Specialist Management of a More Aggressive Skin Cancer
Squamous cell carcinoma (SCC) is a common form of skin cancer that arises from the outer layers of the skin.
Unlike basal cell carcinoma, SCC has a greater potential to grow more rapidly and, in some cases, spread to other parts of the body. Early diagnosis and appropriate treatment are therefore essential.
What Is Squamous Cell Carcinoma?
SCC develops from keratinocytes in the skin and is most often related to cumulative sun exposure.
It commonly occurs on:
- The face and lips
- The ears
- The scalp
- The hands and forearms
If left untreated, SCC can enlarge, invade surrounding tissues, and—less commonly—spread to lymph nodes or other sites.
How It Presents
Squamous cell carcinoma may appear as:
- A scaly, crusted or thickened lesion
- A persistent sore that does not heal
- A raised growth with a rough surface
- A lesion that may bleed, ulcerate, or become tender
Changes are often progressive, and any persistent or evolving lesion should be assessed.
Diagnosis
Diagnosis involves:
- Clinical examination and dermoscopy
- Biopsy to confirm the diagnosis in most cases
Additional assessment may be required for larger or more aggressive lesions, including evaluation of nearby lymph nodes.
Treatment Options
Treatment is guided by the size, location, and characteristics of the tumour.
Surgical Excision
- Removal of the tumour with a margin of healthy tissue
- Provides a high cure rate
- Allows histological confirmation of complete removal
This is the primary treatment for most SCCs, particularly on the face.
Reconstruction
Following removal, reconstruction is tailored to the site and extent of the defect.
Options include:
- Direct closure
- Local flaps
- Skin grafts
The aim is to restore both function and appearance, particularly in visible facial areas.
Additional Treatment
In selected cases, further treatment may be required:
- Wider excision for high-risk lesions
- Surgery to nearby lymph nodes if spread is suspected
- Radiotherapy where indicated
Management is tailored based on the specific features of the tumour.
Recovery
Recovery depends on the extent of surgery and reconstruction.
- Sutures are usually removed within 1–2 weeks
- Healing continues over several weeks
- Scars improve gradually over time
Follow-up is important to monitor healing and detect recurrence early.
Outcomes
When treated appropriately, SCC has:
- High cure rates when detected early
- Good long-term outcomes
- A small but important risk of recurrence or spread in higher-risk cases
Prompt treatment is key to achieving the best outcome.
Risks and Considerations
Potential risks include:
- Scarring (minimised with careful technique)
- Infection or delayed healing (uncommon)
- Incomplete excision requiring further treatment
- Recurrence or spread in more aggressive cases
Early and appropriate treatment reduces these risks.
Specialist Assessment and Treatment
Management of SCC requires careful balance between oncological safety and facial reconstruction.
As a Consultant Maxillofacial Surgeon, treatment is guided by:
- Detailed understanding of facial anatomy and tumour behaviour
- Experience in achieving complete tumour clearance
- Expertise in reconstructive techniques to restore form and function
This ensures that treatment addresses both the cancer and the long-term outcome.
Follow-Up
Ongoing review is important after treatment.
This may include:
- Monitoring the treated area
- Assessment of local lymph nodes where appropriate
- Advice on skin surveillance and sun protection
Consultation
A detailed consultation allows assessment of any suspicious lesion and development of an appropriate treatment plan.
Book a Consultation
For assessment and treatment of squamous cell carcinoma in London, arrange a consultation to discuss your options.