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Squamous Cell Carcinoma

Written by Dr. Rokhsar

What is Squamous cell carcinoma?

Squamous cell carcinoma (SCC) is the second most common form of skin cancer in the US. SCC affects cells in the outer layer of skin. SCC can occur in any area of the body. It usually occurs in areas of the body that have had years of exposure to ultraviolet light from the sun or tanning beds. The most common locations are on the head, neck, hands, and the lower legs. If untreated, the SCC will continue to grow and destroy the surrounding skin and the underlying tissues. SCC does have the ability to spread to other organs of the body. The good news is that when SCC is spotted and treated early, it is highly curable.

What does SCC look like?

An SCC lesion looks like a superficial, dark red growth that feels hard to the touch. As it gets larger, it will become dome-shaped, and may ulcerate and bleed. There may be a white-yellow scale on top of the lesion. When this scale is removed, there is a space filled with dead cells that causes a bad smell.

As with other skin cancers, the definitive diagnosis of SCC can only be made after a biopsy of the skin. A biopsy is performed by removing a piece of the abnormal skin. That piece of skin is then examined under a microscope and is searched for cancerous cells.


The favored treatment of SCC is surgical, in other words, removal of the growth by either excision or Mohs micrographic surgery.

Excision: The doctor cuts out the lesion and some normal skin around the lesion. The doctor then examines the removed tissue and is able to see if the normal skin around the lesion is free of cancerous cells. If there are abnormal cells then the procedure is repeated until the normal skin is free of cancerous cells under the microscope. This method is less desirable in areas of the face.


Mohs micrographic surgery: Physicians licensed to perform Mohs surgery have had a year of extra training. This procedure has similarities to the excision method in that the lesion is removed and then examined under a microscope to ensure complete removal of the cancerous growth. As the name “micrographic” implies, Mohs is different in that it removes the skin growth in thin layers. The removed skin is then “mapped” and processed in such a way that 100% of the margins of skin can be examined for abnormal cells. In this manner; as much normal skin as possible remains intact. This procedure is a specialized, delicate procedure that is especially useful in areas of cosmetic concern, such as the face.


After removal of the SCC, you must return to your dermatologist at regular intervals to have skin exams and to have the excision scar inspected.

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