Many people are aware of melanoma skin cancer and its associated risks, but fewer recognize the potential health risks associated with other forms of skin cancer, such as squamous cell carcinoma. According to Dr. Mark Fleischman of U.S. Dermatology Partners, Overland Park, KS, “Squamous cell carcinoma is significantly more common than melanoma, with an estimated one million cases diagnosed annually in the U.S. Squamous cell carcinoma can progress rapidly and has been increasing in incidence nationwide. If not identified and treated early, it carries the potential to become life-threatening.” In this blog, Dr. Fleischman answers the simple question, “What is squamous cell carcinoma?” and delves deeper into the health risks associated with untreated squamous cell carcinoma.
What Is Squamous Cell Carcinoma (SCC)?
Squamous cell carcinoma of the skin, often simply referred to by the acronym SCC, is a nonmelanoma skin cancer that develops from squamous cells. These flat cells make up the outermost epidermis layer of skin, serving as a barrier to protect the body from environmental aggressors like ultraviolet (UV) radiation. When these cells undergo mutations (often caused by long-term sun exposure), they start growing uncontrollably, forming cancerous lesions.
Causes and Risk Factors
The most common cause of SCC is prolonged or frequent exposure to sunlight or artificial sources of UV radiation like tanning beds. However, it may also be caused by exposure to certain environmental aggressors like arsenic and other chemicals. Additionally, there are other factors that increase the risk for developing non-melanoma skin cancer, including:
- Fair skin.
- History of sunburns, especially severe burns in childhood.
- Weakened immune system, such as in transplant recipients or those with autoimmune diseases.
- Chronic skin inflammation, including conditions like eczema and psoriasis.
- Frequent exposure to carcinogenic chemicals.
Where SCC Develops
SCC typically develops in areas that are exposed to sunlight as UV exposure makes these areas more vulnerable to cellular damage. Areas frequently affected by SCC include the:
- Face
- Scalp
- Ears
- Neck
- Lips
- Hands
- Forearms
What Happens If Squamous Cell Carcinoma Is Not Removed?
Dr. Fleischman says, “It’s a common misperception that squamous cell carcinoma is not a serious skin cancer compared to melanoma. While melanoma tends to get more public attention, SCC can be just as dangerous if ignored. It has the capability to invade deeper tissues, including nerves, muscles, and bone, and in advanced cases, it can metastasize to lymph nodes or distant organs. Early detection and prompt treatment are critical to preventing serious complications.” So, what happens if squamous cells grow without treatment? Some common health concerns related to untreated SCC include:
Local Growth and Disfigurement
Squamous cell carcinoma typically starts as a small bump on the surface of the skin. When left untreated, SCC may grow deeper into the skin’s layers. This can lead to bleeding, infection, and ulceration. As SCC spreads to the underlying tissues, it can cause permanent disfigurement.
Spread into Deeper Tissues
In more advanced cases, SCC can invade tissues like muscles, nerves, and bone. When SCC penetrates deeper layers, serious complications like chronic discomfort, lost mobility of the muscles due to the affected nerve, and nerve pain may occur.
Metastasis: Spreading to Other Areas
While melanoma is known for its risks of metastasis, recent research shows that advanced cutaneous SCC can also be deadly. According to current estimates, SCC’s may cause up to 15,000 deaths annually, compared to approximately 8,290 deaths from melanoma in 2024. When left untreated, any cancer can spread to other areas. This is called metastasis. There are three forms of metastasis: local, regional, and distant. SCC can metastasize through connective tissues, lymph nodes, or bloodstream, leading to the potential for local, regional, and distant metastasis. Research indicates that metastatic SCC accounts for more skin cancer-related deaths each year than melanoma. With early detection and prompt treatment, metastasis risk decreases.
Unique Concerns Related SCC on the Hands
The hands are especially vulnerable to SCC since they are constantly exposed to the sun and the complexity of their anatomical structures. SCC is the most common malignant tumor of the hand, accounting for at least three fourths of hand cancers. This area is especially susceptible because of its thinner skin and proximity to vital structures like tendons, nerves, and blood vessels.
Signs of SCC to Watch For
Related to warning signs of SCC to watch for, Dr. Fleischman says, “You can’t be proactive in seeking skin cancer diagnosis without knowing what to look for. SCC growths occur on sun-exposed areas, but SCC also develops in places like the genitals, inside the mouth, or under fingernails. If you notice new, changing, or persistent skin lesions on any part of the body, consult a dermatologist right away.”
SCC takes many forms, but some common warning signs include:
- A firm, red bump.
- A scaly patch of skin that may be itchy, crusty, or bleed frequently.
- A sore that doesn’t heal or keeps recurring in the same spot.
- A rough, wart-like growth.
- A thickened or raised area that looks different from surrounding skin.
Importance of Early Detection & Regular Skin Checks
When it comes to the importance of early detection, Dr. Fleischman says, “It may be easy to say it’s just a bump when you see a new spot or lesion on your skin, but sometimes ignoring these early warning signs can mean serious consequences down the road. Anytime you see a concerning new skin lesion, bring it to your dermatologist’s attention right away. When diagnosed in the early stages, SCC is much more responsive to treatment.”
Early Detection Is Essential
There are many reasons why early diagnosis of SCC is important, including:
- Delaying diagnosis gives the tumor time to grow and spread.
- Early-stage SCC can be removed more easily with lower risk of scarring.
- Untreated skin cancer may require complex surgeries, radiation, or other advanced cancer treatments.
Receive Regular Skin Cancer Exams
Monthly skin self-exams are crucial to ensuring an early diagnosis and effective treatment. Simply take your time to carefully examine your skin. Note any irregularities in color, texture, or new growths. In addition to monthly self-exams, annual professional skin exams are recommended. A board-certified dermatologist can spot early signs of squamous cell carcinoma that might be easy to miss. More frequent exams may be recommended for those at higher risk.
Treatment Options for SCC
When diagnosed and treated in the early stages, SCC usually responds favorably. The recommended treatment will depend on the size, depth, location and risk factors of the tumor as well as your general health and well-being. Below, Dr. Fleischman describes some of the most common treatment recommendations for SCC.
Mohs Surgery
- Most effective treatment with up to a 99% cure rate.
- Ideal for SCCs on the face, ears, hands, lower legs, feet or other high-risk areas.
- Involves removing the tumor in thin layers, then examining each layer under a microscope until no cancer cells remain.
- Preserves as much healthy tissue as possible.
Surgical Excision
- The tumor and surrounding healthy skin are surgically removed.
- Often recommended for small to medium-sized tumors.
- Provides good cure rates and clear margins.
Electrosurgery and Curettage
- Scraping away the tumor, followed by cauterization of the area to promote healing.
- Generally used for very small, superficial and low-risk SCCs.
- Not recommended for invasive or aggressive tumors.
Radiation Therapy
- Used for patients who cannot safely undergo surgery.
- Effective in treating difficult-to-reach tumors or recurrences.
- May be used as a primary or supplemental treatment.
Topical Treatments or Oral Medications
- Topical treatments like 5-fluorouracil (5-FU) are only appropriate for SCC in situ (Bowen’s disease) when surgery is not recommended.
- Oral medications, such as targeted therapy or immunotherapy, may be used in advanced or metastatic cases.
Prevention Tips
Sun protection and good skincare habits are the most important steps to prevent SCC. A few dermatologist-recommended tips to prevent SCC include:
- Wear sunscreen daily – choose a broad-spectrum sunscreen with SPF 30 or higher. Apply generously to all exposed skin, including the hands! Reapply every 80 minutes, or immediately after swimming or sweating.
- Be sun-smart – avoid peak sun hours (10 am to 4 pm). Seek shade whenever possible. Wear wide-brimmed hats, sunglasses, and UV-protective clothing.
- Avoid tanning beds – tanning beds emit high levels of UV radiation, significantly increasing the risk of skin cancer.
- Monitor skin – take photos of any moles or spots for comparison over time. If a growth changes, bleeds, or doesn’t heal, get it checked immediately.
Schedule a Skin Cancer Screening
At U.S. Dermatology Partners, our board-certified dermatologists are experienced in diagnosing and treating all types of skin cancer, including SCC. Early intervention saves lives. Don’t wait for symptoms to worsen. Schedule a full-body skin exam today and take a proactive step toward protecting your health. Getting started is quick and easy. Take a few moments to complete our online scheduling request form. One of our local team members will reach out to finalize the details of your upcoming visit.
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