skin and sending it to the lab.

• It's the main treatment for nodular, infiltrative and recurrent BCCs, and for most BCCs on the face.
• Pathology confirms the subtype and whether the edges are clear. If they aren't, we'll discuss the next step.
• Most BCC removal is done in our rooms under local anaesthetic, sometimes with a flap or graft on the nose or face.

Numbing, stitches, healing, risks and warning signs are the same as for any skin cancer operation: see our skin cancer surgery page.

The nose is one of the most common places for a BCC. There it often looks like a small, shiny, pearly bump, a spot that bleeds when you blow your nose, or a sore that keeps scabbing.

The skin there is thin and tight over cartilage. Cancer Council's guide for GPs lists the lips, nose, ears, eyelids and scalp as anatomically significant sites, and suggests considering Mohs surgery for morphoeic BCCs, particularly on the nose or the crease beside it.

For a BCC on the nose or face, we confirm the subtype with a biopsy in most cases, plan the margin and repair together so the nose keeps its shape, and refer for Mohs surgery when the subtype or site calls for it. Whether laser-assisted PDT suits a BCC on the face depends on its type and depth, so we talk through surgical and non-surgical options together.

The years of sun behind your BCC often leave rough, scaly sunspots (actinic keratoses) nearby, in sun-damaged skin called field change. A small number of sunspots become squamous cell carcinomas.

Laser solar resurfacing is our in-clinic alternative to prescription field creams and conventional PDT for that field. It's a field treatment, not a treatment for the BCC itself: we treat your BCC first, then the field.

• What it is: the LaseMD ULTRA, a 1927 nm fractional thulium laser, treats the whole area.
• On the day: about an hour of numbing cream, then about 15 minutes of laser.
• Sessions: commonly 2 sessions, about 6 weeks apart.
• Recovery: about 4 to 5 days of redness and flaking.
• The aim: fewer new sunspots, alongside regular skin checks.

BCC is more common after 40, but Cancer Council Queensland notes it can develop in young people. In your 20s or 30s, a scaly pink patch on the back or chest is easy to blame on eczema, so one that keeps flaring in the same place is worth checking. A few rare inherited conditions cause many BCCs from a young age.

In olive, Asian and darker skin, BCC is less common and more often pigmented, so it can be mistaken for a mole. On dermoscopy, a pearly edge and visible blood vessels help tell them apart. Darker skin is also more prone to colour change or thickened scars, which we factor into the choice of BCC treatment.

Your BCC is diagnosed and treated by our specialist dermatologists (FACD): Dr Mitch Robinson, Dr Emily Shao and Dr Benny Yau. A dermatologist performs laser-assisted PDT in our Mount Gravatt clinic. Dr Mitch holds a Master of Skin Cancer (UQ), leads our laser suite and teaches laser to dermatology registrars.

Dr Jimmy Wang (GP, FRACGP) offers lower-priced GP-led skin checks and refers suspected BCCs to our dermatologists. We see patients from Holland Park, Carindale, Sunnybank, Mansfield and across Brisbane's southside, with free onsite parking.