Squamous Cell Carcinoma
Squamous Cell Carcinoma (SCC)
Squamous Cell Carcinoma (SCC) is the second most common type of skin cancer, often arising in areas of the skin frequently exposed to the sun, such as the face, ears, neck, hands, and arms. While SCC is usually curable when detected early, it can become more dangerous if left untreated, potentially spreading to other parts of the body. Some SCCs begin as a precancerous growth called Actinic Keratosis or AK.
What Does SCC Look Like?
SCC can present itself in various forms on the skin, including:
- Rough, Scaly Patches: These patches may be flat or slightly raised, with a red, crusty surface.
- Dome-Shaped Growths: These lumps can develop a central sore that bleeds or forms a crust.
- Non-Healing Sores: Wounds that do not heal, or that heal and then reappear, are common signs of SCC.
- Wart-Like Growths: Some SCCs resemble warts and can develop in unusual locations, like inside the mouth or on the genitals.
Who is at Risk for SCC?
While anyone can develop SCC, certain factors can increase your risk:
- Frequent Sun Exposure: UV radiation from the sun is a significant cause of SCC.
- Fair Skin: Individuals with pale skin, light-colored eyes, and blond or red hair are more susceptible.
- History of Sunburns: Repeated sunburns, particularly during childhood, increase the risk.
- Tanning Bed Use: The use of indoor tanning beds is a known risk factor.
- Previous Skin Damage: Areas of skin that have been previously injured, such as from burns or radiation, are more prone to SCC.
How is SCC Treated?
Treatment options for SCC vary depending on the size, location, and depth of the tumor, as well as the patient’s overall health:
- Excision: The tumor and some surrounding healthy tissue are surgically removed.
- Mohs Surgery: A precise surgical technique that removes the cancer layer by layer, examining each layer under a microscope until no cancerous cells remain.
- Curettage and Electrodessication: The tumor is scraped away, and the area is treated with electric current to destroy any remaining cancer cells.
- Radiation Therapy: Used when surgery is not an option, this treatment involves targeted radiation to destroy cancer cells.
- Photodynamic Therapy (PDT): A chemical is applied to the skin, which becomes sensitive to light, and then exposed to a specific wavelength to kill cancer cells.
Preventing Recurrence and Protecting Your Skin
People who have had SCC are at a higher risk for developing new skin cancers, including melanoma. To reduce the risk of recurrence:
- Regular Skin Exams: Perform regular self-examinations and visit your dermatologist for professional check-ups.
- Sun Protection:
- Seek shade, especially between 10 a.m. and 2 p.m.
- Wear protective clothing, including a wide-brimmed hat and sunglasses.
- Apply broad-spectrum sunscreen with an SPF of 30 or higher to all exposed skin. Reapply every two hours, or more frequently if swimming or sweating.
- Avoid Tanning Beds: The use of tanning beds significantly increases the risk of SCC and other skin cancers.
Frequently Asked Questions About Squamous Cell Carcinoma
What is squamous cell carcinoma?
Squamous cell carcinoma (SCC) is the second most common type of skin cancer, arising from squamous cells in the outer layers of the skin. It most often develops in areas frequently exposed to UV radiation — the face, ears, neck, hands, and arms. Unlike basal cell carcinoma, SCC carries a risk of spreading to lymph nodes and other organs if left untreated, making early diagnosis critical.
What does squamous cell carcinoma look like?
SCC commonly appears as a rough, scaly patch or plaque, an open sore that doesn’t heal, a raised growth with a central depression, or a wart-like growth. Some SCCs begin as actinic keratoses (AKs) — rough, scaly precancerous patches. Any persistent, changing, or non-healing skin lesion should be evaluated promptly by a dermatologist.
What is the difference between squamous cell carcinoma and actinic keratosis?
Actinic keratoses (AKs) are precancerous lesions caused by cumulative UV damage. Left untreated, a small percentage of AKs can progress to invasive squamous cell carcinoma. Treatment of AKs is important not only to prevent progression but because having multiple AKs indicates significant UV damage and higher skin cancer risk overall.
How is squamous cell carcinoma treated?
Treatment depends on tumor size, location, depth, and risk features. Mohs micrographic surgery is preferred for high-risk or large SCCs, particularly on the face, ears, and scalp, where tissue preservation and complete margin control are critical. Other options include standard excision, radiation therapy, and in advanced cases, systemic treatments. Dr. Yoo will discuss the most appropriate approach for your specific situation.
How often should I get checked for skin cancer?
Most dermatologists recommend a full-body skin exam at least once a year, and more frequently for patients with a personal or family history of skin cancer, a history of significant UV exposure, or many moles. Between appointments, perform monthly self-skin checks and promptly report any new, changing, or unusual spots to your dermatologist.