Patients should be advised to use a sunscreen and protective garments and devices, or to stay out of the sun.[44]National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: basal cell skin cancer [internet publication].
https://www.nccn.org/professionals/physician_gls/default.aspx
[99]Sánchez G, Nova J, Rodriguez-Hernandez AE, et al. Sun protection for preventing basal cell and squamous cell skin cancers. Cochrane Database Syst Rev. 2016 Jul 25;(7):CD011161.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011161.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/27455163?tool=bestpractice.com
However, solar damage is sufficiently advanced in most cases such that this will not prevent emergence of new basal cell carcinomas (BCCs).
Early detection and removal effectively prevents further complications.[100]Berking C. Photocarcinogenesis: molecular mechanisms and preventive strategies. Hautarzt. 2007 May;58(5):398-405.
http://www.ncbi.nlm.nih.gov/pubmed/17429584?tool=bestpractice.com
Chemoprevention utilizing oral nicotinamide or capecitabine may be beneficial for high-risk patients.[101]Chen AC, Martin AJ, Choy B, et al. A phase 3 randomized trial of nicotinamide for skin-cancer chemoprevention. N Engl J Med. 2015 Oct 22;373(17):1618-26.
https://www.nejm.org/doi/10.1056/NEJMoa1506197
http://www.ncbi.nlm.nih.gov/pubmed/26488693?tool=bestpractice.com
[102]Schauder DM, Kim J, Nijhawan RI. Evaluation of the use of capecitabine for the treatment and prevention of actinic keratoses, squamous cell carcinoma, and basal cell carcinoma: a systematic review. JAMA Dermatol. 2020 Oct 1;156(10):1117-24.
http://www.ncbi.nlm.nih.gov/pubmed/32639538?tool=bestpractice.com
A hedgehog pathway inhibitor may be used in the management of basal cell nevus syndrome to reduce tumor load and new occurrence of BCC.[60]Tang JY, Mackay-Wiggan JM, Aszterbaum M, et al. Inhibiting the hedgehog pathway in patients with the basal-cell nevus syndrome. N Engl J Med. 2012 Jun 7;366(23):2180-8.
http://www.ncbi.nlm.nih.gov/pubmed/22670904?tool=bestpractice.com