Squamous cell carcinoma (SCC) is the second most common skin cancer. This skin cancer tends to develop in areas that have been exposed to the sun for years. It is most frequently found on the head, neck, ears, lips, arms and hands. Women frequently get SCC on their lower legs. Middle-aged and elderly people, especially those with fair skin and frequent sun exposure, are most likely to be affected.
SCCs are usually slowly-growing, tender, scaly or crusted lumps. The lesions may develop sores or ulcers that fail to heal. They vary in size from a few millimeters to several centimeters in diameter. Sometimes they grow to the size of a pea or larger in a few weeks, though more commonly they grow slowly over months or years. Any lesion, especially those that do not heal, grow, bleed or change in appearance, should be evaluated by a dermatologist.
The majority of cutaneous SCCs are due to exposure to ultraviolet radiation, and they most often arise from precancers or actinic keratoses. Other risk factors for invasive SSC include inherited predisposition to skin cancer, smoking, thermal burn scars, longstanding ulcers, and imunosuppression. SCCs are usually locally destructive. However, if left untreated SCCs can destroy surrounding tissue, muscle and even bone. Aggressive SCCs, especially those of the lips or ears, can spread to other parts of the body like the lymph nodes.
Treatment options vary and depend of the location of the tumor, size, characteristics, and health of the patient among other factors. Surgical excision to remove the entire cancer is the most commonly used treatment. Other treatments include Mohs micrographic surgery, electrodesiccation and curettage, topical creams, light treatments, and laser surgery. Sun exposure avoidance is the primary form of prevention and is important at all ages. Your dermatologist may recommend sunscreens with a SPF 30 or greater, sun protective clothing, avoidance of the sun during midday hours and seeking shade when possible.