Squamous Cell Carcinoma
Squamous cell carcinoma is the second most common skin cancer, arising in the squamous cells of the middle and outer epidermis after years of accumulated ultraviolet exposure from sunlight or tanning beds. Unlike basal cell carcinoma, it has a meaningful capacity to invade deeper structures and to metastasize to lymph nodes and beyond if it is left untreated. Found early, about 95 percent of SCCs are treated successfully, and Mohs micrographic surgery reaches success rates as high as 97 percent while preserving the maximum amount of healthy tissue. Dr. Julia Tzu holds American Board of Dermatology certification in dermatopathology alongside certifications in dermatology and Mohs micrographic surgery, so the pathology report and the operative decision are interpreted by the same physician.
At a Glance
- Squamous cell carcinoma is the second most common form of skin cancer[5]
- Approximately 95% of SCCs detected early are curable with appropriate treatment[1]
- Mohs surgery achieves cure rates up to 97% for squamous cell carcinoma[1]
- Unlike BCC, squamous cell carcinoma can spread to lymph nodes and distant sites if left untreated[2]
What are the symptoms of Squamous Cell Carcinoma?
- Red, scaly patch that may crust or bleed
- Raised, firm bump with rough or scaly surface
- Open sore that doesn't heal or heals and returns
- Wart-like growth that crusts and bleeds
- Flat reddish patch that grows slowly
- New growth on an old scar or chronic wound
- Sore or rough patch on the lip
When should you seek care for Squamous Cell Carcinoma?
- A sore anywhere on the skin that refuses to heal over a few weeks
- A scaly, crusted or wart-like patch that persists, grows, or bleeds when knocked
- Any change in a skin lesion you have had for a while
- A new growth on chronically sun-damaged skin, or in the genital area
- Any concerning change on the lips, ears or scalp
- A lesion on skin that received radiation therapy in the past
- Rough, gritty patches (actinic keratoses), which are precursors and are treated before they progress
- Any of the above in someone taking immunosuppressive medication, where SCC is more likely
Have questions about squamous cell carcinoma? Our team is here to help.
What causes Squamous Cell Carcinoma?
- Cumulative UV radiation from sun exposure
- Tanning bed and sunlamp use
- DNA damage to squamous cells
- Progression from precancerous actinic keratosis
- Chronic skin inflammation or wounds
- Previous radiation therapy to the area
- Immunosuppression
- Chemical exposure
How is Squamous Cell Carcinoma treated?
We offer a service to help manage this condition: Mohs Surgery.
Prognosis
- Approximately 95% of SCCs detected early are successfully treated
- Mohs surgery achieves success rates up to 97%
- Higher risk of recurrence and spread compared to BCC
- Regular follow-up essential to detect recurrence or new cancers
- Patients with one SCC have increased risk of developing another
- Advanced SCC has lower survival rates, emphasizing early detection
Frequently Asked Questions
What is squamous cell carcinoma?
Squamous cell carcinoma (SCC) is the second most common skin cancer, developing from the nonbasal layer of keratinocytes of the epidermis. It typically appears as a red scaly patch, raised scaly or rough bump, or non-healing sore. Unlike basal cell carcinoma, SCC has a higher likelihood of spreading to other parts of the body if untreated, making early detection important.
What does squamous cell carcinoma look like?
SCC often appears as a red, scaly patch that may bleed or crust, a raised firm bump with a rough surface, or an open sore that doesn't heal. It commonly develops on sun-exposed areas like the ears, face, scalp, neck, and backs of hands, but can occur anywhere including the lips, inside the mouth, and around the genital area.
When should I see a dermatologist about a possible SCC?
See a dermatologist promptly if you notice a sore that won't heal, a scaly patch that persists or grows, any concerning change on sun-damaged skin, or growths on the ears, lips, scalp, or genitals. Because SCC can spread, early evaluation and treatment are important for the best outcomes.
How is squamous cell carcinoma different from basal cell carcinoma?
Both are common skin cancers from UV damage, but they differ in important ways. SCC tends to be more invasive and has a higher risk of spreading to lymph nodes or distant sites if left untreated. BCC grows slowly and rarely spreads. Both are highly curable when detected and treated early.
How is squamous cell carcinoma treated?
Treatment depends on the tumor's size, depth, and location. Mohs surgery offers the highest cure rate (up to 97%) while preserving healthy tissue. Other options include surgical excision, curettage, cryotherapy, and radiation. For advanced SCC, immunotherapy with cemiplimab may be recommended.
Is squamous cell carcinoma serious?
SCC should be taken seriously because it can spread if left untreated. However, when caught early, cure rates are approximately 95%. Regular skin self-exams and annual professional skin exams help ensure early detection. Prompt treatment of suspicious lesions leads to excellent outcomes for most patients.
How does squamous cell carcinoma differ from basal cell carcinoma?
Both come from ultraviolet damage and both are usually curable when treated early, but they behave differently. Basal cell carcinoma grows slowly and almost never spreads beyond its local site. Squamous cell carcinoma grows faster, invades deeper, and has a genuine capacity to reach lymph nodes.
Does squamous cell carcinoma come back after treatment?
Recurrence is uncommon after complete removal, and Mohs surgery reaches up to 97 percent success precisely because the margin is verified microscopically during the procedure.
Are actinic keratoses the same thing as squamous cell carcinoma?
No, but they are on the same path. An actinic keratosis is a rough, scaly patch of sun-damaged skin, and some progress to squamous cell carcinoma over time. They are treated while they are still precursors, which is a considerably smaller intervention than treating what they can become.
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Sources & References
This article draws from 5 peer-reviewed sources.
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Medically reviewed by Dr. Julia Tzu, MD, FAAD, FACMS · Last reviewed: 2026-08-05