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Patient guide · Edinburgh

Understanding Squamous Cell Carcinoma

Patient guide · Squamous cell carcinoma

An educational guide to squamous cell carcinoma.

Squamous cell carcinoma (SCC) is the second most common type of skin cancer in the UK. It typically develops on areas exposed to sunlight, such as the face, scalp, ears, and hands. SCC is often very treatable when caught early, but it can grow aggressively and, in advanced cases, spread to other parts of the body — so prompt assessment matters. This guide covers the warning signs, causes, types, treatments, and prevention.

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A squamous cell carcinoma lesion on sun-exposed skin
The basics

What is squamous cell carcinoma?

Squamous cell carcinoma develops from keratinocytes, the cells in the outer layer of the skin (the epidermis). It begins when the DNA of these cells is damaged — often by ultraviolet (UV) radiation — leading to abnormal growth.

  • SCC is a type of non-melanoma skin cancer, and the second most common skin cancer in the UK.
  • It often appears on sun-exposed areas, though it can occur anywhere on the body.
  • It is particularly common in people over the age of 50.

While most SCCs are localised, advanced cases can spread to the lymph nodes and other parts of the body, requiring more intensive treatment. Read more on squamous cell carcinoma at the British Association of Dermatologists.

When to seek help

Warning signs of squamous cell carcinoma

SCC can present in several forms, so it's important to recognise the warning signs:

  • Scaly or crusty patch: a raised, rough lesion that may bleed or ulcerate.
  • Non-healing ulcer: a sore that doesn't heal, often in sun-exposed areas.
  • Thickened skin or growth: a wart-like or horn-shaped projection.
  • Tender or painful area: discomfort in the affected region, though not all SCCs are painful.

If you notice a persistent change to your skin — particularly a lesion that bleeds or fails to heal — have it assessed by a specialist promptly.

Causes

Causes and risk factors

SCC is primarily caused by cumulative exposure to UV radiation, but other factors can contribute:

  • Sun exposure: prolonged or intense exposure, particularly in fair-skinned people.
  • Chronic skin damage: burns, scars, or long-standing wounds.
  • Immune suppression: conditions such as HIV, or medications such as methotrexate or ciclosporin.
  • Age and sex: more common in older adults and slightly more common in men.
  • Skin conditions: disorders such as xeroderma pigmentosum increase susceptibility.
Why treat

Why treat squamous cell carcinoma?

Early treatment is important to prevent complications:

  • Local tissue destruction: untreated SCC can grow deeper into the skin and affect underlying tissue.
  • Metastasis: in advanced cases, SCC can spread to the lymph nodes and other organs.
  • Recurrence risk: treating SCC early reduces the likelihood of recurrence.
Types

Types of squamous cell carcinoma

SCC varies in how it presents, with several subtypes that influence treatment:

  • Cutaneous SCC: the most common form, often linked to sun exposure.
  • Bowen's disease (SCC in situ): a superficial, early form that appears as a red, scaly patch.
  • Keratoacanthoma-like lesions: rapidly growing lesions that can closely resemble SCC and require specialist assessment and histology to confirm what they are.
Treatment options

Treatment options explained

Treatment for SCC depends on the type, size, location, and stage of the lesion:

  • Surgical excision: the lesion is removed with a margin of healthy skin. This is the usual treatment for invasive SCC, with a high success rate.
  • Curettage and cautery, topical therapy, or cryotherapy: may be used for carefully selected low-risk lesions — particularly SCC in situ (Bowen's disease) — rather than for invasive SCC.
  • Radiotherapy: targeted radiation. A non-surgical option, often for patients unable to undergo surgery.
  • Systemic treatments: medication that treats SCC throughout the body — used for advanced or metastatic SCC.

Excised tissue is sent for histological (laboratory) analysis as standard, to confirm the diagnosis and check the margins are clear.

What you pay depends on the diagnosis and the complexity of the lesion — a specialist consultation is £200, and removal pricing is confirmed once the diagnosis is known. See full pricing and arrange a skin cancer assessment in Edinburgh.

During & after

What to expect during treatment

At your consultation, a skin cancer specialist examines the lesion and may take a biopsy to confirm the diagnosis. A tailored treatment plan is then recommended according to the stage of the SCC, the procedure is carried out, and follow-up monitoring confirms recovery and checks for recurrence.

Aftercare tips

  • Keep the area clean: gently wash with soap and water once your dressings are removed, and pat dry.
  • Protect your skin: use sunscreen daily and wear protective clothing.
  • Monitor the area: watch for signs of infection or recurrence.
  • Follow specialist advice: attend all follow-up appointments as recommended.

For full preparation and recovery guidance, read our what to expect page.

Prevention

Preventing squamous cell carcinoma

You can reduce your risk of developing SCC by:

  • Wearing broad-spectrum sunscreen daily (SPF 30 or higher).
  • Avoiding peak sun hours (10am to 4pm).
  • Wearing protective clothing, hats, and sunglasses.
  • Avoiding tanning beds.
  • Performing regular self-checks for changes to your skin.
Expertise

Why choose a plastic surgeon for SCC removal

See a specialist if you notice a persistent sore that doesn't heal, a change in the size, shape, or colour of a lesion, or if you have a history of prolonged sun exposure or previous skin cancer.

Plastic surgeons are uniquely equipped to deliver the best cosmetic and cancer-safe outcome. With advanced training in skin surgery and aesthetics, they can minimise scarring while ensuring the lesion is fully removed. At Skin Surgeons Edinburgh, every procedure is carried out by Dr Kazem Nassar, a Consultant Plastic Surgeon on the GMC Specialist Register, at the Waterfront Private Hospital.

Dr Kazem Nassar is the plastic surgery lead for the South East Scotland melanoma multidisciplinary team (MDT) and also sits on the South East Scotland non-melanoma skin cancer MDT, providing specialist surgical input into the assessment and management of melanoma, non-melanoma skin cancer and complex skin cancer cases.

Frequently asked

Skin cancer FAQs

Skin cancer FAQ

01 What is skin cancer surgery?

Skin cancer surgery removes cancerous lesions — including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. The aim is complete removal while preserving as much healthy tissue as possible.

02 What treatment techniques are used for skin cancer?

Several techniques are used, surgical and non-surgical. Surgical excision removes the cancerous tissue with a margin of healthy skin and is the usual treatment for most invasive skin cancers. Curettage and cautery, topical prescription creams, or cryotherapy may be used for selected low-risk or superficial lesions. The right choice depends on the type of cancer, its risk features, and where it is — your surgeon will explain the options.

03 What are the potential risks of skin cancer treatment?

As with any procedure there are risks. These can include bleeding, infection, problems with wound healing, scarring, altered sensation around the wound, incomplete excision (cancer cells left at the edge of what was removed), and recurrence — any of which may mean further treatment is needed. Your surgeon discusses the risks relevant to your lesion and takes precautions to reduce them.

04 Will there be scarring after treatment?

Scarring depends on the size and location of the lesion and the treatment method used. The surgeon aims for the best possible cosmetic outcome, particularly in cosmetically sensitive areas such as the face.

05 How long does skin cancer treatment take?

The procedure typically lasts from about 30 minutes to a few hours, depending on the complexity and type of treatment.

06 Is skin cancer treatment painful?

Local anaesthetic is applied to the area to prevent pain during surgical treatment. You may feel minor discomfort or a sensation of pressure during and after the procedure.

07 Can I resume normal activities after the procedure?

Most people return to their daily activities shortly afterwards, though recovery time varies — especially for larger or more complex surgery.

08 When should I consider skin cancer treatment?

Seek assessment if you've been diagnosed with BCC, SCC, or melanoma, or if you have a suspicious lesion that is changing in size, shape, or colour, or that bleeds, itches, or causes pain. A changing or non-healing lesion should be seen promptly.

09 How is the skin cancer analysed after removal?

Removed tissue is sent for histological (laboratory) analysis as standard, to confirm the diagnosis and check that all cancerous cells have been removed. This guides whether any further treatment is needed.

10 How do I choose between different treatment options?

The choice depends on the type, size, and location of the cancer, along with your medical history and cosmetic concerns. Your surgeon will discuss the most appropriate option at your consultation.

11 What should I expect in terms of aftercare and healing?

Aftercare involves keeping the treatment site clean, applying any prescribed ointment, and following your surgeon's instructions. Healing time varies but usually takes a few weeks.

12 Can skin cancer recur after treatment, and is follow-up needed?

Although the goal is to remove all cancerous cells, there is a chance of recurrence. A follow-up appointment is usually arranged to check healing and review the histology results. Ongoing surveillance then depends on the diagnosis, the risk features of the lesion, any previous skin cancer history, and MDT advice.

Ready when you are

Arrange a skin cancer assessment.

A changing or non-healing lesion should be seen promptly. Our consultant-led service provides specialist assessment, diagnosis, and treatment, with histology as standard. No GP referral required.

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