Squamous Cell Carcinoma: Causes, Symptoms & Treatment


What is Squamous Cell Carcinoma?

Squamous cell carcinoma is a skin cancer that attacks the squamous cells, the cells that make up the middle and outer layers of the skin. This cancer usually appears on the face, neck, hands, and feet.

Squamous cell carcinoma (SCC) is the second most common type of skin cancer. Although it usually appears on areas of the skin that are frequently exposed to the sun, SCC can also attack other parts of the body that have squamous cells.

How fast does squamous cell carcinoma spread? Squamous cell carcinoma is a type of skin cancer that tends to grow slowly. However, unlike other skin cancers, this type of cancer can spread to bones and other organs. In this condition, SCC will be more difficult to be cured.

Causes of Squamous Cell Carcinoma

SCC is caused by mutations or changes in DNA in the squamous cells in the skin. These mutations cause squamous cells to grow uncontrollably and live longer.

Changes in DNA in squamous cells can be triggered by ultraviolet radiation, such as from exposure to direct sunlight or from a procedure to darken the skin with UV light (skin tanning).

Squamous Cell Carcinoma Risk Factors

There are a number of factors that can increase the risk of developing squamous cell carcinoma, including:

  • Old age
  • Have light skin
  • Have a history of SCC or other types of skin cancer
  • Have a history of sunburn as a child or teenager
  • Have precancerous lesions, such as solar keratosis or Bowen’s disease
  • Have a weak immune system, for example because you have leukemia or lymphoma, have recently had an organ transplant, or are taking immune-suppressing drugs (such as corticosteroids)
  • Long-term exposure to chemicals, such as arsenic
  • Having a job exposed to radiation
  • Suffering from infection with human papillomavirus (HPV) or human immunodeficiency virus (HIV)
  • Suffering from genetic disorders, such as xeroderma pigmentosum, Gorlin syndrome, albinism, and Bazex syndrome
  • Excessive exposure to sunlight, for example from working outdoors
  • Using a tanning tool to darken the skin

Symptoms of Squamous Cell Carcinoma

Squamous cell carcinoma generally attacks skin area that exposed by the sun, such as the scalp, hands, ears, and lips. However, symptoms can also appear in other parts of the body, such as in the mouth, soles of the feet, as well as the genital area and anus.

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The initial symptom of squamous cell carcinoma of the skin is the appearance of red, scaly patches or lumps that feel dry, itchy, and change color (solar keratosis). On the inside of the mouth, such as the tongue, gums, or the walls of the mouth, the initial symptom may be white patches that can’t be cleaned (leukoplakia).

If it has developed, signs and symptoms of squamous cell carcinoma that might be occured such as:

  • Hard red bumps, look like warts
  • Rough red patches that are crusty, scaly, and bleed easily
  • An open wound that won’t heal
  • Wounds with protruding edges and a wound bed that itch and bleed easily

Keep in mind that sores on the skin that don’t heal for a long time or often re-form can also be a sign of squamous cell carcinoma.

Squamous Cell Carcinoma Stage

After the patient is confirmed to have SCC, the doctor will conduct further examinations to determine the stage of SCC. This examination will help the doctor in choosing the right type of treatment for the patient.

The following are the stages or stages of development of squamous cell carcinoma:

  • Stage 0
    Cancer cells are in the top layer of the skin (epidermis) and have not spread to the deep layers of the skin
  • Stage 1
    The tumor is less than 2 cm in size and has not spread to the lymph nodes
  • Stage 2
    The tumor is 2–4 cm in size and has not spread to the lymph nodes
  • Stage 3
    The tumor is larger than 4 cm or has spread to the deep layers of the skin, bone, or to nearby lymph nodes
  • Stage 4
    Tumor of any size that has spread to more than 1 lymph node, bone marrow, or other organs

Squamous Cell Carcinoma Treatment

There are several treatment methods to cure SCC. The method chosen by the doctor will be adjusted to the age and overall health of the patient, the size and area of the affected skin, and the severity of SCC. Some methods that can be done are:

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Electrodesiccation and curettage

Electrodesiccation and curettage is a tumor removal procedure by means of a curette. Once removed, the underlying cancer layer is burned using an electric needle.


Cryosurgery or cryotherapy is a procedure to kill cancer cells using liquid nitrogen. This method can also be performed after curettage.

Laser therapy

Laser therapy is a procedure to kill cancer cells using a laser beam. This method is used on SCC in the skin that is not too deep.

Photodynamic therapy

This procedure is done by giving topical medication to the skin affected by CSS. The skin that has been smeared with the drug was then irradiated with a special light to destroy cancer cells.

Simple excision

A simple excision is a procedure that cuts the cancerous area of skin and the surrounding healthy skin tissue.

Mohs Surgery

Mohs surgery is a procedure to remove cancerous skin, layer by layer, to be examined under a microscope. This method is usually done to remove cancer in the face, nose and ears.


Chemotherapy is a method of killing cancer that has spread to other organs using drugs.

Prevention of Squamous Cell Carcinoma

In the vast majority of cases, squamous cell carcinoma cannot be prevented. However, you can reduce your risk of developing this disease by doing these tips:

  • Avoid sun exposure when it’s hot and change the schedule of outdoor activities to hours when the sun is not hot, if possible
  • Wearing clothing that covers all parts of the skin, including hats and glasses, when traveling
  • Apply sunscreen containing at least SPF 30 to the skin every 2 hours when outdoors, or more often if swimming or sweating
  • Regularly check the skin independently and immediately consult a doctor when there are suspicious changes in the skin
  • Avoid skin tanning


  • Silva, L., & Borges-Costa, J. (2020). Cutaneous Squamous Cell Carcinoma in Solid Organ Transplant Patients. Journal of the Portuguese Society of Dermatology and Venereology, 78(4), pp. 245–351.
  • Stang, et al. (2019). Incidence and Mortality for Cutaneous Squamous Cell Carcinoma: Comparison Across Three Continents. Journal of the European Academy and Venereology, 33(S8), pp. 6–10.
  • National Institute of Health (2019). U.S. National Library of Medicine. Medline. Squamous Cell Skin Cancer.
  • Mayo Clinic (2021). Diseases & Conditions. Squamous Cell Carcinoma of the Skin.
  • Pietrangelo, A. Healthline (2020). Skin Cancer Stages: What do They Mean?


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