Diagnosis and treatment

How is squamous cell carcinoma (SCC) diagnosed?

During your consultation, your specialist will:

Examine the eyelid lesion

• Assess surrounding skin and eyelid structures

• Review your medical history

• Discuss any previous skin cancers

• Examine relevant lymph nodes where appropriate

• Recommend investigations or treatment

A biopsy is often required to confirm the diagnosis and determine the tumour subtype and stage.

Understanding Your Diagnosis

Squamous cell carcinoma of the eyelid varies significantly in its behaviour.

Some tumours are small and straightforward to treat, whereas others may require more extensive surgery, reconstruction, imaging or multidisciplinary management.

The information provided on this website cannot predict the behaviour, stage or prognosis of any individual tumour.

Your consultant will discuss the specific findings and recommendations relevant to your diagnosis.

Understanding Staging

Staging helps determine the size and extent of the cancer and guides treatment planning.

Your specialist may discuss:

• Tumour size

• Depth of invasion

• Involvement of nearby structures

• Features associated with recurrence risk

• Whether additional imaging is required

Most eyelid SCCs are diagnosed at a stage where curative treatment remains possible.

Lymph Node Assessment

Unlike basal cell carcinoma (BCC), some squamous cell carcinomas (SCC) can spread to nearby lymph nodes.

For this reason your specialist may:

• Examine lymph nodes in the head and neck

• Arrange imaging studies

• Recommend additional investigations for higher-risk tumours

These assessments are precautionary and may not be required for every patient.

Treatment for a basal cell carcinoma

Treatment recommendations are tailored to each individual patient. Factors considered include:

• Tumour size

• Location

• Histological subtype

• Previous treatment history

• Cosmetic and functional considerations

Possible treatment options include:

• Standard surgical excision

• Mohs micrographic surgery

• Radiotherapy

• Topical treatments for selected superficial lesions

• Targeted therapies for rare advanced tumours

Mohs micrographic surgery - the gold standard for selected facial skin cancers

Mohs micrographic surgery is the most precise surgical technique available for treating many facial basal cell carcinomas.

It is particularly valuable for cancers involving:

• Eyelids

• Medial canthus (inner corner of the eye)

• Nose

• Lips

• Ears

• Recurrent tumours

• Large or aggressive BCCs

How does mohs surgery work?

Rather than removing a larger margin of tissue in one operation, Mohs surgery removes the cancer in carefully controlled stages.

Each layer is examined under the microscope while you wait. This allows the surgeon to:

• Confirm complete tumour clearance

• Preserve as much normal tissue as possible

• Minimise the size of the reconstruction

• Achieve the highest cure rates available

Benefits of Mohs surgery

Highest cure rates

Mohs surgery provides cure rates of approximately:

• 98-99% for primary BCCs

• 94-97% for recurrent BCCs

Better cosmetic outcomes

By preserving healthy tissue, reconstruction can often be smaller and more precise.

Reduced risk of recurrence

The entire surgical margin is examined, helping minimise the likelihood of cancer cells being left behind.

What to expect on the day of the surgery

Mohs surgery is usually performed under local anaesthetic as a day-case procedure.

The process typically involves:

1. Removal of a small layer of tissue.

2. Immediate microscopic examination.

3. Additional targeted removal only where cancer cells remain.

4. Reconstruction once complete clearance has been achieved.

Because tissue analysis occurs during the procedure, you should expect to spend several hours at the clinic.

Recovery after treatment

Most patients recover quickly following surgery.

Temporary symptoms may include:

• Swelling

• Bruising

• Tightness around the wound

• Mild discomfort

These are generally short-lived and improve steadily over the following days and weeks.

You will be provided with detailed aftercare instructions and access to your clinical team should any concerns arise.

Follow-up and surveillance

Why follow-up matters

Most patients are cured after a single treatment. However, anyone who has developed one BCC has a higher chance of developing future skin cancers.

For this reason, ongoing skin awareness remains important.

Depending on your individual circumstances, we may recommend:

• Routine review appointments

• Periodic skin surveillance

• Photography and lesion monitoring

• Self-examination guidance

Patients with recurrent tumours, multiple skin cancers, significant sun damage or high-risk pathology may benefit from longer-term specialist follow-up.

Monthly skin self-checks

We encourage patients to check their skin once each month.

Please contact us if you notice:

• A new non-healing lesion

• Bleeding or crusting skin changes

• A new lump on the eyelids or face

• Changes around a previous treatment site

• Any lesion that concerns you

Protecting your skin

Reducing the risk of future skin cancers

Having had one skin cancer means looking after your skin becomes even more important.

We recommend:

Daily sunscreen

• SPF 30 or higher

• Broad-spectrum UVA and UVB protection

• Apply to exposed skin every day

Protective clothing

• Wide-brimmed hats

• UV-protective sunglasses

• Long sleeves where practical

Seek shade

• Particularly between 11am and 3pm during spring and summer.

Avoid sunbeds

• Sunbeds significantly increase the risk of skin cancer and should be avoided completely.