Squamous cell carcinoma is one of the most common forms of skin cancer, affecting millions of people worldwide each year. Often caused by prolonged exposure to ultraviolet (UV) radiation, this type of cancer can appear on sun-exposed areas of the body and, if left untreated, may spread to other parts of the body.
In this blog post, we’ll explore what squamous cell carcinoma is, its causes, warning signs, and treatment options
2. What is Squamous Cell Carcinoma?
Squamous cell carcinoma (SCC) is a type of skin cancer that begins in the squamous cells — flat, thin cells found in the outer layer of the skin (the epidermis). These cells play a key role in protecting your body from environmental damage such as UV radiation, chemicals, and infections.
SCC is considered a non-melanoma skin cancer, meaning it’s generally less aggressive than melanoma but more likely to grow deeper into the skin and spread to other parts of the body if not treated early. It often develops in areas of the skin that have had prolonged exposure to the sun, such as the face, ears, neck, scalp, and hands.
While squamous cell carcinoma most commonly affects the skin, it can also occur in other parts of the body where squamous cells are found — including the lining of the mouth, throat, lungs, and other organs.
Early diagnosis is crucial, as SCC can usually be treated effectively when caught in its early stages. Left untreated, however, it may grow larger, invade nearby tissues, or metastasize to distant parts of the body.
3. Causes and Risk Factors
Squamous cell carcinoma is primarily caused by long-term exposure to ultraviolet (UV) radiation, either from sunlight or artificial sources like tanning beds. UV radiation damages the DNA in skin cells, and over time, this can lead to abnormal cell growth and the development of cancerous lesions.
🔍 Common Causes:
- Sun exposure: Cumulative sun damage, especially in people who spend a lot of time outdoors without protection, is the leading cause of SCC.
- Tanning beds: Artificial UV light can be just as harmful — or even more so — than natural sunlight.
- Chronic wounds or inflammation: Long-standing sores, burns, or skin conditions that cause inflammation can increase the risk of SCC.
- Radiation exposure: Previous treatment with radiation therapy may increase the likelihood of skin cancers forming in the treated area.
- Exposure to carcinogens: Contact with harmful substances like arsenic or certain industrial chemicals can contribute to skin cancer.
⚠️ Risk Factors:
- Fair skin, light eyes, and blond or red hair: People with less melanin are more vulnerable to UV damage.
- Age: SCC is more common in individuals over the age of 50.
- Immunosuppression: Those with weakened immune systems (e.g., organ transplant recipients, people with HIV) are at greater risk.
- History of skin cancer: Having had SCC, basal cell carcinoma, or actinic keratosis increases your chances of recurrence.
- HPV infection: Certain strains of the human papillomavirus have been linked to squamous cell carcinoma, especially in the genital and throat regions.
- Genetic conditions: Disorders like xeroderma pigmentosum increase skin sensitivity to UV light and cancer risk.
Understanding these causes and risk factors can help you take steps toward prevention and early detection — both of which are key in managing squamous cell carcinoma effectively.
4. Signs and Symptoms
Squamous cell carcinoma (SCC) often develops slowly, but recognizing the early signs can make a big difference in effective treatment. SCC typically appears on areas of the skin that receive frequent sun exposure, such as the face, ears, neck, scalp, hands, and lips, but it can occur anywhere on the body — even in places not commonly exposed to sunlight.
🚩 Common Signs and Symptoms:
- A rough, scaly patch that may crust or bleed
- A firm, red nodule or bump that doesn’t go away
- An open sore that doesn’t heal or repeatedly heals and reopens
- A wart-like growth
- Thickened or raised skin, especially around a sore or lesion
- A persistent sore on the lip, ear, or genitals
- In some cases, the affected area may itch, burn, or feel tender
SCC can sometimes be mistaken for non-threatening skin conditions like eczema or psoriasis, which is why persistent or unusual changes in your skin should always be checked by a dermatologist.
If left untreated, squamous cell carcinoma can grow deeper into the skin and, in more advanced cases, spread (metastasize) to nearby lymph nodes or other organs.
5. Diagnosis
Diagnosing squamous cell carcinoma (SCC) begins with a thorough physical examination by a healthcare provider, usually a dermatologist. If you have a suspicious skin lesion or sore that isn’t healing, your doctor will evaluate its appearance, size, location, and any symptoms you’ve experienced.
🩺 Step-by-Step Diagnosis Process:
1. Visual Examination
The doctor will examine the lesion using a tool called a dermatoscope, which provides a magnified view of the skin to assess the pattern, color, and borders of the lesion.
2. Medical History
Your doctor may ask about:
- Duration and changes in the lesion
- Sun exposure habits
- History of tanning bed use
- Personal or family history of skin cancer
- Immune system health
3. Skin Biopsy
If SCC is suspected, the next step is a skin biopsy, which is the only way to confirm a diagnosis. During this procedure, a small sample of the abnormal tissue is removed and sent to a lab for microscopic analysis.
Types of biopsies include:
- Shave biopsy: Removes the top layers of skin
- Punch biopsy: Removes a deeper core of tissue
- Excisional biopsy: Removes the entire lesion if it’s small
4. Further Testing (if needed)
If the SCC is large, aggressive, or appears to have spread, your doctor may recommend:
- Imaging tests (e.g., CT scan, MRI, or PET scan)
- Lymph node biopsy to check for metastasis
Early diagnosis is critical because squamous cell carcinoma is highly treatable when caught in its early stages. Regular skin checks and timely medical attention can significantly improve outcomes.
6. Treatment Options
The treatment for squamous cell carcinoma (SCC) depends on several factors, including the size and location of the tumor, how deeply it has grown, and whether it has spread. Fortunately, most cases of SCC can be effectively treated, especially when detected early.
Here are the most common treatment options:
🛠️ 1. Mohs Surgery
- What it is: A precise surgical technique where the tumor is removed layer by layer and each layer is examined under a microscope until no cancerous cells remain.
- Best for: High-risk or recurring SCC, especially on the face, ears, or other sensitive areas.
- Benefit: Highest cure rate with minimal removal of healthy tissue.
✂️ 2. Excisional Surgery
- What it is: The entire tumor is cut out, along with a margin of surrounding healthy skin to ensure all cancer cells are removed.
- Best for: Small to medium tumors in less cosmetically sensitive areas.
- Benefit: Straightforward and effective.
❄️ 3. Cryotherapy (Cryosurgery)
- What it is: The cancer cells are frozen using liquid nitrogen and then destroyed.
- Best for: Very small, superficial SCCs.
- Benefit: Non-invasive, quick procedure.
☢️ 4. Radiation Therapy
- What it is: High-energy rays are used to destroy cancer cells.
- Best for: Patients who can’t undergo surgery or when the cancer is in a difficult-to-treat area.
- Benefit: Effective for older adults or advanced tumors.
💊 5. Topical Treatments
- What it is: Medicated creams like 5-fluorouracil (5-FU) or imiquimod are applied to the skin.
- Best for: Superficial squamous cell carcinoma or precancerous lesions.
- Benefit: Non-invasive, can be done at home under medical supervision.
🧬 6. Immunotherapy / Targeted Therapy
- What it is: Drugs that help the immune system recognize and attack cancer cells.
- Best for: Advanced or metastatic SCC.
- Example: Cemiplimab (Libtayo), a PD-1 inhibitor used for aggressive SCC.
- Benefit: A treatment option when surgery or radiation isn’t possible.
🩹 After Treatment
- Regular follow-ups are essential to monitor for recurrence.
- Additional skin protection and lifestyle adjustments are recommended to prevent future cases.
Early-stage squamous cell carcinoma is highly curable, especially when promptly treated. The key is early detection, appropriate treatment, and ongoing skin monitoring.
7. Prognosis and Recurrence
The prognosis for squamous cell carcinoma (SCC) is generally excellent when the cancer is detected and treated early. In most cases, treatment completely removes the cancer and prevents it from returning. However, the risk of recurrence or developing new skin cancers remains, especially in individuals with significant sun damage or other risk factors.
✅ Prognosis
- Cure rate: When caught early, SCC has a cure rate of over 95%.
- Advanced SCC: If the cancer spreads to deeper tissues, lymph nodes, or distant organs (metastasis), it becomes more difficult to treat and may require more aggressive therapies.
- Factors influencing prognosis:
- Tumor size and depth
- Location (e.g., scalp, lips, ears may be higher risk)
- Patient’s immune system status
- Whether the cancer has recurred
🔁 Recurrence Risk
Even after successful treatment, squamous cell carcinoma can return, either at the same site or elsewhere on the body. Patients who’ve had SCC are also at increased risk of developing other types of skin cancer, including basal cell carcinoma and melanoma.
Common recurrence scenarios:
- Incomplete removal of the initial tumor
- High-risk tumors (large size, aggressive growth)
- Immunosuppressed individuals
- Failure to follow up with regular skin checks
🛡️ Reducing Recurrence Risk
- Attend regular dermatology checkups (typically every 6–12 months)
- Practice sun safety daily — use SPF, wear hats, avoid peak UV hours
- Monitor your skin for new or changing lesions
- Treat precancerous lesions like actinic keratosis early
8. FAQs About Squamous Cell Carcinoma
Is squamous cell carcinoma deadly?
In most cases, squamous cell carcinoma is not deadly, especially when diagnosed and treated early. However, if left untreated, SCC can grow deeper into the skin and potentially spread (metastasize) to other parts of the body, which can become life-threatening. Early detection is key to successful outcomes.
Can SCC spread to lymph nodes?
Yes, squamous cell carcinoma can spread to the lymph nodes, especially in more advanced or aggressive cases. This is more likely if the tumor is large, located in a high-risk area (like the ears or lips), or if the patient has a weakened immune system. Regular follow-ups and prompt treatment help reduce this risk.
What does SCC look like?
SCC can appear in several forms, including:
- A scaly red patch that may crust or bleed
- A firm bump or nodule
- An open sore that doesn’t heal
- A wart-like growth
These lesions usually form on sun-exposed areas such as the face, ears, neck, scalp, or hands. If you notice a persistent or unusual skin change, consult a dermatologist.
Is SCC curable?
Yes, squamous cell carcinoma is highly curable, especially when caught early. Most cases can be effectively treated with procedures like Mohs surgery, excisional surgery, or topical treatments. The prognosis is excellent when the cancer is diagnosed at an early stage.
Conclusion
Squamous cell carcinoma is a common and often treatable form of skin cancer, especially when detected early. Understanding its causes, recognizing the warning signs, and taking preventive measures like sun protection and regular skin checks can make a significant difference. If you notice any unusual skin changes, don’t wait—consult a dermatologist promptly. Early action saves lives.
