UNDERSTANDING SQUAMOUS CELL CARCINOMA

What Is Squamous Cell Carcinoma and Why Early Treatment Matters

Squamous cell carcinoma (SCC) is the second most common form of skin cancer, developing from abnormal growth of the flat, thin squamous cells found in the upper layer of the epidermis. It most often appears on areas of the skin that receive the most sun exposure: the face, ears, scalp, lips, neck, hands, forearms, and lower legs. At the Dermatology Office of Dr. Ellen Turner in Dallas and Irving, we help patients recognize, diagnose, and effectively treat SCC with personalized care tailored to each case.

The Skin Cancer Foundation estimates that approximately 1.8 million cases of SCC are diagnosed in the United States each year, and its incidence has been rising by an estimated 2 to 4 percent annually. Unlike basal cell carcinoma, SCC is more likely to grow deeper into the skin and, in some cases, spread to other parts of the body. Early diagnosis and treatment are essential. When caught early, SCC is highly curable and rarely causes serious complications.

Dr. Turner has extensive experience diagnosing and treating skin cancer, guiding every patient through their options with clarity and reassurance. Whether a suspicious lesion is SCC or another condition, our priority is an accurate diagnosis followed by a treatment plan tailored to your health, lifestyle, and cosmetic goals.

SCC at a Glance

  • ✓The second most common form of skin cancer in the United States
  • ✓Approximately 1.8 million U.S. cases diagnosed each year
  • ✓Can grow deeper into the skin and, in some cases, spread if untreated
  • ✓Highly treatable when diagnosed early, with multiple effective options

1.8M

New U.S. cases each year

97-99%

SRT cure rates in clinical studies

PATIENT RESULTS

Real Results from Dr. Turner’s Dallas and Irving Patients

Actual patients treated for squamous cell carcinoma with Superficial Radiation Therapy at our Dallas and Irving offices. Individual results may vary.

Before and after Superficial Radiation Therapy for squamous cell carcinoma
Before and after Superficial Radiation Therapy for squamous cell carcinoma

WHEN TO SEE A DERMATOLOGIST

How to Recognize the Warning Signs of Squamous Cell Carcinoma

SCC can look like many things, from a stubborn rough patch to a wart-like growth, or a bump that keeps returning. If a lesion on your skin looks or feels different and does not go away, do not wait to have it checked.

The 5 warning signs of squamous cell carcinoma: rough scaly patch, firm dome bump, non-healing sore, wart-like growth, and cratered bump

01

Rough, Scaly Patch

May be itchy, tender, or crusty. Often persistent and does not respond to moisturizers.

02

Firm, Dome-Shaped Bump

Skin-colored, pink, or red. May feel hard and rough to the touch.

03

Non-Healing Sore

Crusts, bleeds, or oozes and returns after appearing to heal.

04

Wart-Like Growth

Raised, elevated lesion, sometimes with a crusted or ulcerated surface.

05

Rapidly Growing Bump

Central crust, may grow quickly over weeks (keratoacanthoma variant).

If you notice any of these signs, contact our Dallas or Irving office for prompt evaluation. Early diagnosis of SCC dramatically improves treatment outcomes and reduces the risk of spread.

SUBTYPES

The Different Forms of Squamous Cell Carcinoma

SCC is not a single disease. Dermatologists and dermatopathologists recognize several distinct subtypes, each with its own appearance, behavior, and preferred treatment approach.

Five subtypes of squamous cell carcinoma: in situ, invasive, keratoacanthoma, verrucous, and high-risk

EARLIEST FORM

SCC In Situ (Bowen’s Disease)

Confined to the very top layer of the skin and not yet invasive. Typically a well-defined, scaly, red or brown patch that may be mistaken for eczema or psoriasis. When treated at this stage, cure rates approach 100%.

MOST COMMON INVASIVE FORM

Invasive SCC

A firm red bump, scaly patch, or crusted sore that has grown beyond the top layer of skin into the deeper dermis. Requires prompt treatment to prevent further growth or spread.

RAPID-GROWTH VARIANT

Keratoacanthoma

A rapidly growing, dome-shaped tumor with a distinctive crater-like center filled with keratin, appearing over weeks rather than months. Should always be evaluated and treated.

WART-LIKE VARIANT

Verrucous SCC

A slow-growing, wart-like variant most often appearing on the feet, mouth, or genital area. Rarely metastasizes but can invade locally if untreated.

AGGRESSIVE SUBTYPES

High-Risk Subtypes

Includes desmoplastic, sarcomatoid, and acantholytic SCC. Poorly defined borders, deeper invasion, and higher risk of recurrence or spread.

WHY SCC DEVELOPS

Understanding Your Risk

SCC is strongly linked to lifetime ultraviolet exposure, but several other factors also raise your risk. Knowing your personal risk profile helps you and Dr. Turner plan the right screening schedule.

UV Exposure

Cumulative sun exposure and indoor tanning are the leading causes. Regular daily SPF 15+ use reduces SCC risk by approximately 40 percent.

Fair Skin & Light Eyes

People with light skin, blue or green eyes, and red or blond hair are at higher risk, though SCC can develop in all skin tones.

Age & Sex

Most SCCs develop after age 65, and men are approximately twice as likely as women to develop SCC.

Immunosuppression

Organ transplant recipients are approximately 100 times more likely than the general public to develop SCC.

Precancerous Lesions & Prior Skin Cancer

Actinic keratoses, Bowen’s disease, and a personal history of any skin cancer significantly increase your risk.

HPV, Chemicals & Chronic Wounds

Certain HPV strains, arsenic exposure, ionizing radiation, and long-standing scars, burns, or non-healing wounds all raise SCC risk.

THE DIAGNOSTIC PROCESS

How a Suspicious Lesion Becomes a Confirmed Diagnosis

A definitive SCC diagnosis always requires a biopsy. Here is what to expect at your Dallas or Irving appointment.

How a skin biopsy confirms squamous cell carcinoma
Step 1 – Clinical Skin Examination
▾
  • ✓Dr. Turner performs a thorough visual examination of the lesion in question and any other suspicious areas
  • ✓Your personal and family history of skin cancer, sun exposure, and any prior biopsies is reviewed
  • ✓Symptoms such as bleeding, tenderness, rapid growth, or non-healing are documented
  • ✓If a biopsy is recommended, the reasons are fully explained before proceeding
Step 2 – Skin Biopsy
▾
  • ✓The area is cleansed and locally anesthetized so the procedure is comfortable
  • ✓Depending on the lesion, a shave, punch, or excisional biopsy is performed
  • ✓The tissue sample is sent to a certified dermatopathology lab for microscopic evaluation
  • ✓The biopsy site is dressed and simple aftercare instructions are provided
Step 3 – Pathology Review
▾
  • ✓A dermatopathologist, a physician specifically trained in skin pathology, examines the tissue
  • ✓The report confirms whether cancer is present, identifies the SCC subtype, and documents depth of invasion and any perineural involvement
  • ✓In situ (Bowen’s), invasive, keratoacanthoma, and high-risk subtypes each guide treatment differently
  • ✓Dr. Turner personally reviews every report before contacting the patient
Step 4 – Treatment Consultation
▾
  • ✓Dr. Turner determines your customized treatment plan based on your specific diagnosis, the behavior of the squamous cell carcinoma, and all available treatment options
  • ✓Location, size, subtype, depth of invasion, your health, and cosmetic priorities all factor into the plan
  • ✓For most patients, several effective treatments are available, and the choice is a collaborative one
  • ✓You leave with a clear next-step plan and a scheduled follow-up

TREATMENT OPTIONS

Modern, Effective Treatments for Squamous Cell Carcinoma

Multiple effective treatments are available for SCC. Dr. Turner evaluates each case and, when appropriate, prioritizes non-invasive options that preserve tissue and minimize scarring while delivering excellent cure rates.

Preferred Non-Invasive Option

Superficial Radiation Therapy (SRT)

A precisely targeted, low-energy radiation treatment that destroys abnormal cells while preserving healthy tissue. SRT is non-invasive, painless, and scar-free, with published cure rates of 97 to 99 percent in clinical studies, comparable to Mohs surgery. Especially valuable for cosmetically sensitive areas such as the nose, ears, eyelids, lips, and lower legs, and for patients who prefer or medically require a non-surgical approach.

Dr. Turner has partnered with a board-certified radiation oncologist to bring this advanced option to patients in Dallas, Irving, and the greater Dallas–Fort Worth area.

Standard Surgical Excision

Performed under local anesthesia. The tumor is removed with a margin of healthy tissue to ensure clearance. Effective for most SCCs, but produces a scar and requires wound care during healing.

Topical 5-Fluorouracil Cream

For very superficial SCCs and Bowen’s disease, prescription 5-FU cream can destroy abnormal cells on the skin’s surface over several weeks. Can cause temporary redness, crusting, and swelling.

Mohs Micrographic Surgery

Historically referred to as the “gold standard” for high-risk SCCs, Mohs involves removing skin layer by layer with microscopic evaluation until no cancer cells remain. Highly effective but invasive, with associated risks of bleeding, scarring, infection, and prolonged wound care. Dr. Turner reserves Mohs for cases where it is truly the most appropriate option and offers less invasive alternatives when clinically suitable.

OUR PREFERRED APPROACH

Why Superficial Radiation Therapy Is Changing How SCC Is Treated

For many patients with SCC, Superficial Radiation Therapy offers the same excellent cure rates as surgery, without the cutting, stitches, downtime, or scarring. It is one of the most exciting advancements in skin cancer care available today.

Superficial Radiation Therapy device at the Dermatology Office of Dr. Ellen Turner

01

Non-Invasive

No incisions, no stitches, no sutures. Treatment is delivered externally with a small applicator held against the skin.

02

97-99% Cure Rates

Recent large-scale studies of image-guided SRT report freedom-from-recurrence rates exceeding 99 percent at 2, 4, and 6 years, comparable to Mohs surgery.

03

Scar-Free

Because SRT does not cut the skin, treated areas heal without a surgical scar, especially important on the face, ears, lips, and lower legs.

04

No Downtime

Patients return to their daily routine immediately after each session, with no bandages or wound care required.

SRT is not appropriate for every patient or every lesion. Dr. Turner will discuss whether SRT fits your specific diagnosis, the tumor’s location and depth, and your medical history during your consultation.

LONG-TERM SKIN HEALTH

Prevention, Follow-Up, and Long-Term Skin Health

Successful SCC treatment is one part of the story. Preventing new skin cancers and catching any recurrence early is the other. Here is what we recommend.

01

Daily Sun Protection

Physical block SPF 30 or higher every day, reapplied every two hours in direct sun. Regular use reduces SCC risk by approximately 40 percent.

02

Avoid Indoor Tanning

Indoor tanning significantly raises the risk of all skin cancers, including SCC. There is no safe level of tanning bed exposure.

03

Monthly Self-Exams

Check your skin monthly for new spots, rough patches, changing lesions, or sores that will not heal.

04

Professional Screening

Full-body dermatology exams every 6 to 12 months. Roughly 60 percent of skin cancer patients develop another within 10 years.

PATIENT QUESTIONS

Frequently Asked Questions

Is squamous cell carcinoma serious?▾
SCC is more serious than basal cell carcinoma because it can grow deeper into the skin and, in a small percentage of cases, spread to lymph nodes or other parts of the body. However, when caught early, which is the case for the great majority of patients, SCC is highly curable with excellent outcomes. Prompt evaluation of any suspicious lesion is the most important step.
How is SCC different from basal cell carcinoma?▾
Both are non-melanoma skin cancers caused primarily by UV exposure, but SCC tends to grow more quickly and has a higher likelihood of spreading if left untreated. SCC often appears rougher and scalier than BCC, which typically appears as a pearly translucent bump. Treatment options overlap, though SCC generally requires slightly wider margins of tissue clearance.
Will Superficial Radiation Therapy leave a scar?▾
SRT is a non-invasive treatment that does not cut the skin, so it does not produce a surgical scar. During and shortly after treatment, some patients notice temporary redness, dryness, or mild skin changes in the treated area, similar to a mild sunburn, which typically settle over the following weeks. Long-term cosmetic outcomes for SRT are excellent, especially compared to surgical scars on the face, ears, lips, and lower legs.
How long does a course of SRT for SCC take?▾
Most patients complete a treatment course of approximately 15 to 20 sessions over 4 to 7 weeks, with 2 to 3 short sessions per week. Each individual session takes only a few minutes. Your specific plan is determined by the size, depth, and location of the tumor, and Dr. Turner and the radiation oncology team will outline your full schedule at your consultation.
Why does Dr. Turner favor SRT over Mohs surgery for SCC?▾
Mohs surgery is highly effective, but it is invasive: it involves cutting, stitching, wound care, and produces a scar. Recent large-scale studies show that SRT achieves comparable cure rates, exceeding 99 percent freedom from recurrence at 2, 4, and 6 years, without any of the surgical burden. For lesions in cosmetically sensitive areas like the nose, ears, lips, eyelids, or lower legs, and for elderly patients or those with health conditions that make surgery less ideal, SRT is often the more patient-friendly option. Dr. Turner still recommends Mohs when it is genuinely the best fit for a specific case, particularly for high-risk or recurrent tumors.
Can SCC come back after treatment?▾
Recurrence at the treated site is uncommon with modern treatments. All standard options have low recurrence rates. However, anyone who has had one SCC has a higher-than-average chance of developing another skin cancer, since the underlying UV damage affects a broader area. Roughly 60 percent of skin cancer patients develop another skin cancer within 10 years. Dr. Turner recommends full-body skin exams every six months for anyone with a history of skin cancer.
What are the side effects of SRT?▾
Reported side effects are typically mild and localized to the treated area. Common effects include temporary redness, dryness, itching, and mild skin peeling during and shortly after the treatment course. Some patients experience longer-term hypopigmentation (lightening) of the treated skin or fine visible blood vessels (telangiectasias) that develop over months to years. Serious side effects are rare. Dr. Turner and the radiation oncology team review all potential side effects with you before treatment begins.
Can SCC spread to other parts of the body?▾
Yes, though it is uncommon when SCC is diagnosed and treated early. Most SCCs remain localized to the skin. High-risk features that raise the chance of spread include larger tumor size, deeper invasion, perineural involvement (tumor tracking along nerves), certain aggressive histologic subtypes, and immunosuppression. This is why early evaluation and prompt treatment are so important. The great majority of SCCs are cured before they have any chance to spread.
How can I prevent squamous cell carcinoma?▾
Because UV exposure is the primary cause of SCC, the most effective prevention is daily physical block sunscreen (SPF 30 or higher), reapplied every two hours in direct sun. Regular daily sunscreen use has been shown to reduce SCC risk by approximately 40 percent. Add protective clothing, wide-brimmed hats, and UV-blocking sunglasses. Avoid the sun during peak hours (10 a.m. to 4 p.m.) when possible, and never use tanning beds. Regular full-body skin exams are also essential for early detection.
Does insurance cover SCC treatment?▾
Most medical insurance plans, including Medicare, cover the diagnosis and treatment of squamous cell carcinoma. This includes the initial biopsy and standard treatments such as excision, Mohs, topical therapies, and Superficial Radiation Therapy. Coverage details, deductibles, and copays vary by plan. Our office team is happy to help you understand your benefits and any expected out-of-pocket costs before treatment begins.

MEDICAL DERMATOLOGY | DALLAS & IRVING

Don’t Wait to Have That Suspicious Spot Checked

If you have noticed a lesion that is new, growing, rough, non-healing, or simply looks different, do not wait. Board-certified dermatologist Dr. Ellen Turner and her team provide expert diagnosis and a full range of treatment options for squamous cell carcinoma, including advanced Superficial Radiation Therapy, in Dallas and Irving.