Squamous Cell Carcinoma (SCC): The Second Most Common Skin Cancer, and a Treatable One

6 days ago

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Squamous Cell Carcinoma (SCC) is a skin cancer caused by abnormal growth of keratinocytes, the main cells of the outer layer of the skin. It is the second most common skin cancer after Basal Cell Carcinoma (BCC), and it matters because, although uncommon, it can spread to lymph nodes and other organs. The good news is that when it is found early, SCC can be cured with surgery.

How SCC differs from BCC and Melanoma

The three main types of skin cancer differ in how they grow and spread: BCC grows slowly and rarely spreads, SCC grows faster and has a low but significant chance of spreading, and Melanoma is the most dangerous type and spreads quickly. SCC has a very high cure rate (over 90%) when found early, but if left untreated for a long time, larger surgery may be needed.

Risk factors for SCC

SCC is linked to several factors that damage or alter skin cells over the long term, including:

Cumulative UV exposure — the main factor in people with fair skin, and also seen in Asians who work outdoors for long periods.
Actinic Keratosis (AK) — a precancerous lesion that can turn into SCC if left untreated.
HPV infection — infection with certain HPV types, especially SCC in the genital area.
Weakened immunity — for example organ transplant recipients and people with HIV have a higher risk.
Chronic wounds — long-standing sores, old burn scars or lichen sclerosus lesions.
Chemicals — exposure to chemicals such as arsenic or tar.

Symptoms and appearance of SCC

Signs of SCC to watch for and see a doctor about promptly include:

A sore that does not heal — a sore or raised bump that does not heal and has a firm, raised edge.
Rough skin — a crusted base or a rough, raised growth resembling a wart (warty surface).
Easy bleeding — some lesions bleed easily or ooze fluid.
Common locations — usually in frequently sun-exposed areas such as the lower lip, face, ears and hands.
Mucous membranes — it may occur in the lining of the mouth or genitals, which is linked to HPV.

Relationship with Actinic Keratosis

Actinic Keratosis (AK) is a precancerous lesion caused by cumulative UV exposure. It appears as rough, scaly pink or brown skin on the face, ears, hands and scalp. About 5-10% of AK lesions may develop into SCC if not treated, so treating AK early is the best way to prevent SCC.

Diagnosing SCC

A definitive diagnosis requires a skin biopsy for pathology examination. The dermatologist assesses the depth of the lesion and the appearance of the cells to determine the grade and risk level, which is key information for planning treatment.

Treating SCC

Treatment depends on the size, location and risk level of the lesion. Options include:

Mohs Micrographic Surgery — the gold standard for SCC on the face and other important areas, with a cure rate of over 97%.
Standard surgery — surgical removal of the lesion (excision) in typical cases.
Radiation therapy — for some locations that are difficult to operate on, or in older adults.
Immunotherapy — the drug cemiplimab for SCC that has spread or cannot be removed surgically.
Lymph node assessment — examining the lymph nodes in higher-risk cases.

The choice of treatment must be considered individually by a dermatologist, so appropriate assessment and follow-up are important.

Frequently asked questions

How does SCC differ from BCC and Melanoma? The three main types of skin cancer differ: BCC grows slowly and rarely spreads, SCC grows faster and has a low but significant chance of spreading, and Melanoma is the most dangerous type and spreads quickly. SCC has a very high cure rate (over 90%) when found early, but if left for a long time, larger surgery may be needed.

How is SCC related to Actinic Keratosis? Actinic Keratosis (AK) is a precancerous lesion caused by cumulative UV exposure. It appears as rough, scaly pink or brown skin on the face, ears, hands and scalp. About 5-10% of AK lesions may develop into SCC if not treated. Treating AK early is the best way to prevent SCC.

Can SCC be cured? SCC has a very high cure rate when it is found and treated at an early stage. Removing the lesion completely by surgery, especially Mohs Micrographic Surgery, has a cure rate of over 97% on the face, so a sore or bump that does not heal should not be left for long.

Which sores should I see a doctor about as possible SCC? See a dermatologist if you have a sore or raised bump that does not heal within a few weeks, has a firm raised edge, a crusted or rough wart-like surface, bleeds easily or oozes fluid, especially in frequently sun-exposed areas such as the lower lip, face, ears and hands.

If you have a sore or bump on your skin that does not heal within a few weeks, especially in a frequently sun-exposed area, do not ignore it. Consult a dermatologist at Siam Dermatology for an early assessment. Call +66 61 448 7000 or LINE @siamderm

Written by Dr. Patara Voravutinon, Dermatologist · Last reviewed July 16, 2026