Squamous cell carcinoma treatment (Treatment of cutaneous squamous cell carcinoma (cSCC))
Treatment to remove a squamous cell carcinoma, a common type of skin cancer, most often by cutting it out with a margin of healthy skin.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Squamous cell carcinoma is a common skin cancer; the main treatment is removing it, most often by cutting it out with a margin of healthy skin.
- Most SCCs caught early are low risk and removing them usually cures them, but a small number can come back or spread, so follow-up matters.
- Removed tissue is checked in a laboratory; results usually take about 1–2 weeks and decide whether any more treatment is needed.
- Skin cancer should be managed by an appropriate skin cancer specialist or team; when it is first suspected you are normally referred on an urgent suspected-cancer pathway. The pathway's name and target differ across the UK — in England, the Faster Diagnosis Standard aims to confirm or rule out cancer within 28 days of referral, rather than guaranteeing a first appointment within 2 weeks.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Removes the cancer, which for most early, low-risk SCCs is curative
Curettage and cautery is not suitable for higher-risk SCCs or where a clear margin must be checked in the lab.
Keep the dressing dry and intact. Some soreness, bruising and a little oozing are normal. Rest the area, especially if it is on a leg or hand, and take...
A clear laboratory result explained to you, including whether margins were clear.
Keep the dressing dry and intact. Some soreness, bruising and a little oozing are normal. Rest the area...
Follow the wound-care advice you are given. Non-dissolvable stitches are often removed around 5–14 days depending...
The laboratory report usually comes back in about 1–2 weeks. You will be told whether the cancer was fully removed...
The scar gradually settles, fading and softening over several months. Protect it from the sun while it heals.
What is squamous cell carcinoma treatment?
A squamous cell carcinoma (SCC) is a common type of skin cancer that grows from cells in the outer layer of the skin. It is usually caused by years of sun exposure and most often appears on sun-exposed areas like the face, ears, scalp, lips, neck, backs of the hands and lower legs.
The main aim of treatment is to remove all of the cancer. The most common way to do this is a minor operation that cuts out the SCC along with a margin of normal-looking skin around and beneath it, under local anaesthetic. The removed tissue is sent to a laboratory to check the cancer has been fully removed.
Most SCCs are found early and are low risk, and removing them usually cures them. Some SCCs are higher risk because of their size, site, depth or how they look under the microscope, or because the person's immune system is suppressed. These may need wider surgery, specialist (Mohs) surgery, radiotherapy, or discussion by a skin cancer team.
This guide explains the common treatments, what to expect afterwards, and how to make sure you are looked after by an appropriate skin cancer specialist. It is not a substitute for advice from the team treating you.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Surgical excision vs Mohs surgery
| Point | Standard excision | Mohs surgery |
|---|---|---|
| Best for | Most low-risk SCCs | Higher-risk or facial SCCs |
| Margin check | After surgery, in the lab | During surgery, layer by layer |
| Healthy skin removed | A set margin | As little as possible |
| Time | Usually one short visit | Can take several hours |
Your specialist recommends the approach based on the SCC's size, site, depth and risk. Not every clinic or area offers Mohs surgery.
Preparing for your procedure
- You should normally be referred and assessed through a skin cancer service after a diagnosis or strong suspicion; ask who is responsible for your care.
- Tell the team about all your medicines, especially blood thinners (such as warfarin, clopidogrel or DOACs), and any bleeding problems.
- Tell them if your immune system is suppressed (for example after an organ transplant or with certain medicines), as this affects risk and follow-up.
- Mention any pacemaker or implanted device, as this can affect how heat (cautery) is used.
- Arrange transport if the lesion is near your eye or on a hand or foot, or if a larger repair is planned.
- Ask whether stitches will need removing, when, and whether you will need time off work.
- Ask what the wound will look like and where any scar will be before you agree.
What happens
For a standard excision, the area is cleaned and numbed with local anaesthetic injections, so you are awake but should not feel pain. The surgeon cuts out the SCC with a margin of normal skin around and beneath it, then closes the wound with stitches, a graft or a flap.
The procedure for a single, straightforward lesion often takes around 30–60 minutes. The removed tissue is sent to a laboratory, where a pathologist checks the type of cancer and whether the edges (margins) are clear.
You usually go home the same day with a dressing and aftercare advice. The team will tell you when and how you will get your results, and whether any stitches need to be removed.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Curettage and cautery is not suitable for higher-risk SCCs or where a clear margin must be checked in the lab.
- Surgery alone may not be enough for very advanced, deeply invasive or spread disease, which needs a skin cancer team.
- A lesion that has not been confirmed as SCC should be properly diagnosed first, not just removed and discarded.
- Cosmetic concerns should not drive treatment choices for a cancer; complete removal comes first.
Delay or rearrange if…
- There is active skin infection at the site that should be treated first.
- Blood-thinning medicines need to be reviewed or adjusted with the prescriber before surgery.
- The diagnosis or risk category is unclear and needs the pathology or a skin cancer team discussion first.
- You cannot get urgent help if bleeding or infection occurs after the procedure.
- You are unwell, and a short delay will not allow the cancer to progress significantly.
Alternatives to discuss
- Mohs micrographic surgery for higher-risk or facial tumours where tissue sparing matters.
- Radiotherapy where surgery is not suitable or the patient prefers it after discussion.
- Curettage and cautery for selected small, low-risk lesions.
- Discussion by a skin cancer multidisciplinary team for advanced or uncertain cases.
- For very frail patients, careful watch-and-wait may rarely be considered after specialist advice.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Removes the cancer, which for most early, low-risk SCCs is curative
- The removed tissue can be examined to confirm the cancer was fully taken out
- Confirms the exact type and risk of the cancer to guide any further care
- Can usually be done under local anaesthetic as a short outpatient procedure
- Helps prevent the cancer growing, becoming harder to treat, or spreading
Risks & complications
- A permanent scar where the cancer was removed
- Bruising, swelling and soreness around the wound
- Bleeding or oozing in the first day or two
- Tightness or a pulled appearance as the wound heals
- Wound infection needing antibiotics
- Incomplete removal, with the lab showing cancer at the edges, so more treatment is needed
- A wound that is slow to heal, especially on the lower leg
- Numbness or altered sensation near the scar
- A graft or flap that partly fails to heal
- Damage to nearby structures such as a nerve, with weakness or lasting numbness
- The cancer coming back at the same site after apparently complete removal
- Spread of the cancer to lymph nodes or elsewhere (more likely with higher-risk tumours)
The most important uncertainties are whether the cancer has been fully removed and whether it is higher risk. Larger tumours, those on the ear, lip or temple, deeper or poorly differentiated tumours, and tumours in people with a suppressed immune system carry more risk of coming back or spreading. Ask your specialist what risk category your SCC is, what the margin result means, and what follow-up you need.
Published figures to discuss
Outcomes depend heavily on the individual tumour. Most SCCs caught early are low risk and removing them is usually curative, but rates of recurrence and spread rise sharply with higher-risk features such as large size, certain sites (ear, lip, temple), depth, poor differentiation, perineural invasion and immune suppression. The figures below are cautious ranges from published cohorts and should be read as illustrative, not a personal prediction.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Spread to lymph nodes or beyond (metastasis), overall | Often quoted around 2–5% across all SCCs | Much lower for small low-risk tumours and substantially higher for high-risk tumours; your specialist can explain your category. | Incidence of metastasis from cutaneous SCC and its risk factors — PubMedpubmed.ncbi.nlm.nih.govPublished figure |
| Local recurrence after treatment | Low single figures for low-risk tumours; markedly higher for high-risk tumours | Risk is greatest in the first one to two years, which is why higher-risk SCCs are followed up. | Incidence of metastasis from cutaneous SCC and its risk factors — PubMedpubmed.ncbi.nlm.nih.govSource-linked context |
| Developing another skin cancer within 5 years | Roughly 40% after a low-risk SCC, reported as high as around 80% for higher-risk SCC in patient information | Reflects widespread sun damage; supports ongoing skin checks and sun protection. | Incidence of metastasis from cutaneous SCC and its risk factors — PubMedpubmed.ncbi.nlm.nih.govPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Recovery is usually straightforward for a small excision, but it depends a lot on the size of the wound and where it is. Wounds on the lower leg, and grafts or flaps, take longer to heal.
- Soreness, bruising and mild swelling around the wound for a few days
- A neat scar that is pink or firm at first and fades over months
- Some tightness or pulling near the wound as it heals
- Waiting a week or two for the laboratory result
- Being advised to check your own skin and protect it from the sun in future
Aftercare
- Keep the wound clean and dry as instructed, and leave the dressing in place as advised.
- Take simple pain relief such as paracetamol if you need it.
- Avoid strenuous activity, bending or lifting that pulls on the wound in the early days.
- Watch for signs of infection (increasing redness, heat, swelling, pain or discharge) and report them.
- Attend to have stitches removed if you have non-dissolvable ones.
- Protect the healing scar from the sun with clothing or sunscreen.
- Make sure you know when and how you will get your results and who to contact with questions.
- Check the rest of your skin regularly and report any new or changing lesions.
- Date and place for stitch removal noted
- Clear written wound-care instructions
- Spare dressings if you have been told to change them
- Simple pain relief at home
- A way to keep a leg or hand wound rested and raised if relevant
- Clinic or skin cancer nurse contact number saved
- A note of when your results are due
Scars and how they heal
Surgical removal of an SCC always leaves a scar, because skin has to be cut and removed. The size depends on the size of the cancer, the margin taken, and how the wound is closed. A straight excision usually leaves a thin line that fades over months; a graft or flap leaves a larger or patchwork scar. Scars on the face often settle well, but those on the lower leg, back and chest can spread or thicken. Your surgeon should show you where the scar will be and how big it is likely to be before you agree.
⚠ Get urgent help if…
- Bleeding from the wound that does not stop with firm pressure
- Increasing redness, heat, swelling, throbbing pain or discharge (signs of infection)
- A fever or feeling generally unwell after the procedure
- The wound edges coming apart, or a graft or flap turning dark
- Spreading numbness, weakness or loss of movement near the wound
- A new lump near the scar or in nearby glands (for example in the neck, armpit or groin)
- The treated area starting to grow, bleed or change again later
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good result means the laboratory confirms the SCC has been completely removed with clear margins, and the cancer does not come back. For most early, low-risk SCCs this is the usual outcome.
No treatment can guarantee the cancer will never return or that a new skin cancer will not appear elsewhere, because the same sun damage affects the surrounding skin. If the margins are not clear, or the tumour is higher risk, you may be offered further surgery, radiotherapy, or closer follow-up. Having had one skin cancer means you are at higher risk of another, so ongoing skin checks and sun protection are important.
Complete removal of a low-risk SCC is usually a lasting cure for that lesion. However, people who have had one SCC have a raised chance of developing another skin cancer in the years that follow, so long-term sun protection and self-checks matter. Higher-risk SCCs are followed up for a period because recurrence and spread, if they happen, are most likely in the first couple of years.
Related tests, treatments or support
An SCC excision may be combined with treatment of other sun-damaged skin found at the same time, such as actinic (solar) keratoses or other skin cancers. Higher-risk cases may be discussed by a skin cancer multidisciplinary team and combined with radiotherapy or, rarely, other treatments. Your specialist will explain if anything beyond removing the SCC is recommended.
Follow-up & long-term care
After surgery you will be told your laboratory result, usually within about one to two weeks, and whether the margins were clear. Stitches, if used, are removed at a set time depending on the body site. People with low-risk SCCs often need little routine follow-up, while those with higher-risk SCCs are usually reviewed regularly for a period to check for recurrence, spread and new skin cancers. You should be told who to contact if you notice a problem between appointments.
- Protect your skin from the sun with clothing, shade and high-factor sunscreen.
- Check your own skin regularly and learn what your scar normally looks like.
- Report any new, changing, bleeding or non-healing lesion promptly.
- Attend any follow-up skin checks you are offered.
- Tell any future clinician about your history of skin cancer, especially if your immune system is suppressed.
Repeat, follow-on and what comes next
- If the lab shows cancer at the margins, a second procedure (re-excision) or radiotherapy may be needed.
- Higher-risk tumours may need wider surgery, lymph node assessment or a team discussion.
- A graft or flap occasionally needs revision if part of it does not heal.
- New skin cancers may appear over time and need separate treatment.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear laboratory result explained to you, including whether margins were clear.
- Written wound-care and emergency instructions, with a named contact route.
- A defined follow-up plan matched to your tumour's risk.
- Advice on sun protection and self-examination of your skin.
- Onward referral or team discussion arranged promptly for higher-risk disease.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether you have already been diagnosed or still need a biopsy and pathology
- The type of treatment (simple excision, curettage and cautery, Mohs surgery or radiotherapy)
- The size and site of the cancer and how the wound is closed (direct stitching, graft or flap)
- The surgeon's or operator's fee and the facility or theatre fee
- Laboratory (pathology) reporting of the removed tissue
- Follow-up appointments and any skin cancer team discussion
- Treatment of any further sun-damaged areas found at the same time
- The specialist's fee and the facility fee
- Pathology (laboratory) fees for examining the removed tissue
- What happens, and what it costs, if the margins are not clear and more surgery is needed
- Whether wound closure (graft or flap) and dressings are included
- Follow-up appointments and skin checks
- What happens if a complication such as infection or bleeding occurs
- Whether and how your care links back to NHS records and your GP
On the NHS? Skin cancer, including squamous cell carcinoma, is normally diagnosed and treated on the NHS. When it is first suspected you are usually referred on an urgent suspected-cancer pathway, whose name and target differ across the UK (in England, the Faster Diagnosis Standard aims to confirm or rule out cancer within 28 days of referral, rather than guaranteeing a first appointment within 2 weeks). Private care is used mainly for speed, choice of specialist or convenience.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being told your tumour's risk category or what the margin result means.
- Having a lesion removed by scrape-and-burn when a clear margin should have been checked in the lab.
- No clear plan for follow-up, despite higher-risk features.
- Underplaying the scar size, especially for grafts, flaps or lower-leg wounds.
- Not being told who sees the result, or who to contact if there is a problem.
Marketing red flags
- Claims of 'scarless' skin cancer removal.
- Treating a suspected skin cancer without a proper diagnosis or pathology.
- Promising a guaranteed cure with no mention of recurrence or follow-up.
- Pushing cosmetic add-ons during cancer treatment.
- No link back to NHS records, your GP or a skin cancer team for higher-risk disease.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What risk category is my SCC, and why?
- What does my margin (the edge of what was removed) result mean?
- Will this be standard excision, Mohs surgery, or another treatment, and why?
- Where will my scar be and how big is it likely to be?
- Do I need follow-up, how often, and for how long?
- What signs should make me contact you urgently, and who do I call?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is squamous cell carcinoma treated on the NHS?
Will removing it cure the cancer?
Will I have a scar?
How long until I get my results?
What if the cancer was not fully removed?
Can squamous cell carcinoma come back?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Non-melanoma skin cancer British Association of Dermatologists — Squamous cell carcinoma (patient leaflet) Non-melanoma skin cancer: UK National Multidisciplinary Guidelines — PMC Guidelines of care for the management of cutaneous squamous cell carcinoma — PMC Recurrent and metastatic cutaneous SCC: cohort of 774 patients — PMC Incidence of metastasis from cutaneous SCC and its risk factors — PubMed NHS England — Cancer waiting times monitoring dataset guidance
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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