Basal Cell Carcinoma Prevention Guidelines

Guideline Recommendations

• The American Academy of Dermatology recommends against the use of oral retinol to reduce the incidence of future basal cell carcinomas (BCCs) in patients with a history of BCC (Strength of Recommendation: A, Level of Evidence: I) 1, 2, 3
• The American Academy of Dermatology guidelines state that topical and oral retinoids are not recommended for reducing the risk of subsequent BCC in patients with a history of BCC 4

Supporting Evidence

What Actually Works for BCC Prevention

• The American Academy of Dermatology recommends annual skin cancer screening for patients with a history of BCC (Strength A, Level I evidence) 1, 2
• The American Academy of Dermatology and Praxis Medical Insights recommend sun protection measures, including broad-spectrum sunscreen, sun avoidance during peak hours, protective clothing, and wide-brimmed hats 1, 2, 4
• The American Academy of Dermatology and Praxis Medical Insights recommend skin self-examination with family assistance for hard-to-see areas 1, 2, 4
• Praxis Medical Insights recommends complete avoidance of tanning beds and sunlamps, which are classified as carcinogenic 4

Critical Pitfalls to Avoid

• The American Academy of Dermatology guidelines supersede earlier recommendations, and older guidelines or anecdotal experience should not be relied upon for BCC prevention 1, 2, 3
• The American Academy of Dermatology and Praxis Medical Insights recommend against prescribing retinol based on its effectiveness for squamous cell carcinoma prevention, as this benefit does not extend to BCC, and against recommending other ineffective supplements such as selenium or β-carotene 1, 2, 3, 4