Warts

Warts

Warts are benign (not cancerous) skin growths that appear when a virus infects the top layer of the skin. Viruses that cause warts are called human papillomavirus (HPV). You are more likely to get one of these viruses if you cut or damage your skin in some way.

Wart viruses are contagious. Warts can spread by contact with the wart or something that touched the wart.

Warts can grow on any part of your body.

Warts are often skin-colored and feel rough, but they can be dark (brown or gray-black), flat, and smooth. 

Warts: Signs and symptoms

There are a few different types of warts. The type is determined by where it grows on the body and what it looks like. The following describes the signs (what a person sees) and symptoms (what a person feels) for some of the different types of warts.

Common warts

(also called vurruca vulgaris)

If you see a wart on your child's face, check your child's hands for warts. The virus that causes warts can spread from the hands to the face through touch or nail biting. 

  • Common warts have these traits:
  • Grow most often on the fingers, around the nails, and on the backs of the hands.
  • Are more common where skin was broken, such as from biting fingernails or picking at hangnails.
  • Can have black dots that look like seeds (often called "seed" warts).
  • Most often feel like rough bumps. 

Foot warts 

also called plantar warts

Plantar warts have these traits:

  • Grow most often on the soles (plantar surface) of the feet.
  • Can grow in clusters (mosaic warts).
  • Often are flat or grow inward (walking creates pressure, which causes the warts to grow inward).
  • Can hurt, feels like you have pebbles in your shoe.
  • Can have black dots.

Flat warts

Flat warts have these traits:

  • Can occur anywhere. Children usually get them on the face. Men get these most often in the beard area, and women tend to get them on their legs.
  • Are smaller and smoother than other warts.
  • Tend to grow in large numbers — 20 to 100 at a time.

Filiform warts

Filiform warts have these traits:

  • Looks like long threads or thin fingers that stick out.
  • Often grows on the face: around the mouth, eyes, and nose.
  • Often grow quickly.

HIV weakens the immune system, so the body often cannot fight the virus that causes the warts.

Warts: Who gets and causes

Who gets warts?

Anyone can get warts. Some people are more prone to getting a wart virus (HPV) than others. These people are:

  • Children and teens.
  • People who bite their nails or pick at hangnails.
  • People with a weakened immune system (the body’s defense system).

In children, warts often go away without treatment. A dermatologist should treat warts that hurt, bother the child, or quickly multiply.

What causes warts?

Viruses called human papillomavirus (HPV) cause warts. It is easier to catch a virus that causes warts when you have a cut or scrape on your skin. This explains why so many children get warts. Warts also are more common on parts of the body that people shave such as the beard area in men and the legs in women. You can spread warts from one place on your body to another.

Warts can spread from person to person. You can get warts from touching a wart on someone’s body. Some people get a wart after touching something that another person’s wart touched, such as a towel. It often takes a few months for warts to grow large enough to see.

Warts: Tips for managing

Warts can often be treated at home. The following explains when you can safely treat warts at home and when you should see a dermatologist.

Self-treatment

You can get some wart remedies without a prescription and treat the warts yourself. This may be enough to get rid of the warts. The only problem with self-treatment is that you might mistake another kind of skin growth for a wart. Some skin cancers look like warts.

You should see a dermatologist when you have:

  • A suspicion that the growth is not a wart.
  • A wart on your face or genitals.
  • Many warts.
  • Warts that hurt, itch, burn, or bleed.
  • A weakened immune system.
  • Diabetes. Never try to remove any wart on your foot if you have diabetes. If you cut or burn your skin, it could cause lasting damage to the nerves in your feet.

At-home remedies

You can use the following at home: 

  • Salicylic acid: You can treat warts at home by applying salicylic acid. This medicine is available without a prescription. It comes in different forms — a gel, liquid, or plaster (pad). You should apply salicylic acid to the wart every day. Before applying the salicylic acid, be sure to soak the wart in warm water. 
  • Salicylic acid is rarely painful. If the wart or the skin around the wart starts to feel sore, you should stop treatment for a short time. It can take many weeks of treatment to have good results — even when you do not stop treatment.
  • Other home remedies: Some home remedies are harmless, such as covering warts with duct tape. Changing the tape every few days might peel away layers of the wart. Studies conflict, though, on whether duct tape really gets rid of warts.
  • Many people think certain folk remedies and hypnosis get rid of warts. Since warts may go away without treatment, it's hard to know whether a folk remedy worked or the warts just went away.

Ask your dermatologist if you are unsure about the best way to treat a wart.

Prevention

To prevent warts from spreading, dermatologists recommend the following:

  • Do not pick or scratch at warts.
  • Wear flip-flops or pool shoes in public showers, locker rooms, and pool areas.
  • Do not touch someone’s wart.
  • Keep foot warts dry, as moisture tends to allow warts to spread.

Vitiligo

Vitiligo

Vitiligo (vit-uh-lie-go) causes the skin to lose color. Patches of lighter skin appear. Some people develop a few patches. Others lose much more skin color.

Vitiligo usually affects the skin, but it can develop anywhere we have pigment. Patches of hair can turn white. Some people lose color inside their mouths. Even an eye can lose some of its color.

People of all races and ethnicities get vitiligo.

Vitiligo is not contagious. It is not life-threatening. But, vitiligo can be life-altering. Some people develop low self-esteem, no longer want to hang out with friends or develop serious depression. Most people have vitiligo for life, so it’s important to develop coping strategies.

A coping strategy that helps many people is to learn about vitiligo. Another helpful strategy is to connect with others who have vitiligo.

Vitiligo: Signs and symptoms

Vitiligo causes loss of color. Your dermatologist may call this “loss of pigment” or “depigmentation.” We can lose pigment anywhere on our bodies, including our: 

  • Skin.
  • Hair (scalp, eyebrow, eyelash, beard).
  • Inside the mouth.
  • Genitals.

 Most people who get vitiligo lose color on their skin. The affected skin can lighten or turn completely white. Many people do not have any other signs or symptoms; they feel healthy.

A few people say that the skin affected by vitiligo itches or feels painful.

Vitiligo has types and subtypes

If you are diagnosed with vitiligo, your dermatologist may tell you what type and subtype you have.

Subtypes: The subtype tells you how much vitiligo appears on the body. The vitiligo subtypes are:

Localized: One or a few spots or patches appear, but these are limited to one or a few areas of the body.

Generalized: Most people develop this subtype, which causes scattered patches on the body.

Universal: Most pigment is gone. This is rare.

There is no way to predict how much color a person will lose. Color loss can remain unchanged for years. Some people see patches enlarge and new patches appear. On a rare occasion, the skin regains its lost color.

Vitiligo: Who gets and causes

Who gets vitiligo?

Millions of people worldwide have vitiligo. Nearly half get it before they reach 21 years of age. Most will have vitiligo for the rest of their lives. It is very rare for vitiligo to disappear.

Vitiligo occurs about equally in people of all skin colors and races. About half the people who get vitiligo are male and half are female.

The risk of getting vitiligo increases if a person has:

  • A close blood relative who has vitiligo.
  • An autoimmune disease, especially Hashimoto’s disease (a thyroid disease) or alopecia areata (causes hair loss).

What causes vitiligo?

Vitiligo develops when cells called melanocytes (meh-lan-o-sites) die. These cells give our skin and hair color.

Scientists do not completely understand why these cells die. One type of vitiligo, non-segmental vitiligo, may be an autoimmune disease. An autoimmune disease develops when the body mistakes a part of itself as foreign. If the body mistakes these cells as foreigners, it will attack and kill these cells.

Studies suggest that the other type of vitiligo, segmental vitiligo, has a different cause. This type seems to develop when something in the body’s nervous system goes awry.

Vitiligo: Diagnosis, treatment, and outcome

How do dermatologists diagnose vitiligo?

If your dermatologist suspects that you have vitiligo, your dermatologist will:

  • Review your medical history, and may ask specific questions such as whether anyone in your family has vitiligo.
  • Perform a physical exam, looking carefully at the affected skin.

You also may need a blood test to check the health of your thyroid gland. People who have vitiligo often have an autoimmune thyroid disease. A blood test will tell whether your thyroid is healthy. If you have thyroid disease, treatment can successfully control it.

How do dermatologists treat vitiligo?

If you have vitiligo, you should discuss treatment options with your dermatologist. There are many treatment options. The goal of most treatments is to restore lost skin color.

Vitiligo cannot be cured, but many treatments help to restore lost skin color.

Here are some key facts about treatment options to help you start a conversation with your dermatologist. The type of treatment that is best for you will depend on your preference, overall health, age and where the vitiligo appears on your body. Some people choose not to treat vitiligo. 

1. No medical treatment (use cosmetics to add lost color):

 Cosmetic options include makeup, a self-tanner and skin dye.

  • Offers safe way to make vitiligo less noticeable.
  • Often recommended for children because it avoids possible side effects from medicine.
  • Drawbacks: Must be repeatedly applied, can be time-consuming, takes practice to get natural-looking result. 

2. Medicine applied to the skin:

 Several different topical (applied to the skin) medicines can repigment the skin.

  • Prescribed for small areas.
  • The most commonly prescribed medicine is a potent or super-potent topical corticosteroid. About half, 45 percent, of patients regain at least some skin color after 4 to 6 months.
  • A topical corticosteroid may be combined with another medicine to improve results.
  • Topical medicine works best in people with darkly pigmented skin.
  • Topical medicines are most effective on certain areas of the body, such as the face. They are least effective on the hands and feet.
  • Not all topical medicines should be used on the face.
  • Drawbacks: These medicines have possible side effects, so patients must be carefully monitored. A possible serious side effect of using of a topical corticosteroid for a year or longer is skin atrophy. This means the skin becomes paper thin, very dry and fragile. 

3. Light treatment:

 Uses light to repigment the skin.

  • Patient may sit in a light box or receive excimer laser treatments.
  • Light box used to treat widespread vitiligo; laser used to treat small area.
  • Works best on the face; least effective on hands and feet.
  • Effective for many patients; about 70 percent see results with excimer laser.
  • Results can disappear. About half, 44 percent, see results disappear within 1 year of stopping treatment. After 4 years, about 86 percent lose some color restored by treatment.
  • May cause patients with darkly pigmented skin to see areas of darker skin after treatment, but treated skin usually matches untreated skin within a few months.
  • Requires a time commitment. Patients need 2 to 3 treatments per week for several weeks.
  • May be combined with another treatment such as topical corticosteroid. 

4. PUVA light therapy:

  • Uses UVA light and a medicine called psoralen to restore skin color.
  • Psoralen may be applied to the skin or taken as a pill.
  • Can treat widespread vitiligo.
  • About 50 percent to 75 percent effective in restoring pigment to the face, trunk, upper arms and upper legs.
  • Not very effective for the hands or feet.
  • Time-consuming, requiring treatment at a hospital or PUVA center twice a week for about 1 year.
  • Psoralen can affect the eyes, so this treatment requires eye exams before starting treatment and after finishing treatment.
  • To help prevent serious side effects, patients need to be carefully monitored.

5. Surgery:

  • May be an option when light therapy and medicines applied to the skin do not work.
  • For adults whose vitiligo has been stable (not changed) for at least 6 months.
  • Not for children.
  • Not for people who scar easily or develop keloids (scars that rise above the skin).
  • Different surgical procedures available. Most involve removing unaffected skin or skin cells and placing where need pigment.
  • Can be effective for 90 percent to 95 percent of patients.
  • Possible side effects include failure to work, cobblestone-like skin and infection.

6. Unconventional treatment:

  • Some vitamins, minerals, amino acids and enzymes have been reported to restore skin color in people who have vitiligo.
  • Most have not been studied, so there is no evidence to support these treatments and no knowledge of possible side effects.
  • Ginkgo biloba, an herb, has been studied in a clinical trial. Results from this trial indicate that the herb may restore skin color and stop vitiligo from worsening.
  • In the ginkgo biloba trial, 10 patients given ginkgo biloba had noticeable or complete return of skin color. Two patients taking the placebo (contains no active ingredient) also had noticeable or complete return of skin color.
  • Because some patients taking the placebo regained their skin color, more study is needed.

If you have treatment to restore lost skin color, it’s possible that the color will return slowly or incompletely. Sometimes, a treatment does not work.

7. Depigmentation:

  • This treatment removes the remaining pigment from the skin.
  • Very few patients opt for this treatment.
  • Removing the rest of the pigment leaves a person with completely white skin.
  • It may be an option for an adult who has little pigment left and other treatment has not worked. Removing the remaining pigment can be an effective way to get one skin color.
  • To remove the remaining color requires you to apply a cream once or twice day. This cream gradually removes color from the skin.
  • Depigmentation can take 1 to 4 years.
  • Once treatment is finished, some people see spots of pigment on their skin from being out in the sun. To get rid of these spots, you can use the cream that removed your remaining skin color.

Outcome

It is not possible to predict how a patient will respond to treatment. It is important to keep in mind that no one treatment works for everyone. Results can vary from one part of the body to another. Combining two or more treatments often gives the best results.

Treatment Q&A

Q: Can a child with vitiligo be treated?

A: Yes, but some treatments are not appropriate for children. The following may be an option for a child:

Medicine applied to the skin.

PUVA that uses psoralen applied to the skin. PUVA therapy that uses the psoralen pill is usually not recommended until after 12 years of age. Even then, the risk and benefits of this treatment must be carefully weighed.

For children with extensive vitiligo, a dermatologist may recommend narrowband UVB light treatments.

Q: Are researchers looking for more effective treatment?

Yes. They are studying the genes involved in vitiligo. Researchers believe that by identifying all of the genes involved in vitiligo, they will learn what destroys the cells that give skin its color. With this knowledge, it should be possible to develop better treatments. One of the key goals of this research is to develop a treatment that will permanently stop the skin 

Vitiligo: Tips for managing

Dermatologists share the following tips with their patients who have vitiligo.

Protect your skin from the sun

  • Everyone who has vitiligo can benefit from sun protection. Here’s why:
  • Skin that has lost its color sunburns very easily.
  • A bad sunburn can worsen vitiligo.
  • If you have fair skin, avoiding a tan usually makes the vitiligo barely noticeable.
  • If you chose to treat vitiligo with depigmentation, that is removing the remaining color from your skin, the sun can cause spots of color to form on your skin. You will need to depigment your skin again to remove these spots of color.

To protect your skin from the sun, dermatologists recommend:

1. Use sunscreen.

Generously apply sunscreen every day to skin that will not be covered by clothing. Use a sunscreen that offers:

  • UVA/UVB protection (label may say “broad spectrum”)
  • A sun protection factor (SPF) of 30 or more
  • Water resistance

2. Apply sunscreen every day.

Be sure to apply it at least 15 minutes before going outdoors.

3. Reapply sunscreen when outdoors.

If you will be outdoors, be sure to reapply the sunscreen:

  • Every 2 hours, even on cloudy days.
  • After being in water or sweating.

4. Wear clothing that protects your skin from the sun.

Skin covered by clothing that has a high SPF does not need sunscreen. Not all clothing offers high SPF. A long-sleeve denim shirt has an SPF of about 1,700. A white t-shirt only has an SPF 7, and a green t-shirt has about an SPF 10.

You can boost the SPF of clothing, by adding a product that increases the SPF of clothing during the wash cycle. You add this product to the wash machine. The increase in SPF is usually good for about 20 washings.

5. Seek shade.

This is especially important when your shadow is shorter than you are. That’s when the sun’s damaging rays are at their strongest and you are likely to sunburn.

Do not use tanning beds and sun lamps.

These are not safe alternatives to the sun. These, too, can burn skin that has lost pigment.

If you want to add color to your skin, consider using a cosmetic. 

Cosmetics can safely add color to your skin if you want to add color without undergoing treatment. Cosmetics that can add color are self-tanners, dyes, and makeup. Here are some tips that dermatologists offer their patients:

  • Select a water-proof product.
  • Self-tanners and dyes last longer than makeup.
  • Dyes work best for white spots.
  • When looking for a self-tanner, choose a product that contains dihydroxyacetone.
  • With practice, most people can achieve a natural look with a concealing cream or self-tanner.

Do not get a tattoo.

Getting a tattoo can cause something called Keobnerization or the Koebner phenomenon. What this means is when you wound your skin, which getting a tattoo does, a new patch of vitiligo can appear about 10 to 14 days later.

Learn about vitiligo.

Knowledge often improves a person’s quality of life. It helps to know about treatment options so that you know what is possible. Learning more about vitiligo can help you decide what feels right for you. You may want to treat it, camouflage with cosmetics, or just let it be. Only you can decide what’s right for you.

If you decide not to treat vitiligo, it’s still important to see a dermatologist for an accurate diagnosis and physical. Vitiligo is a medical condition, not just a cosmetic concern.

Connect with others who have vitiligo.

The emotional aspects of having vitiligo are often overlooked, but they are real. If a child has vitiligo, other children may tease and bully. People can stare. Studies conclude that many people who have vitiligo have a decreased quality of life.

Tinea versicolor

Tinea versicolor

We all have yeast living on our skin. When the yeast grow out of control, a person can get a skin disease called tinea versicolor.

Your dermatologist may tell you that you have a fungal infection on your skin. Yeast is a type of fungus. 

Tinea versicolor is not contagious.

You cannot get tinea versicolor from someone else. You cannot give it to someone.

Many people get tinea versicolor. It is one of the most common skin diseases in tropical and subtropical areas of the world. People who live in tropical areas may have tinea versicolor year-round.

Tinea versicolor: Signs and symptoms

The first sign of tinea versicolor is often spots on the skin. The other signs and symptoms are:

  • The spots are lighter (sometimes darker) than the surrounding skin. The color of the spots can be white, pink, salmon, red, tan, or brown.
  • The spots can appear anywhere on the body.
  • Spots can be dry and scaly.
  • Skin may itch where the spots appear.
  • Spots become more noticeable as the skin tans. The yeast prevents the skin from tanning.
  • Spots grow slowly.
  • As the yeast grows, the spots can combine and form patches of lighter (or darker) skin.
  • The spots may disappear when the temperature drops and return in the spring or summer when the air gets warm and humid.

Sometimes the spots are so faint that people do not realize they have tinea versicolor. If tinea versicolor causes light spots on the skin, it can be mistaken for vitiligo. Vitiligo is a skin disease that causes the skin to lose its color.

Tinea versicolor: Who gets and causes

Who gets tinea versicolor?

The yeast that causes tinea versicolor lives on everyone's skin. It is not clear why the yeast overgrows on some people's skin and not others. We do know the following about tinea versicolor:

  • People of all skin colors get it.
  • Teens and young adults are most susceptible because they have oily skin.
  • Older adults and children rarely get it unless they live in a tropical or subtropical area.
  • People who live in non-tropical areas often see tinea versicolor disappear during the cool, dry months.

What causes tinea versicolor?

Yeast normally live on our skin. When the yeast overgrows, it causes the skin disease tinea versicolor. It is believed that the following can cause the yeast to overgrow:

  • Hot, humid weather.
  • Lots of sweating.
  • Oily skin.
  • A weakened immune system.

Tinea versicolor: Diagnosis, treatment, and outcome

How do dermatologists diagnose tinea versicolor?

A dermatologist can often look at the skin and tell whether a patient has tinea versicolor. If there is any doubt, the dermatologist will do one of the following to make an accurate diagnosis:

  • Gently scrape off a bit of the skin. This will be examined under a microscope.
  • Look at the skin with a special device called a Wood's lamp. The dermatologist will hold the Wood's lamp about 4 or 5 inches from the affected skin. If the patient has tinea versicolor, the affected skin appears yellowish green in color when looked at with this lamp.

How do dermatologists treat tinea versicolor?

What a dermatologist prescribes depends on several things. These include where the tinea versicolor appears on the body, how much of the skin is affected, how thick the spots have grown, and climate.

Treatment for tinea versicolor may include:

  • Medicine applied to the skin: This is the most common treatment. There are anti-fungal shampoos, soaps, creams, and lotions that can keep the yeast under control. The active ingredient in these medicines is often selenium sulfide, ketoconazole, or pyrithione zinc.
  • Medicated cleansers: Tinea versicolor often returns, especially when a person lives in a place that is warm and humid. Using a medicated cleanser once or twice a month, especially during warm and humid periods, can prevent the yeast from overgrowing again.
  • Anti-fungal pills: A dermatologist may prescribe these pills if the tinea versicolor covers a large area of the body, is thick, or often returns after it is treated. These pills are taken for a short time. But anti-fungal pills can cause unwanted side effects. They can interfere with other medicine that you take. A dermatologist will monitor a patient who takes this medicine.

Outcome

With treatment, the yeast is easy to kill. The skin, however, may stay lighter (or darker) for weeks or months. The skin will eventually return to its normal color. To help even out your skin tone, you should protect your skin from the sun and not tan. 

Tinea versicolor can return. When the air outdoors is warm and humid, the yeast can quickly grow out of control. Some people who live in a tropical climate may need to use a medicated cleanser to prevent the yeast from overgrowing. People who live in an area that becomes warm and moist each spring may see tinea versicolor return every year.

Tinea versicolor: Tips for managing

If tinea versicolor is mild, you may be able to treat it yourself. There are anti-fungal products that you can buy without a prescription. These include:

  • Shampoo that contains selenium sulfide.
  • Anti-fungal cream or ointment that contains miconazole, clotrimazole, or terbinafine.

When using these products, dermatologists recommend the following:

  • Wash and dry the affected skin.
  • Apply a thin layer of the anti-fungal cream or ointment. Do this once or twice a day for at least 2 weeks.
  • When using a shampoo, wait 5 or 10 minutes before rinsing.

If you do not see an improvement after 4 weeks, you should make an appointment to see a dermatologist.

Some people need stronger medicine, so they see a dermatologist. Whether you self-treat or see a dermatologist, these tips can help you get better results:

  • Stop using skin care products that are oily. Use products that say non-oily or non-comedogenic.
  • Wear loose clothes. Nothing should feel tight.
  • Protect your skin from the sun. A tan makes tinea versicolor easier to see.
  • Do not use a tanning bed or sun lamp. Again, a tan makes tinea versicolor easier to see.

How to protect your skin from the sun

To get the best results, you need to protect your skin from the sun. To do this, you should apply sunscreen every day. Be sure to apply the sunscreen 20 minutes before you go outside. And apply it to all skin that will not be covered by clothing. Make sure to use a sunscreen that offers:

  • UVA and UVB protection (label may say broad-spectrum).
  • Sun Protection Factor (SPF) of 30 or more.
  • Non-greasy formula (label may say non-comedogenic).

Squamous Cell Carcinoma

Squamous cell carcinoma: Signs and symptoms

This skin cancer often develops on skin that has soaked up the sun for years. The face, ears, lips, backs of the hands, arms, and legs are common places for squamous cell carcinoma (SCC) to form. Signs include:  

  • A bump or lump on the skin that can feel rough.
  • As the bump or lump grows, it may become dome-shaped or crusty and can bleed.
  • A sore that doesn’t heal, or heals and returns.
  • Flat, reddish, scaly patch that grows slowly (Bowen’s disease).
  • In rare cases, SCC begins under a nail, which can grow and destroy the nail. 

SCC can begin in a pre-cancerous growth

Some SCCs begin in a pre-cancerous growth called an actinic keratosis (ak-ti-nik ker-ah-TOE-sis), or AK. In adults 40 and older, it is believed that about 40 to 60 percent of SCCs begin in an AK. Signs and symptoms of an AK include:

  • Small, pink, rough, dry, scaly patch or growth on skin.
  • Rough patch or growth that feels irritated or even painful when rubbed.
  • Itching or burning on a patch of skin.
  • Lips feel constantly dry and have a whitish color or feel scaly.

Squamous cell carcinoma: Who gets and causes

This skin cancer is most common in fair-skinned people who have spent years in the sun. But people of all skin colors get squamous cell carcinoma (SCC). Your risk of developing SCC increases if you have any of the following risk factors: 

Your physical traits

  • Pale or light-colored skin.
  • Blue, green, or gray eyes.
  • Blond or red hair.
  • An inability to tan.

What you’ve done

  • Spent a lot of time outdoors, for work or leisure, without using sunscreen or covering up with clothing.
  • Used tanning beds or sunlamps.
  • Been exposed to cancer-causing chemicals (e.g., arsenic in drinking water, tar, worked with some insecticides or herbicides).
  • Smoked tobacco. 
  • Spent lots of time near heat, such as a fire.

Your medical history

  • Diagnosed with actinic keratoses (AKs).
  • Badly burned your skin.
  • Ulcer or sore on your skin that has been there for many months or years.
  • Taking medicine that suppresses your immune system.
  • Infected with human papillomavirus (HPV).
  • Overexposure or long-term exposure to x-rays, such as patients who received x-ray treatments for acne in the 1940s.
  • Received many PUVA treatments.
  • Have one of these medical conditions: xeroderma pigmentosum, epidermolysis bullous, or albinism.

Causes

Most SCC is caused by ultraviolet (UV) rays from the sun or tanning beds. Other causes include:

  • Long-term exposure to cancer-causing chemicals, such as when a person smokes tobacco, is exposed to tar, drinks from a water supply that contains arsenic, or uses some insecticides or herbicides.
  • A serious burn.
  • Ulcer or sore on the skin that has been there for many months or years.
  • Some types of the human papillomavirus (HPV).

Squamous cell carcinoma: Diagnosis, treatment, and outcome

The only way to diagnose any type of skin cancer, including squamous cell carcinoma (SCC), is with a skin biopsy. Your dermatologist can perform this procedure during an office visit.

A skin biopsy should not cause anxiety. To perform a skin biopsy, your dermatologist will remove the entire growth or part of it. Your dermatologist may send this to a laboratory or look at it under a microscope. The findings will be communicated in a biopsy report.

If the biopsy report states that you have SCC, your dermatologist will consider many factors to determine which treatment will be best. 

The type of treatment a patient receives depends on how deep the cancer has grown and whether it has spread. SCC is often treated with:

Excision: This is a surgical procedure that your dermatologist often can  perform during an office visit. It involves numbing the area to be treated and cutting out any remaining tumor plus some normal-looking skin around the tumor. 

Like the skin biopsy, this removed skin is examined under the microscope. This may be done at a laboratory or by your dermatologist. The doctor who looks at the removed skin needs to see whether the normal-looking skin is free of cancer cells. If not, more skin will need to be removed. This is a common way to treat SCC.

Mohs surgery: Named for the doctor who developed this surgery, Mohs (pronounced "moes") is a specialized surgery used to remove some skin cancers. It offers the highest cure rate for difficult-to-treat squamous cell cancers. Your dermatologist will tell you if Mohs surgery is right for you.

If Mohs surgery is recommended, this is what you can expect. The surgeon will cut out the tumor plus a very small amount of normal-looking skin surrounding the tumor. While the patient waits, the Mohs surgeon uses a microscope to look at what was removed. The surgeon is looking for cancer cells. 

If necessary, the Mohs surgeon will continue to remove a very small amount of skin and look at it under the microscope. This continues until the surgeon no longer sees cancer cells. 

Radiation: This treatment is usually reserved for SCCs that cannot be cut out, or when cutting may not be the best choice. A patient may need 15 to 30 radiation treatments. 

When the SCC is caught early, it may be treated by: 

Curettage and electrodesiccation: This treatment consists of two steps. First, your dermatologist scrapes away the tumor. Then electricity is used to destroy any remaining cancer cells. These two steps are repeated.

Photodynamic therapy (PDT): This treatment uses light to remove some very early skin cancers. PDT is a two-step process. First, a chemical is applied to the skin. The chemical remains on the skin for some time so that it can be absorbed. Then the skin is exposed to a special light to kill the cancer cells.

Laser treatment: Lasers can be used to remove an SCC that sits on the surface of the skin. This treatment is only recommended for early SCCs.

Chemotherapy cream: Cream that contains a chemotherapy drug, 5-fluorouracil (5-FU), can be used to treat SCC in the earliest stage.  

Outcome 

With treatment, most SCCs are cured. Early treatment is recommended. When allowed to grow, this skin cancer can grow deep, destroying tissue and even bone. In some cases, SCC spreads to the lymph nodes and other parts of the body. This can cause serious health problems. 

Squamous cell carcinoma: Tips for managing

Most people diagnosed with squamous cell carcinoma (SCC) have a very good prognosis. When caught early and removed, this skin cancer has an excellent cure rate.

Risk

Anyone who has had SCC has a higher risk for getting another skin cancer. To help patients manage this higher risk, dermatologists recommend the following:

Keep all follow-up appointments with your dermatologist. When found early, skin cancer usually can be cured. Even melanoma, the deadliest skin cancer, has a cure rate of nearly 100% when found early and treated.

Perform skin self-exams. Patients who are diagnosed with skin cancer are taught how to examine their own skin for signs of skin cancer. Be sure to examine your own skin as often as recommended by your dermatologist.

If you see anything on your skin that is growing, bleeding, or in any way changing, immediately call your dermatologist’s office. Change can be a sign of skin cancer. Found early and treated, skin cancer can be cured.

Protect your skin from the sun and indoor tanning. This is essential to prevent further damage, which can increase the risk of getting another skin cancer. Here are tips that dermatologists give their patients to help them protect their skin:

  • Wear sunscreen and lip balm that offer sun protection. Apply these daily, even in the winter, and be sure to use sunscreen and lip balm that offer:
  • SPF 30 or higher.
  • Broad-spectrum (UVA/UVB) protection.
  • Water resistance.
  • Apply the sunscreen and lip balm to dry skin 15 minutes before going outdoors.
  • Apply the sunscreen to every part of your body that will not be covered by clothing. 
  • Whenever possible wear a wide-brimmed hat, long sleeves, and pants. 
  • Wear sunglasses to protect the skin around your eyes.
  • Avoid outdoor activities when the sun is strongest — between 10 a.m. and 2 p.m.
  • Avoid tanning and never use a tanning bed or sun lamp.

Use condoms. Your dermatologist may recommend using condoms. This can prevent an HPV infection, which reduces the risk for getting SCC on the genitals. 

Limit the amount of alcohol you drink and do not smoke. Smoking and drinking alcohol can increase your risk of getting SCC in your mouth.

 

 

Request Appointment