Squamous Cell Carcinoma (SCC) Treatment

Supporting Early Detection and Comprehensive Treatments for Your Skin’s Health

Squamous cell carcinoma (SCC) develops from the squamous cells in the outer layers of the skin. Though this type of skin cancer is slower to develop compared to melanoma, it can be more aggressive than basal cell carcinoma (BCC) and has a greater potential to spread if not treated promptly. 

SCC commonly develops on areas of the body that receive frequent sun exposure, but it can occur anywhere on the skin. In its early stages, it is highly treatable with localized procedures. However, when the diagnosis is delayed, the cancer can grow deeper into the skin, in some cases spreading to lymph nodes or other areas of the body.

Because of this, recognizing SCC early is crucial to successfully addressing it. At Connolly Dermatology, we focus on timely evaluation for an accurate diagnosis. From there, we can provide individualized treatment to protect your skin health and overall well-being.

What Causes SCC?

Squamous cells form the outermost layer of the skin, the epidermis. When the DNA of these cells is damaged, they can grow uncontrollably and develop into skin cancer cells. 

The most common cause of damage is long-term exposure to ultraviolet (UV) radiation, often resulting from prolonged sun exposure. UV exposure disrupts normal cell repair processes, causing abnormal cells to form and multiply. 

Other causes of SCC come from areas of chronic skin injury or inflammation. Long-standing wounds, scars, burns, or areas previously treated with radiation can become sites where squamous cells change abnormally. Genetics, certain chemicals, environmental exposures, and infections may also play a role.

Risk Factors

Several factors increase the likelihood of developing squamous cell carcinoma:

• Chronic Sun Exposure: Long-term exposure to UV radiation increases the risk of abnormal cell growth over time. Areas of the body that receive frequent sun exposure (face, ears, scalp, arms, and hands) are especially vulnerable to developing SCC.
• Fair Skin, Light Hair, or Light Eyes: People with these features have less natural melanin, which provides some protection against UV radiation. As a result, their skin is more susceptible to cumulative sun damage and other causes.
• Older Age: SCC is more common in older adults because sun damage accumulates over decades. Even sun exposure from earlier years can contribute to skin cancer development later in life.
• Weakened Immune System: This reduces the body’s ability to detect and destroy abnormal cells before they become cancerous. Individuals taking immunosuppressive medications or living with certain medical conditions are at a higher risk for developing SCC and may experience more aggressive disease.
• History of Precancerous Lesions: Actinic keratoses are rough, scaly patches caused by sun damage and are considered early warning signs for SCC. Without treatment or monitoring, some actinic keratoses can progress into invasive SCC over time.
• Previous Skin Cancer: Having a history of skin cancer significantly increases the likelihood of developing SCC again. Prior skin cancer indicates underlying sun damage and heightened susceptibility.

Individuals with these risk factors should be particularly vigilant about developing SCC or any other type of skin cancer. Routine skin exams and monitoring for new or changing lesions can help detect potential cases of SCC in its early stages.

Signs and Symptoms of SCC

Most cases of squamous cell carcinoma develop gradually, though some subtle early signs may appear, resembling common skin conditions. Because SCC can become more aggressive if left untreated, recognizing warning signs early is essential to treating it. 

Many patients first notice a persistent change in their skin that continues to worsen over time. These changes most often occur on sun-exposed areas of the body, but SCCs can appear anywhere on the body. Regular full-body examinations help ensure timely diagnosis and effective treatment before complications develop.

Diagnosis and Evaluation

If you notice any of these signs on your skin, it’s important to seek prompt evaluation. Squamous cell carcinoma can resemble common skin conditions at first. However, delaying care increases the risk of deeper invasion and complications. Early assessment allows for accurate diagnosis and timely squamous cell carcinoma treatments, often with simpler procedures and better outcomes. 

At Connolly Dermatology, accurate diagnoses are the foundation of effective treatments for squamous cell carcinoma. Our board-certified dermatologists follow a structured approach to confirm the diagnosis and determine the most appropriate care plan.

Thorough Skin Examination and Dermoscopy

Our dermatologists conduct a comprehensive, full-body skin examination. We will carefully assess the features of suspicious lesions (size, color, texture, and borders) as well as the surrounding skin. 

Using a noninvasive diagnostic tool called a dermoscopy, we get a magnified visualization of structures beneath the skin’s surface that are not visible to the naked eye. This added detail helps distinguish SCC from benign lesions and other skin cancers. This can improve diagnostic accuracy and guide our decisions about whether a biopsy is needed.

Biopsy To Confirm SCC and Its Depth

If a lesion appears suspicious, a skin biopsy is performed to confirm the diagnosis. During this procedure, a sample is removed under local anesthesia and sent to a pathology laboratory. The biopsy confirms whether SCC is present.

This step also provides important information about how deeply the cancer extends into the skin. Depth and other microscopic features help determine the aggressiveness of the tumor, informing treatment recommendations. If necessary, oncology specialists may be referred for further evaluation. 

Assessment of Tumor Size, Location & Risk of Spread

Once SCC is confirmed, we assess key factors that influence treatment and prognosis. These include the tumor’s size, location, growth pattern, and whether it shows features associated with higher risk. Lesions on commonly affected areas, as well as those that are larger or recurrent, may require more advanced treatment. 

We also evaluate the risk of spread to nearby tissue or lymph nodes when appropriate. This comprehensive assessment allows us to create a personalized treatment plan. Depending on your condition, your treatment can include complete cancer removal, minimizing recurrence, and preserving skin function and appearance.

At Connolly Dermatology, our diagnostic process is designed to provide a clear path forward for every patient.

Treatments for Squamous Cell Carcinoma (SCC) 

The best squamous cell carcinoma treatments for one patient can often vary. This is why each case must be tailored to the individual, considering factors like the size and depth of their cancer cells, location, and their overall health. 

At Connolly Dermatology, our goal is to completely eliminate cancer cells while minimizing the risk of recurrence, preserving as much healthy tissue as possible. We offer a range of surgical and non-surgical treatment options, recommending the most suitable treatment based on clinical guidelines and your specific diagnosis.

Surgical Treatment

Surgical treatments for squamous cell carcinoma are the most common and effective approach. Skin cancer cells are directly removed until all abnormal cells have been addressed. This can also include an appropriate margin of healthy skin to ensure all abnormal cells are removed. 

Surgical options offer high cure rates and are often the preferred approach for invasive or higher-risk SCC.

Standard Excision 

This is the most common approach for many low- to moderate-risk SCC. The dermatologist will remove the visible tumor, along with a surrounding margin of healthy skin, to ensure that all cancerous cells are eliminated. The area is numbed with local anesthesia, and the tissue is sent to a pathology laboratory to confirm that the margins are clear.

Preparation is minimal, typically involving a review of medications and instructions to keep the area clean before the procedure. After excision, stitches may be placed to support the healing process. The prognosis is excellent, and most patients recover well with proper wound care and follow-up.

Mohs Micrographic Surgery

Mohs micrographic surgery is a specialized technique used for SCCs that are high-risk, recurrent, or large areas. This can also be used for lesions located in cosmetically or functionally sensitive areas such as the face, ears, lips, or hands. The procedure involves removing the cancer layer by layer and examining the tissue under a microscope. This process is repeated until no cancer cells remain. 

This approach allows for maximum preservation of healthy tissue while ensuring complete cancer removal. The process occurs in stages, so preparation may be more extensive. Mohs surgery offers the highest cure rates for certain SCCs and is especially effective for reducing recurrence.

Non-Surgical Treatment

Non-surgical treatments focus on destroying cancerous cells without cutting the skin. They are typically reserved for small, superficial, or early-stage SCCs and for patients who may not be ideal surgical candidates. Careful selection is essential to ensure effectiveness and safety.

Cryotherapy

Liquid nitrogen is used to freeze and destroy abnormal skin cells. Often used for very small, superficial, and low-risk SCCs, the procedure can be performed in-office without anesthesia. 

Some patients experience brief discomfort during the freezing process, but side effects are generally minimal. After treatment, the area may blister or scab before healing over several weeks. While cryotherapy can be effective for select lesions, close follow-up is essential to ensure complete resolution. The prognosis is generally good when lesions are carefully selected and closely monitored.

Topical Chemotherapy

Prescription medications can be applied directly to the skin to destroy cancerous cells. These treatments are typically reserved for superficial SCCs that have not invaded deeper layers of the skin. 

Patients are instructed on proper application and expected skin reactions, which may include redness, irritation, or crusting during treatment. Prognosis can be favorable for carefully selected cases, though regular follow-up is necessary to confirm complete clearance.

Photodynamic Therapy 

Photodynamic therapy combines a photosensitizing medication with a controlled light source to destroy abnormal cells. The medication is applied to the skin and absorbed by cancerous cells, which are then activated by light exposure during an in-office session.

PDT is used for selected superficial SCCs and may be an option for patients seeking a non-surgical approach. Patients may experience redness or peeling during healing. When appropriately selected, PDT can offer good cosmetic outcomes and effective treatment.

Follow-Up and Monitoring

Squamous cell carcinoma treatments do not completely eliminate the risk of recurrence or the development of new skin cancers in the future. Patients will need ongoing follow-up to ensure no new or recurring skin cancers have developed. 

Follow-up care includes:

• Regular full-body skin exams to monitor for recurrence or new lesions
• Individualized follow-up schedules based on tumor risk and history
• Education on self-exams, helping patients recognize early changes
• Preventive strategies, including sun protection and skin care guidance

After treatment, follow-ups can be spaced gradually. During the first two years, your dermatologist may recommend appointments every few months. If there are no suspicious new growths, this can taper into yearly follow-ups. At Connolly Dermatology, we can support your long-term skin health and peace of mind.

Risk Reduction and Prevention

While not all skin cancers can be prevented, adopting protective habits and maintaining regular dermatologic care can help lower the risks.

• Use Sunscreen: Incorporate using a broad-spectrum sunscreen with a Sun Protection Factor (SPF) of at least 30 into your morning skincare routine. This helps protect the skin from harmful UV radiation. If you are spending long periods outdoors, reapply every two hours.
• Be Mindful Before Going Outdoors: Wear protective clothing, wide-brimmed hats, and UV-blocking sunglasses to reduce your skin’s exposure to UV rays. Avoid prolonged sun exposure between 10 a.m. and 4 p.m. – times when UV rays are strongest.
• Avoid Tanning Beds: Tanning beds and UV lights emit artificial UV exposure that can increase the risk of SCC and other skin cancers. Even occasional use can contribute to long-term DNA damage in skin cells.
• Perform Routine Self-Skin Checks: Aside from your regular full-body exam with your dermatologist, you should conduct a monthly self-exam to spot any changes to your skin. Pay attention to new growths, non-healing sores, or rough, scaly patches.
• Schedule Skin Evaluations: Most adults should have a yearly full-body exam with a dermatologist. A routine full-body skin exam can identify subtle or early signs of SCC that may be easy to miss at home. Individuals with higher risk may need more frequent exams.