Could That New Red Bump Be Squamous Cell Carcinoma Returning? What to Know After Mohs Surgery

Understanding Skin Cancer Recurrence: When to Be Concerned About New Growths After Treatment

While recurrence is possible, don't panic yet - schedule a check-up with your dermatologist to examine the bump, as many things can cause red bumps on the skin. They will determine if it's recurrent cancer or a benign growth.

If you've had squamous cell carcinoma (SCC) treated with Mohs surgery in the past, noticing a new red bump near the original treatment site can trigger immediate concern. Five years after successful treatment, you might have thought your skin cancer journey was behind you—but now you're wondering: could this be the cancer returning?

At Dermatology and Skin Health, we understand the anxiety that suspicious skin changes can cause, especially for former skin cancer patients. While Mohs surgery offers impressively high cure rates, recurrence remains a possibility that patients should be aware of, even years after treatment.

This comprehensive guide explores the possibility of SCC recurrence after Mohs surgery, how to identify warning signs, and the important steps to take if you notice a concerning new growth.

Schedule a skin cancer screening at Dermatology & Skin Health today for peace of mind and early detection of any concerning new growths

The Question Everyone Asks: Could My Squamous Cell Carcinoma Return After Mohs Surgery?

The short answer is yes—it's possible, though not common. Even after the highly effective Mohs surgical technique, squamous cell carcinoma can recur in some cases. What's important to understand is that recurrence doesn't mean your initial treatment failed, rather, it reflects the persistent nature of certain skin cancers and the biological factors that can influence their behavior.

When you notice a new red bump near a previous Mohs surgery site, it's natural to fear the worst. However, many skin conditions can cause red bumps that have nothing to do with cancer. Only a board-certified dermatologist can determine whether a suspicious growth represents cancer recurrence or something entirely benign.

Understanding Squamous Cell Carcinoma and the Mohs Surgery Advantage

Before diving deeper into recurrence concerns, let's briefly review what squamous cell carcinoma is and why Mohs surgery is often the treatment of choice.

What Is Squamous Cell Carcinoma?

Squamous cell carcinoma is the second most common form of skin cancer, affecting more than 1.8 million Americans annually. It develops in the squamous cells that make up the middle and outer layers of your skin, often in sun-exposed areas like the face, ears, neck, and hands. SCC typically appears as:

• Scaly red patches
• Elevated growths with a central depression
• Open sores that bleed or crust
• Wart-like growths

Unlike basal cell carcinoma (the most common skin cancer), SCC has a somewhat higher risk of spreading to other parts of the body if left untreated, making prompt and thorough treatment essential.

Why Mohs Surgery Is Often Recommended

Mohs micrographic surgery represents the gold standard treatment for many squamous cell carcinomas, particularly those in cosmetically sensitive areas or with aggressive features. During this specialized procedure:

1. The surgeon removes the visible tumor and a thin layer of surrounding tissue
2. This tissue is immediately processed and examined under a microscope while you wait
3. If cancer cells remain, additional tissue is removed only from areas where cancer persists
4. This precise process continues until the area is cancer-free

This meticulous approach achieves two critical goals: it ensures complete cancer removal while preserving as much healthy tissue as possible. The technique boasts cure rates of 97-99% for primary (never before treated) skin cancers, making it remarkably effective.

The Reality of Recurrence: How Often Does SCC Return After Mohs Surgery?

Despite the high success rate of Mohs surgery, recurrence remains a possibility that all skin cancer patients should be aware of. Studies show that the recurrence rate for squamous cell carcinoma after Mohs surgery is approximately 3-5% over five years, lower than with standard excision techniques.

Several factors influence recurrence risk:

Tumor-Specific Factors

• Size and depth: Larger and deeper tumors have higher recurrence rates
• Location: SCC in certain areas (lips, ears, temples, around eyes) tends to be more aggressive
• Histological subtype: Certain variants like poorly differentiated or desmoplastic SCC are associated with higher recurrence risk
• Perineural invasion: When cancer travels along nerve pathways, recurrence risk increases

Patient-Specific Factors

• Immune status: Immunosuppressed patients face higher recurrence rates
• Genetic conditions: Patients with certain genetic syndromes may experience more aggressive disease
• Prior radiation: Previous radiation treatment can complicate tumor behavior
• Continued UV exposure: Significant sun exposure after treatment increases risk

Don't go it alone - get personalized guidance on your skin cancer recurrence risk from Dermatology & Skin Health's compassionate team

Is 5 Years a Common Timeframe for SCC Recurrence?

The timing of squamous cell carcinoma recurrence follows a pattern that's important to understand. Most recurrences happen within the first two years after treatment. By the five-year mark, the likelihood of recurrence has decreased significantly—but it hasn't disappeared completely.

A five-year recurrence would be considered less common, but certainly not unheard of in clinical practice. This highlights the importance of continued vigilance and regular skin checks, even years after successful treatment.

Visual Clues: What Does Recurrent Squamous Cell Carcinoma Look Like?

Identifying a potential SCC recurrence can be challenging, even for patients who've experienced skin cancer before. Recurrent SCC may appear similar to or different from the original tumor. Common presentations include:

Characteristic Appearances of Recurrent SCC

• A firm, red nodule or bump near the original surgical site
• A persistent, non-healing sore that bleeds easily
• A flat, scaly patch with irregular borders
• A raised growth with a central depression
• A thick, wart-like lesion with a rough surface

It's important to note that recurrent tumors sometimes grow beneath the skin's surface before becoming visibly apparent. This is one reason why unusual sensations—persistent tenderness, numbness, or tingling near a previous surgical site—should never be ignored, even without visible skin changes.

The Diagnostic Dilemma: Is That Red Bump Cancer or Something Else?

When you notice a new red bump near a previous Mohs surgery site, numerous possibilities exist beyond cancer recurrence. Common non-cancerous conditions that might be confused with recurrent SCC include:

Potential Mimics of Recurrent SCC

Actinic keratosis	A precancerous growth that appears as a rough, scaly patch
Seborrheic keratosis	A benign growth that can look wart-like
Pyogenic granuloma	A rapidly-growing vascular lesion that bleeds easily
Folliculitis	Inflammation of hair follicles causing red, pimple-like bumps
Hypertrophic scarring	Raised, thickened scar tissue from previous surgery
Basal cell carcinoma	Another form of skin cancer with a different appearance
Dermatofibroma	A firm, benign skin nodule
Keratoacanthoma	A rapidly-growing lesion that can resemble SCC

Only microscopic examination of tissue can definitively distinguish between these various possibilities. Self-diagnosis is never recommended, regardless of how familiar you may be with your previous cancer experience.

What to Do If You Notice a Suspicious New Bump?

If you discover a concerning growth near a previous Mohs surgery site, follow these steps:

1. Document the lesion: Take clear photos if possible, noting size and any changes
2. Contact your dermatologist promptly: Mention your history of SCC and Mohs surgery
3. Request priority scheduling: Emphasize your skin cancer history when making the appointment
4. Avoid manipulation: Don't pick, scratch, or attempt home treatments on the area
5. Continue sun protection: Limit sun exposure to the area until evaluated

While waiting for your appointment, try to maintain perspective. Remember that many post-surgical changes and new growths are completely benign. However, early evaluation ensures that if recurrence has occurred, it can be addressed quickly and effectively.

Don't delay, contact Dermatology & Skin Health at the first sign of a suspicious bump for timely evaluation by specialists you can trust.

How to Manage Recurrent Squamous Cell Carcinoma

If your dermatologist confirms that your new red bump is indeed recurrent SCC, several treatment options may be considered:

Surgical Approaches

• Mohs surgery: Often the first choice for recurrent tumors due to its precision and tissue-sparing qualities
• Standard excision: Surgical removal with predetermined margins when Mohs is not available
• Curettage and electrodesiccation: Scraping the tumor away and destroying remaining cells with electric current (for very superficial recurrences only)

Non-Surgical Alternatives

• Radiation therapy: May be recommended for patients who cannot undergo surgery or as adjuvant therapy
• Systemic medications: For very advanced cases or those at high risk of further spread
• Topical therapies: May be considered for superficial recurrences in certain situations
• Photodynamic therapy: Light-activated treatment may be appropriate for certain superficial recurrences

At Dermatology and Skin Health, we offer advanced treatment options including Mohs surgery performed by fellowship-trained Mohs surgeons like Dr. Mendese, ensuring you receive the most effective care for recurrent skin cancer.

Moving Forward with Knowledge and Confidence

Discovering a new red bump near a previous Mohs surgery site can be alarming, especially five years after your initial treatment. While recurrence is certainly possible, many other benign conditions could explain the new growth. The most important step is prompt evaluation by a qualified dermatologist who understands your history and can provide accurate diagnosis.

At Dermatology and Skin Health, our team of specialists, led by Dr. Gary Mendese, offers comprehensive care for patients with skin cancer history, including advanced diagnostic techniques and cutting-edge treatment options. 

If you're concerned about a potential skin cancer recurrence or simply due for a follow-up examination, contact Dermatology and Skin Health today.