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SQUAMOUS CELL CARCINOMA
 Squamous cell carcinoma is the second most common type of skin cancer. It appears as pink-to-red scaly growths usually on sun-exposed
surfaces such as the scalp, face, ears, hands, and arms.
It is estimated that one in five Americans will develop skin cancer during their lifetime. Approximately one million new skin cancers are diagnosed
each year in the United States. Eighty percent are basal cell carcinoma, 16% are squamous cell carcinoma and 4% are melanoma. (Statistics provided by the American Academy of Dermatology.)
Risk factors for squamous cell carcinoma include fair skin, freckles, blue eyes and blonde hair. Environmental factors such as excessive ultraviolet
light exposure from the sun or tanning booths also present a high risk.
People on immunosuppressant medications such as organ transplant patients are particularly susceptible. Other important factors increasing susceptibility to squamous cell include occupational x-ray exposure,
environmental exposure to coal or chemicals such as arsenic and scarring from trauma, diseases or burns. Finally, family history plays an important role as some individuals are more susceptible to skin cancer.
Many times squamous cell carcinoma develops from a pre-existing actinic keratosis. The risk of an actinic keratosis developing into a squamous cell
carcinoma ranges from less than 1% to 20% in a one-year period. If an actinic area does develop into a squamous cell carcinoma, the risk of the cancer spreading is between 2% and 6%.
Squamous cell carcinoma is characterized into several distinct types. These types are characterized as follows:
Bowen’s disease: This is a superficial squamous cell carcinoma. It may occur on sun-protected or sun-damaged skin. Bowen’s disease has a
unique association with arsenic exposure. However, its most common presentation is on sun damaged skin.
Erythroplasia of Queyrat: This is a distinctive form of squamous cell carcinoma occurring on the penis. It is characterized as a bright red,
non-healing plaque, most common in older uncircumcised men.
Bowenoid papulosis: This type of squamous cell carcinoma presents as multiple flesh-colored, red or brown growths on the genitals of both men and
women. There is an association with the wart virus called human papilloma virus type 16. It is often mistaken as a wart.
Invasive squamous cell carcinoma: This type of skin cancer can occur anywhere on the body. It is characterized as a nonhealing, indistinct, red,
scaling growth. This type of skin cancer typically presents on chronically sun-damaged skin. Squamous cell carcinoma is especially of concern when
present on the ears, nose, lips or external genitalia. Equally problematic are lesions presenting in a site of previous injury or chronic ulceration. The
potential for spreading is much greater when in these locations.
The cure rate for squamous cell carcinoma is approximately 95% when treated properly. The tumor should be treated by a dermatologist or plastic
surgeon. The extent and type of treatment depends on the characteristics, size and location of the tumor.
Recommendations:
Sun avoidance, protection and sunscreen are the basics of good skin care. Skin rejuvenation and health is accomplished by daily maintenance and sun protection.
The three most widely used treatments for healthy skin include antioxidants, Vitamin A preparations and exfoliating agents.
Antioxidants: Antioxidants are an emerging concept in skin health and maintenance. The sun’s ultraviolet radiation produces tissue damaging free
radicals that are absorbed and neutralized by antioxidants. The most common antioxidants are Vitamins A, C, E and beta-carotene.
Antioxidants are most effective when applied topically. Topical Vitamin C is the most widely used. In addition to its antioxidant properties, topical Vitamin C stimulates cell replication and collagen production. The result is a
thickening of the skin with a reduction in the appearance of fine lines and wrinkles.
Vitamin A: Vitamin A is available in common forms such as Retin-A® (tretinoin) or retinol. Retin-A® is prescription strength and is stronger than
over-the-counter Vitamin A derivatives. Over-the-counter retinol, though less potent, is very effective in treating sun damage. When used consistently, the
milder formulations provide effective treatment while avoiding many of the side effects such as redness, irritation and peeling that is associated with the prescription products. (See retinol)
Topical Vitamin A is also essential for skin health and maintenance. The skin has receptors that specifically absorb Vitamin A, aiding in cellular
growth and differentiation. The results are impressive, with a reduction of fine lines and wrinkles and a complexion that is smooth, supple and evenly pigmented.
Exfoliation: Skin exfoliation is achieved by mild acid application to the skin. The acids currently in use are alpha and beta hydroxy acids. (See hydroxy acids.) Hydroxy acids are readily absorbed into the deeper layers of the
epidermis. Effects include superficial exfoliation and stimulation of both the epidermis and dermis. The result is skin thickening with more uniform
pigmentation and a reduction in the appearance of fine lines and wrinkles.
What treatment regimen is right for you?
Dermatologists uniformly agree that skin health and maintenance should be addressed twice-daily using one product in the morning and another in the
evening. If a simplified regimen is tolerated, products can always be added and combined based on individual goals and preferences.
Remember, damaged skin is the result of many years of sun exposure. Expect improvement to occur gradually with a consistent daily program of skin care maintenance.
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