Squamous Cell Carcinoma

Squamous Cell Carcinoma

Squamous cell carcinoma is the second most common form of skin cancer.  About 15,000 Americans die of squamous cell carcinoma each year, caused by the uncontrolled growth of squamous cells in the epidermis (top layer of skin). However, it’s almost always curable when caught early. Everyone in your family should have an annual skin exam with a dermatologist. (Some insurances cover this exam.)

What are the symptoms?

Squamous cell carcinoma often looks like thick, rough, scaly patches, open sores, or warts, with a raised bump and central depression. These patches, sores, or “warts” may bleed, and the skin around them will likely show signs of sun-damage—wrinkling or uneven pigmentation. These patches may be raised, crusty, or scabby.

Squamous cell carcinoma can occur anywhere, including the genitals or mouth, but it usually occurs in an area that receives sun exposure. These include the face, lips, scalp, tops of ears, limbs, or torso.

Who gets it?

Anyone can get squamous cell carcinoma, but you’re at greater risk if you have blonde or red hair, light skin, and/or light eyes. Extensive sun exposure or a history of basal cell carcinoma also increase your risk.

While the majority of diagnoses occur in older adults, incidents are increasing among young adults, Latinos, and other people of color. This is the most common type of skin cancer affecting African-Americans, and it often occurs at the site of a burn wound or another inflammatory skin injury.

What are the associated conditions?

Bowen’s disease is an early form of squamous cell carcinoma that looks like a reddish-brown crusty patch and may be mistaken for psoriasis or eczema. It may be caused by sun exposure or by chemical exposure to arsenic, radiation, and other carcinogens. 

Actinic keratoses are rough, scaly growths that often occur in clusters. Before the keratoses visibly develop, you can usually feel them. The affected patch of skin may have a sandpaper texture. Keratoses may disappear and reappear, and sometimes they itch, turn red, or even bleed. They are considered precancerous lesions and should be removed.

Actinic cheilitis is a form of actinic keratosis often found on your lower lip. If your lips are frequently dry, chapped, cracked, and burning, mention this to your dermatologist.

Leukoplakia is white patches on the tongue, cheek, or elsewhere inside the mouth that may develop into squamous cell carcinoma. They may be caused by tobacco or heavy alcohol use, or a chronic irritation, such as a sharp edge of dentures or braces.

What is the treatment?

Often squamous cell carcinoma is treated by Mohs Surgery, which is usually an outpatient procedure performed under local anaesthetic. Affected areas of the skin are removed slowly, a layer at a time, until no cancerous skin remains. Occasionally, the wound may need reconstructive surgery or a skin flap or graft.

Other options include cutting out the cancer, scraping off the affected cells and burning the site with an electrocautery needle, to kill any remaining cancer cells, or freezing off the cells using cryosurgery.

If the cancer has already spread beyond your skin, you will be referred to an oncologist.

Prevention Methods

Practice safety in the sun!  Our dermatologists recommend avoiding direct sun when it’s rays are at their peak, between 10 a.m. and 2 p.m. If you are in the sun, wear protective clothing, hats, sunglasses, and a high SPF mineral sunscreen. Reapply sunscreen every two hours or after water. Never go to tanning beds. Keep infants out of the sun altogether.

Conduct a self-skin exam on a monthly basis to track any abnormal changes and be sure to schedule your annual skin cancer screenings with your dermatologist. You’ll need a professional skin exam every six months if you have a history of skin cancer or if you develop a new spot on your skin.

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