What Does Squamous Cell Carcinoma Look Like?

Squamous cell carcinoma (SCC), also known as squamous cell cancer, is the second most common type of skin cancer following basal cell carcinoma. About 1 million cases are diagnosed each year in the United States. It begins in the squamous skin cells located in the top layer of skin called the epidermis. The DNA in squamous cells can become damaged from ultraviolet (UV) rays from the sun or tanning beds. When this occurs, they begin to grow at an out-of-control rate, leading to skin cancer

Fortunately, when caught early, most cases of squamous cell carcinoma are curable. Knowing the early warning signs is critical to receiving an early diagnosis and treatment. 

Unprotected exposure to UV rays is a major risk factor for squamous cell carcinoma. The more time you spend in the sun (or a tanning bed), the more likely you are to develop SCC. About 90% of non-melanoma skin cancers (including SCC) are related to exposure to UV rays. Other risk factors of SCC include light skin, age (over 50), male sex, immunosuppression, human papillomavirus, chronic scarring conditions, family history, and toxic exposures.

Where Squamous Cell Carcinoma Occurs

SCC can be found anywhere on the body, but is most commonly seen in sun-exposed areas. Common SCC sites include the face, ears, lips, scalp, shoulders, neck, hands, and forearms. It’s also possible to be diagnosed with SCC in areas without sun exposure, such as inside the mouth, under fingernails or toenails, on the genitals, or in the anus. 

Precancerous Stage

The earlier SCC is caught and treated, the higher the likelihood that it will be cured. While it’s important to be able to recognize the signs of cancer, it’s also essential to be able to identify the signs and symptoms of precancer.

As areas of our skin are damaged by the sun, their shape and color begin to change. Knowing what these changes look like can help you seek treatment from your dermatologist early. It’s possible to treat and remove precancerous growths before they ever turn into skin cancer.

Early Signs of Sun Damage 

Liver spots, or age spots, on an elderly woman's skin.


CRISTINA PEDRAZZINI/SCIENCE PHOTO LIBRARY / Getty Images

Age spots, discolored skin, and deep wrinkles are all signs of damage to the skin caused by the sun’s UV rays. These symptoms can also be related to tanning bed use. A loss of skin firmness and elasticity is another sign of sun damage. Changes to the skin can later turn into precancerous growths. 

Precancerous Lesions

Actinic keratosis

Robert Kirk / Getty Images

Precancerous lesions are changes to the skin that result from sun damage. It’s estimated that 40% to 60% of all SCC cases first begin as precancers.  

The most common form of SCC precancer is actinic keratosis, also called solar keratosis. These growths form mainly because of exposure to UV rays (photo cancerization), and once you develop one, you are at high risk of developing more. Estimates of the 10-year rate of malignant transformation of actinic keratosis (the likelihood that they'll become cancerous) range from 6% to 10%, with approximately 60% of squamous cell carcinomas arising from actinic keratosis.

An actinic keratosis looks like a small, rough patch of skin. It may be scaly and crusty as well. Possible colors of these lesions include reddish or brownish hues. Some of these growths can also be invisible to the naked eye. Actinic keratoses are often easier to feel than to see. They most often appear on sun-exposed areas like the face, ears, lips, scalp, shoulders, neck, and hands. 

Other types of SCC precancerous lesions include:

  • Actinic cheilitis: A precancerous growth usually affecting the lower lip. It appears as a patch of dry, scaly skin that is pale or white.
  • Leukoplakias: White patches found inside the mouth. They usually affect the tongue, lips, gums, and cheeks. They may be caused by sun damage or chronic irritation from tobacco or alcohol.
  • Bowen’s disease: Also known as squamous cell carcinoma in situ, this is an early, noninvasive phase of SCC. The affected patch of skin resembles eczema, and is often scaly and red. It is usually caused by sun damage or exposure to chemicals. 

Scaly Red Patches

keratinizing squamous cell carcinoma of the skin - stock photo


sdigital

SCC can first appear as a thick, rough patch of skin. It is often red and scaly. While it is usually painless, it may ooze or bleed. The scaly patch of skin, also known as hyperkeratosis, will have irregular borders and may be itchy. 

This feature can help differentiate between squamous cell carcinoma and basal cell carcinoma, the most common form of skin cancer. Basal cell carcinoma most commonly appears as a pearly white, dome-shaped papule (bump) with prominent telangiectatic surface vessels (meaning you can see tiny dilated blood vessels), while squamous cell carcinoma most commonly appears as a firm, smooth, or thickened papule or plaque, often with a break on the skin in the middle. 

The color of an SCC lesion can vary greatly from person to person. They are most commonly red or pink, but may also appear brown, black, white, or yellow. SCC lesions in the mouth often appear as white patches while lesions beneath the nails look brown or black.

Open Sores

SCC lesions can develop in open sores or scars that you already have. They can also progress to resemble an open sore on their own. The sore may bleed and ooze, then crust over. If you notice a sore that never seems to heal, it’s time to get it checked out. You may also notice that the lesion appears to get better, but then quickly returns. This is another sign that it’s time to see the dermatologist. 

Elevated Growths

keratinizing squamous cell carcinoma of the skin - stock photo


sdigital

As SCC lesions progress, they may appear elevated, especially around the edges. While the edges are raised, the center of the sore looks sunken or depressed. The elevated growth is usually pink or red, but can also be flesh-colored. At this point in the disease, the lesion can start to spread more quickly.

Wart-Like Nodule

Medical portrait of Invasive Skin Cancer on left arm of a patient.


DouglasOlivares

Finally, an SCC lesion can start to resemble a wart with raised edges. The area may bleed and crust over, but never heal. The lesion usually appears as a single wart and may grow in size. Advanced cases of SCC can appear as a small horn-shaped growth that turns brown.

In most cases of SCC, the lesion is painless. However, some individuals experience pain or soreness at the site. Others notice itching or a "pins and needles" feeling on the cancerous growth. Numbness is also possible.

A Word From Verywell

The earlier squamous cell carcinoma is diagnosed and treated, the better the outcome. Perform monthly skin self-checks to look for new skin growths, warts, or sores that don’t heal. While most cases of SCC are curable, this cancer can become disfiguring and even lead to death when left untreated. If you have any new skin growths that you’re concerned about, see your doctor right away.

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Article Sources
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  1. Skin Cancer Foundation. Squamous Cell Carcinoma Warning Signs. Updated January 2021.

  2. Kim Y, He YY. Ultraviolet radiation-induced non-melanoma skin cancer: Regulation of DNA damage repair and inflammation. Genes Dis. 2014 Dec 1;1(2):188-198. doi: 10.1016/j.gendis.2014.08.005

  3. Que SKT, Zwald FO, Schmults CD. Cutaneous squamous cell carcinoma: Incidence, risk factors, diagnosis, and staging. J Am Acad Dermatol. 2018 Feb;78(2):237-247. doi: 10.1016/j.jaad.2017.08.059

  4. American Academy of Dermatology Association. Skin cancer types: Squamous cell carcinoma symptoms.

  5. Firnhaber JM. Diagnosis and treatment of Basal cell and squamous cell carcinoma. Am Fam Physician. 2012 Jul 15;86(2):161-8.

  6. Filosa A, Filosa G. Actinic keratosis and squamous cell carcinoma: clinical and pathological features. G Ital Dermatol Venereol. 2015 Aug;150(4):379-84.

  7. Skin Cancer Foundation. Actinic Keratosis Overview. Updated January 2021.

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