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Treating Squamous Cell Carcinoma of the Skin
If you’ve been diagnosed with squamous cell carcinoma (SCC) of the skin, also known as squamous cell skin cancer, your treatment team will discuss your options with you. It’s important to weigh the benefits of each treatment option against the possible risks and side effects.
On this page
- Who treats squamous cell skin cancer?
- Types of treatment for squamous cell skin cancer
- Treating actinic keratosis
- Treating Bowen disease
- Common treatment approaches for squamous cell carcinoma of the skin
- Making treatment decisions
- Help getting through cancer treatment
- Choosing to stop treatment or choosing no treatment at all
Who treats squamous cell skin cancer?
You might have different types of doctors on your treatment team.
Most squamous cell skin cancers, as well as precancers, are treated by dermatologists, doctors who specialize in treating skin diseases.
In some situations, such as if your cancer is more advanced, you might be treated by other types of doctors as well, such as:
- A surgical oncologist, general surgeon, or plastic surgeon, who treats cancer with surgery
- A radiation oncologist, who treats cancer with radiation therapy
- A medical oncologist, who treats cancer with medicines such as targeted drugs, immunotherapy, or chemotherapy
You might have many other specialists on your treatment team as well, including physician assistants (PAs), nurse practitioners (NPs), nurses, pharmacists, nutrition specialists, social workers, and other health professionals.
Types of treatment for squamous cell skin cancer
Based on the stage and location of the cancer and other factors, your treatment options might include:
Surgery, radiation therapy, or other local treatments can also be used to treat actinic keratoses, which are skin precancers, and Bowen disease (squamous cell carcinoma in situ), a very early form of SCC.
Treating actinic keratosis
Actinic keratosis (AK) is a skin precancer. It is often treated because it might turn into squamous cell skin cancer. But because this risk is low, treatments are generally aimed at avoiding scars or other disfiguring marks as much as possible.
Treatment options for AK depend on several factors, including:
- The number and location of the tumors
- A person’s preferences
- Which treatments are available
If there is only one AK or just a few, the most common treatment options include:
- Cryotherapy (cryosurgery) – destroying the tumor(s) with extreme cold
- Minor surgery, such as curettage and electrodesiccation or shave excision
- Other local treatments such as laser therapy or photodynamic therapy (PDT)
If there are several AKs in the same area of sun-damaged skin, treatments are typically aimed at the whole area. These are known as field-directed therapies. Options might include:
- Topical creams, gels, or ointments such as fluorouracil (5-FU), 5-FU plus calcipotriene, imiquimod, tirbanibulin, or diclofenac
- Skin resurfacing, either with a laser or dermabrasion
- Chemical peeling
- Cryotherapy
- Curettage and electrodesiccation
- Photodynamic therapy (PDT)
Close observation of AKs instead of treatment might be an option in some situations, especially if:
- The side effects of treating the AK(s) would likely outweigh the potential benefits
- A person has a limited life expectancy
If you have AKs and they’re not treated, it’s important that you and your doctor check them regularly for changes that might be signs of skin cancer.
Treating Bowen disease
Bowen disease, also known as squamous cell carcinoma in situ, is a very early form of squamous cell carcinoma in which the cancer cells are still only in the top layers of the skin.
Bowen disease is most often treated by surgery with a standard excision, cutting out the tumor and a small margin of normal skin around it. Mohs surgery might be an option as well, especially for larger tumors or those where the borders aren’t clear.
Depending on the size and location of the tumor, other treatment options might include:
- Curettage and electrodesiccation
- Photodynamic therapy (PDT)
- Cryosurgery
- Topical chemotherapy, such as fluorouracil (5-FU)
- Imiquimod or other topical therapies, in some situations
Common treatment approaches for squamous cell carcinoma of the skin
Treatment options for SCC of the skin depend on the risk that the cancer might come back after treatment or spread to another part of the body. This is based on factors such as:
- The size and location of the tumor
- How the cancer cells look under a microscope
- Whether a person has a weakened immune system
Surgery is the most common treatment for low-risk squamous cell skin cancer. Options might include:
- Curettage and electrodesiccation or shave excision for small, well-defined tumors
- Standard excision (wide excision)
- Mohs surgery or similar techniques, in certain circumstances
Other treatment options might include:
- Radiation therapy, if a person can’t have or doesn’t want surgery
- Local treatments to destroy the cancer such as cryotherapy, for small, well-defined tumors
- Topical medicines, if the cancer is part of a larger area of sun-damaged skin
These cancers have at least one feature that puts them at higher risk of returning after treatment or of spreading to other parts of the body.
Because these cancers can be harder to treat, often a team of different types of doctors gets together to determine the best treatment options. Sometimes tests might be needed to see whether the cancer has spread before treatment, such as an MRI or CT scan, or a sentinel lymph node biopsy (SLNB).
Initial treatment
Surgery is usually the main treatment, if it can be done. Surgery options for higher-risk tumors might include:
- Standard excision (wide excision)
- Mohs surgery or similar techniques, especially for very high-risk SCCs
If the first surgery didn’t remove all the cancer, it is said to have positive surgical margins. In this case, a second surgery, either wide excision or Mohs surgery, might be done.
Radiation therapy might be an option for people who can’t have or don’t want surgery, or if it’s not clear that surgery can remove all of the cancer.
If it’s not clear that surgery can remove all of the cancer or if it’s likely to result in serious side effects, another option might be to give neoadjuvant therapy first with the immunotherapy drug cemiplimab (Libtayo). This might shrink the cancer and allow a less extensive surgery to be done.
Adjuvant (additional) treatment might be given after surgery if there’s a very high risk of the cancer coming back or spreading. For example, radiation therapy might be given if:
- The surgical margins were positive, meaning that not all of the cancer was removed
- The cancer has invaded nearby small nerves
- There are other reasons there’s a higher risk that the cancer might come back
For some people at high risk of the cancer coming back who’ve had surgery and radiation therapy, adjuvant treatment with the immunotherapy drug cemiplimab (Libtayo) can help lower the chances of the cancer recurring.
If SCC spreads, it most often goes to nearby lymph nodes first. Sometimes, the cancer can form separate tumors in the skin between the main tumor and the lymph nodes. This type of spread is called satellitosis or in-transit metastasis.
SCC that has spread can be harder to treat, so usually a team of different types of doctors gets together to determine the best treatment options. Sometimes further tests might be needed to determine the extent of cancer spread before treatment.
Treatment options
Treatment options depend on how far and where the cancer has spread, and whether the doctors feel it can be removed safely.
If possible, surgery such as Mohs surgery or a wide excision might be recommended to try to remove the cancer. Radiation therapy might be another option, especially if surgery can’t be done for some reason or if it’s likely to result in unacceptable side effects.
As with other higher-risk SCCs, adjuvant treatment such as radiation or immunotherapy might be recommended after surgery. In some situations, immunotherapy might be considered before surgery, to try to shrink the cancer so a less extensive surgery can be done. This is known as neoadjuvant treatment.
Other treatments might also be used for SCC that has spread beyond the skin, depending on where it has spread.
Lymph node dissection or radiation therapy: Removing regional (nearby) lymph nodes might be recommended for some SCCs that are very large or have grown deeply into the skin, as well as if the lymph nodes feel enlarged or hard. The removed lymph nodes are looked at under a microscope to see whether they contain cancer cells.
Sometimes, radiation therapy might be recommended, either instead of or in addition to lymph node surgery.
Immunotherapy: For advanced SCCs that can’t be cured with surgery or radiation therapy, an immunotherapy drug such as cemiplimab (Libtayo), pembrolizumab (Keytruda), or cosibelimab (Unloxcyt) might be an option.
The benefits of these drugs aren’t as clear in people with weakened immune systems, such as people who take medicines for autoimmune diseases or who have had an organ transplant, so the balance between the risks and benefits needs to be considered carefully.
Systemic chemotherapy and targeted therapy: Although immunotherapy is usually the preferred drug treatment, chemotherapy and targeted therapy drugs might be other options if immunotherapy can’t be given or if it stops working. These types of treatment might be combined or used separately.
Making treatment decisions
It’s important to discuss all your treatment options, including their goals and possible side effects, with your treatment team so you can make the decision that best fits your needs.
Take your time and think about all your options. Ask questions if you are unsure about anything.
Questions to ask before squamous cell carcinoma treatment
Understanding your diagnosis and choosing a treatment plan
- What are my treatment choices?
- Which do you recommend and why?
- How much experience do you have treating squamous cell carcinoma?
- Will I be OK if the cancer is just removed with no other treatment?
- What will treatment be like? Where will it be done?
- Will I have a scar after treatment? How big will it be?
- Does one type of treatment lessen the chance of cancer coming back more than another?
- How quickly do we need to decide on treatment?
- Should I get a second opinion? Can you recommend someone?
What to expect during treatment
- What should I do to be ready for treatment?
- How long will treatment last?
- What will it be like? Where will it be done?
- How might treatment affect my daily activities? Can I still work?
- Are there any limits on what I can do?
- How will we know if the treatment is working?
- What are the chances the cancer will come back? What would we do if this happens?
Side effects and long-term effects
- What are the risks or side effects of treatment?
- Can I do anything to manage or reduce these side effects?
- What symptoms or side effects should I tell you about right away?
- How can I reach you or someone on your team on nights, holidays, or weekends?
Support and resources
- What if I need help with transportation to and from treatment?
- Is there someone I can talk to if I feel overwhelmed, depressed, or distressed?
- Who can I talk to if I’m concerned about the costs and insurance coverage for my treatment?
Other things to consider
Seeking a second opinion: If time allows, consider getting a second opinion. This can give you more information and help you feel more confident about the treatment plan you choose.
Clinical trials: Clinical trials study new treatments and might offer access to promising options not widely available. They are also how doctors learn better ways to treat cancer. Ask your doctor about clinical trials you might qualify for.
Integrative (holistic) and alternative methods: You might hear about herbs, diets, acupuncture, massage, or other ways to relieve your symptoms or treat your cancer. Integrative therapies are used with standard care, whereas alternative ones are used instead of standard treatments. Some of these might help with symptoms, but many aren’t proven to work and could even be harmful. Talk with your care team first to make sure they’re safe and won’t interfere with treatment.
Help getting through cancer treatment
People with cancer need support and information. Knowing all your options and finding the resources you need will help you make informed decisions about your care.
Whether you’re thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. It’s important to communicate with your cancer care team so you understand your diagnosis, the recommended treatment, and ways to maintain or improve your quality of life.
Different types of programs and support services might be helpful, and they can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.
The American Cancer Society also has programs and services to help you get through treatment, including rides to treatment, lodging, and more. Contact the ACS cancer helpline for more information.
Choosing to stop treatment or choosing no treatment at all
It is rare for squamous cell skin cancer to spread to the point where it can’t be removed, but it can happen. If treatments have been tried and are no longer controlling your cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life.
Choosing not to treat your cancer
Some people might not want to be treated at all, especially if the cancer is advanced and the benefits of treatment aren’t likely to outweigh the risks. There are many reasons you might decide not to get treatment, but it’s important to talk to your cancer care team as you make that decision. Remember that even if you choose not to treat your cancer, you can still get supportive care to help with pain or other symptoms.
Hospice care
People with advanced cancer who are expected to live less than 6 months might want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people near the end of life.
You and your family are encouraged to talk with your cancer care team about hospice care options, which include hospice care at home, a special hospice center, or other healthcare locations.
Nursing care and special equipment can make staying at home a workable option for many families.
The treatment information given here is not official policy of the American Cancer Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor. Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don’t hesitate to ask your cancer care team any questions you may have about your treatment options.
- Written by
- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Aasi SZ, Hong AM. Treatment and prognosis of low-risk cutaneous squamous cell carcinoma (cSCC). UpToDate. 2026. Accessed at https://www.uptodate.com/contents/treatment-and-prognosis-of-low-risk-cutaneous-squamous-cell-carcinoma-cscc on June 17, 2026.
Berman B. Treatment of actinic keratosis. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/treatment-of-actinic-keratosis on June 17, 2026.
DeSimone JA, Hong AM, Ruiz ES, Jambusaria-Pahlajani A. Recognition and management of high-risk (aggressive) cutaneous squamous cell carcinoma. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/recognition-and-management-of-high-risk-aggressive-cutaneous-squamous-cell-carcinoma on June 12, 2026.
Eisen DB, Asgari MM, Bennett DD, et al. Guidelines of care for the management of actinic keratosis. J Am Acad Dermatol. 2021;85(4):e209-e233.
Hanna GJ, Dharanesswaran H, Giobbie-Hurder A, et al. Cemiplimab for Kidney Transplant Recipients With Advanced Cutaneous Squamous Cell Carcinoma. J Clin Oncol. 2024;42(9):1021-1030.
Martins RG. Systemic treatment of advanced basal cell and cutaneous squamous cell carcinomas. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/systemic-treatment-of-advanced-basal-cell-and-cutaneous-squamous-cell-carcinomas on June 17, 2026.
National Cancer Institute. Skin Cancer Treatment (PDQ®)–Health Professional Version. 2025. Accessed at https://www.cancer.gov/types/skin/hp/skin-treatment-pdq on June 17, 2026.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Squamous Cell Skin Cancer. Version 2.2026. Accessed at https://www.nccn.org on June 17, 2026.
Warrier G, Gupta A, Sedhom R. How Can Palliative Care Help Me? JAMA Intern Med. 2023;183(11):1284.
Wysong A. Squamous-cell carcinoma of the skin. N Engl J Med. 2023;388:2262-2273.
Xu YG, Aylward JL, Swanson AM, et al. Chapter 67: Nonmelanoma Skin Cancers. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.
Last Revised: August 27, 2026
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
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