Squamous Cell Carcinoma Treatment in Edinburgh
Squamous cell carcinoma (SCC) is the second most common form of skin cancer. It usually appears as a scaly, crusted, or ulcerated patch on sun-exposed skin and, unlike basal cell carcinoma, can spread if left untreated, which is why timely excision matters.
At Waterfront Private Hospital, squamous cell carcinoma is treated by consultant plastic surgeons and a consultant dermatologist on the GMC Specialist Register. The consultant who assesses your lesion plans the excision, performs the surgery, reviews the histology with you, and arranges your follow-up. For high-risk SCC — large lesions, recurrent disease, head-and-neck sites, or patients on immunosuppression — your case is discussed at the South East Scotland Skin Cancer Multidisciplinary Team meeting before any onward treatment is recommended.
Guide price from £1,495 for excision under local anaesthetic. Cases requiring more complex reconstruction are priced from £2,195. Final pricing follows clinical assessment.
Contents
Squamous cell carcinoma at a glance
- What it is — a skin cancer arising from squamous cells of the epidermis, with potential to spread if untreated.
- Where it appears — sun-exposed areas: face, ears, scalp, lips, hands and forearms.
- Treatment — surgical excision with a clear margin; reconstruction planned at the same operation where required.
- Consultants — Mr Ben Aldridge and Mr Kazem Nassar, both on the GMC Specialist Register and the regional skin cancer MDT.
- Anaesthesia — local anaesthetic for most cases.
- Guide price — from £1,495; larger or more complex cases from £2,195. Final pricing follows clinical assessment.
- High-risk disease — discussed at the regional skin cancer MDT; any systemic treatment is delivered through the NHS pathway.
How squamous cell carcinoma is diagnosed and treated
Diagnosis begins with clinical examination and dermoscopy at consultation. If the appearance is consistent with SCC, your consultant will discuss whether to proceed directly to excisional biopsy or to take a small diagnostic biopsy first. For most well-defined lesions, excision with a planned clear margin is the most efficient route — it removes the lesion and provides the histology in a single procedure.
The excised tissue is sent for pathology. The report confirms the diagnosis, measures the margins, and identifies any high-risk features — such as tumour thickness, perineural invasion, poor differentiation, or invasion into deeper structures. Your consultant reviews the report with you in person, not by letter.
Where histology confirms a low-risk SCC fully excised with clear margins, treatment is complete, and you move to a surveillance schedule. Where the histology shows high-risk features, your case is discussed at the South East Scotland Skin Cancer Multidisciplinary Team meeting, and onward investigation or treatment is arranged through the NHS pathway where required.
What to expect — from consultation to final review
Consultation — usually within 1-2 weeks of enquiry. Your consultant examines the lesion, performs dermoscopy, explains the diagnosis and treatment plan, and books surgery.
Surgery — excision is performed under local anaesthetic in most cases, in a single visit. Larger or more complex reconstructions may use sedation or general anaesthesia. The wound is closed primarily, with a local flap or with a skin graft, depending on the size and site.
Histology — the pathology report is usually available within two weeks. Your consultant communicates the result and discusses next steps with you directly.
Wound review — stitches are typically removed at 7 to 14 days, depending on the site. The consultant who performed your surgery is the consultant who sees you for follow-up.
Surveillance — follow-up runs for several years, tailored to the risk features of your lesion. Lower-risk cases are reviewed less frequently; higher-risk cases are seen more often. NHS-based surveillance is the standard pathway for high-risk patients and can be supplemented privately at Waterfront, where you prefer.
When to seek assessment
Common features that warrant prompt review include:
- A scaly, crusted or ulcerated patch on sun-exposed skin that does not heal
- A tender or painful raised lesion that bleeds easily
- A rapidly enlarging lump, particularly on the ear, lip, scalp or back of the hand
- A pre-existing actinic keratosis that has thickened or become tender
- Any new or changing lesion in a patient on long-term immunosuppression, including transplant recipients
SCC is a cancer with the potential to spread, so a delay in assessment has consequences that early treatment avoids.
Risks and what they mean
Surgical risks are explained in detail at the consultation and include:
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- Scarring — every excision leaves a scar. Reconstruction is planned to place the scar in the most favourable orientation for the site.
- Bleeding and bruising — usually minor and self-limiting.
- Infection — uncommon; managed with antibiotics where needed.
- Incomplete excision — if margins are involved on histology, a second procedure to clear the margin is recommended.
- Recurrence — risk depends on tumour features. Local recurrence is uncommon after complete excision of low-risk SCC and more likely with high-risk features.
- Regional or distant spread — uncommon in low-risk SCC; the risk rises with depth, perineural invasion, immunosuppression and head-and-neck sites. The MDT discussion exists to identify these patients and route them into the appropriate NHS pathway.
Aftercare
Wound care advice is provided in writing on the day of surgery. The Waterfront nursing team is available for the first week for any wound-related concerns. Your consultant remains accessible throughout your surveillance period — not only at scheduled appointments.
Sun protection advice and surveillance frequency are tailored to your individual risk. Patients with a single low-risk SCC are guided differently to patients with multiple lesions, field change, or immunosuppression.
Cost of squamous cell carcinoma treatment
Guide prices at Waterfront Private Hospital:
- Excision under local anaesthetic — from £1,495
- Larger or more complex excision and reconstruction — from £2,195
- Cases requiring sedation or general anaesthesia — priced after assessment
The fee covers consultation, surgery, histopathology, and routine follow-up. Final pricing depends on lesion size, site, and the reconstruction required, and is confirmed in writing after consultation.
High-risk SCC requiring sentinel lymph node biopsy, formal lymph node clearance, or systemic treatment is managed through the NHS pathway and is not charged for at Waterfront.
Your consultants
Squamous cell carcinoma at Waterfront is treated by Mr Ben Aldridge and Mr Kazem Nassar. Both are on the GMC Specialist Register, both sit on the South East Scotland Melanoma and Skin Cancer Multidisciplinary Team, and both treat SCC in their NHS practice — including lymph node clearance where indicated. The consultant you choose is the consultant who sees you through diagnosis, surgery, histology review and surveillance.
Frequently asked questions
Who will treat my squamous cell carcinoma?
How quickly can I be seen?
Will I need a biopsy before surgery?
What anaesthetic is used?
What does the surgery involve?
What happens if the margins are not clear?
What is the South East Scotland Skin Cancer MDT and why does it matter?
Do you perform sentinel lymph node biopsy or lymph node clearance at Waterfront?
What is the recurrence risk?
How often will I be followed up?
I’m on immunosuppression — does that change my treatment?
How is treatment paid for?
Page authors
Mr Ben Aldridge, MB ChB, MSc, PhD, MRCP, FRCS (Plast), GMC [6049481], is a Consultant Dermatologist and Plastic Surgeon at Waterfront Private Hospital in Edinburgh. He is the UK's only consultant dual-qualified in dermatology and plastic surgery, holds a PhD in skin lesion diagnostics, is a co-author of national skin cancer guidelines, and chairs the South East Scotland Melanoma Multidisciplinary Team.
Mr Kazem Nassar, MBChB, FRCS (Plast), GMC 7131999, is a Plastic and Reconstructive Surgeon Consultant with over 10 years of experience. He practices at St John’s Hospital and the Western General Hospital in Edinburgh, specialising in melanoma, skin cancer treatments, breast surgery, and post-cancer reconstructive surgery.
