Squamous Cell Carcinoma (SCC)
In Brief
Squamous cell carcinoma (SCC) is a common type of skin cancer that typically develops in areas exposed to the sun over many years. Unlike BCC, SCC has the potential to spread beyond the original site, so early detection and treatment matter. Dermoscopy and biopsy enable accurate diagnosis. Treatment depends on the size, location, and type of the tumor, and may include surgical excision or Mohs surgery.
Squamous cell carcinoma develops in the squamous cells of the outer layer of the skin. It is the second most common form of skin cancer, with an incidence rate of approximately 58 cases per 100,000 residents in Israel. SCC is more likely to spread than BCC, making prompt treatment essential. SCC often appears on sun-damaged skin and areas of chronic inflammation. Given Israel's intense sun exposure, SCC rates are particularly elevated, making regular skin checks essential for early detection.
Symptoms
- Firm, red nodule on the skin
- Flat lesion with a scaly, crusted surface
- New sore or raised area on an old scar
- Rough, scaly patch on the lip that may become an open sore
- Wart-like growth that crusts or bleeds
Treatment Options
- Mohs Micrographic Surgery - recommended for high-risk SCC
- Wide local excision
- Radiation therapy for inoperable cases
- Lymph node evaluation if metastasis is suspected
- Adjuvant therapy for advanced cases
Why Mohs Surgery?
Mohs surgery is especially important for high-risk SCC, including tumors on the face, recurrent tumors, and those with aggressive histologic features. The real-time margin control ensures complete removal while preserving maximum healthy tissue.
Learn about Mohs SurgeryTreatment Comparison
| Method | Description | Best For |
|---|---|---|
| Mohs Surgery | Layer-by-layer removal with 100% real-time margin examination. Cure rate ~97% for SCC. | High-risk SCC: face, ears, lips, recurrent, perineural invasion |
| Wide Local Excision | Surgical removal with 4-6mm safety margins. Tissue sent for pathology. | Low-risk SCC on trunk or limbs |
| Radiation Therapy | External beam radiation over multiple sessions. | Patients who cannot undergo surgery, or as adjuvant after excision |
| Curettage & Electrodesiccation | Scraping and cauterization. Quick but no margin control. | Small, well-defined, low-risk SCC only |
| Immunotherapy (Cemiplimab) | Checkpoint inhibitor for locally advanced or metastatic SCC. | Advanced SCC not amenable to surgery or radiation |
Frequently Asked Questions
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Read more →This medical content was reviewed and verified by Dr. Yehonatan Kaplan on April 8, 2026