Squamous Cell Carcinoma (SCC): Your GoodRx Guide

What is squamous cell carcinoma?

Squamous cell carcinoma (SCC) is the second most common type of skin cancer. It’s more common than melanoma, but it’s less common than basal cell cancer. 

SCC comes from squamous cells. These are a type of skin cell that also line other parts of the body, like the lungs, mouth, vagina, and esophagus. That means you can have squamous cell cancer in other parts of the body too. 

This article is just about SCC that happens on the skin, also known as cutaneous SCC.  

SCC can occur anywhere on the skin, but it’s more likely on areas of skin that are regularly exposed to sun. Anyone can develop SCC, but it’s more common in people with light skin and hair as well as people who’ve had an organ transplant. 

SCC is highly curable when it’s diagnosed early. But without treatment, SCC can grow and become life-threatening. 

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What does SCC look like?

SCC usually happens on sun-exposed skin, like the face, ears, neck, and back of hands. SCC can also develop in scars or skin that is chronically inflamed. Early SCCs tend to be flatter and smaller than more advanced SCC. 

Here are some typical signs of SCC:

• A rough, scaly patch of skin that doesn’t heal  

• An elevated round growth with a central crater

• A wart-like growth that’s scaly or crusty

• A sore that doesn’t heal and bleeds

Photo credit: Maria Robinson, MD	Photo credit: Jorge Garcia, MD
Photo credit: Maria Robinson, MD

Sometimes, a SCC will develop from a precancerous spot called an actinic keratosis. These are small, rough patches of skin that are usually pink and develop on sun-exposed skin. It’s common to have many actinic keratoses at once.  

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What causes SCC?

SCC starts when squamous skin cells grow out of control. Most often, this is because of too much ultraviolet (UV) exposure. This usually comes from the sun, tanning beds, or both. Over time, these UV rays damage the DNA (genetic instruction code) inside skin cells. When this damage is permanent, the skin cells can start to grow uncontrollably and form skin cancer.

Some people have a higher risk of developing SCC than others. Having these risk factors doesn’t mean you’ll get SCC. But knowing about them is important. It can help you change certain behaviors and take steps to get regular skin screening.

Here are the main risk factors for SCC:

• Having light skin, blond or red hair, or blue or green eyes

• Getting UV exposure from the sun or a tanning bed

• Being over the age of 50

• Having many severe sunburns in the past

• Having many X-rays in the past

• Exposure to certain chemicals, like arsenic

• Having a skin cancer in the past

• Infection with the human papillomavirus (HPV)

• Having a weakened immune system, like if you’ve had an organ transplant

• Having certain medical conditions, like xeroderma pigmentosum

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Diagnosing SCC

To diagnose SCC, a dermatologist or other healthcare provider will examine your skin and then usually do a skin biopsy. Here’s what that looks like:

• Skin exam: Your provider will check your skin for signs of SCC. If there’s a concerning spot, they’ll usually do a skin biopsy to confirm the diagnosis.

• Skin biopsy: This is a minor surgical procedure done in your provider’s office. They numb your skin with a small needle and then use a surgical blade to remove the skin spot. You may get stitches after the procedure. Your provider then sends the tissue to a lab where a pathologist evaluates it for SCC. It usually takes 2 to 5 days to get the results. 

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Treating SCC

Treating SCC depends on its size, where it is on the body, and your overall health. 

Here are some treatment options for a small SCC that hasn’t spread beyond the skin:

• Surgical treatments: These work by cutting out the cancer. This is done with an excision or Mohs surgery (a special type of excision that spares normal skin).

• Destruction: This means destroying the cancer by freezing it (cryosurgery) or scraping it off (curettage and electrodesiccation).

• Photodynamic therapy: This uses a special medication and light to target skin cancer cells.

• Topical chemotherapy: This uses 5-fluorouracil and imiquimod creams to kill cancer cells. These are off-label treatments.

• Radiation: This uses high-energy waves or particles (like X-rays) to kill cancer cells. This is used when surgery isn’t an option and for more advanced SCCs.  

When a SCC is large, involves nerves, or has spread beyond the skin, it may need additional treatment with medication that targets the immune system (like Libtayo or Keytruda) or chemotherapy.

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Prevention

It’s not possible to completely prevent SCC. But there are ways to significantly lower your odds of getting it. The most important thing you can do is protect your skin from UV rays and the sun. 

Here are some steps you can take to help prevent SCC:

• Stay in the shade between 10AM and 4PM.

• Use sunscreen every day.

• Avoid tanning and tanning beds.

• Wear sun-protective clothing.

• Stop smoking (or don’t start).

• Check your skin regularly.

• See a dermatologist if you have risk factors or a worrisome spot.

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