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Dermal metastases in squamous cell carcinomas of the head and neck are rare. The purpose of this study was to evaluate incidence, site, prognostic significance, and treatment modalities of dermal metastases of squamous cell carcinoma of the head and neck.Medical records were retrospectively analyzed. Statistical analysis was performed using Fisher exact test, Cox regression, and Kaplan–Meier curves.Fifty-one patients with dermal metastases were evaluated. Dermal metastases were located in the neck, face, chest wall, and upper extremities. The median time from diagnosis of the primary tumor to the occurrence of dermal metastases was 16 months. Survival after manifestation of dermal metastases ranged from 1 to 65 weeks. Localization and treatment of dermal metastases did not significantly correlate with survival.Dermal metastases indicate the terminal phase of disease. No positive effect of certain therapy modalities could be validated. Therefore, invasive therapies should be abandoned in favor of best supportive care.