Basal cell carcinomas often appear as small, smooth, shiny, or pale growths, or as a waxy lump. They also may develop from a flat area that is only slightly different in appearance from normal skin. Some basal cell carcinomas may emerge so slowly that they go unnoticed as new growths.
Basal cell carcinomas rarely cause pain in their earliest stages, although they may bleed after a minor injury and then form a scab and heal. Because this crusting and healing can recur over months or years with little apparent growth, one may mistake the tumor for a sore or wound.