When we step out into the sun, our scalp is the part of our body that is most exposed to the sun's damaging rays. And because our heads are covered in hair, changes in the skin that alert us to possible skin cancers are hidden.
Unfortunately, scalp melanomas are the most lethal of all melanomas. One study found that people with scalp and neck melanomas were twice as likely to die compared to those with melanomas elsewhere on their bodies.
So, with difficulty in detecting them and a poorer prognosis than melanomas on other parts of the body, what can those at risk do to prevent scalp melanoma? And what should you do if you detect a suspicious spot or skin growth on your scalp?
Can you get melanoma on the scalp?
Yes, you can get melanoma on the scalp. Melanoma skin cancers can occur on any part of the body which has pigment-producing cells called melanocytes.
Although melanoma is the least common type of skin cancer to be found on the scalp, after basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), it is the most serious and deadly of the three skin cancer types. This is because melanoma often develops suddenly and, if left untreated or goes undetected, can rapidly spread to other organs and lymph nodes.
Why are scalp melanomas more lethal?
Although melanomas on the scalp and neck account for only 6% of all melanomas, they make up around 10% of melanoma-related deaths, according to one study. Melanomas have been found to be more lethal than other types of scalp cancer and there are two main reasons for this.
The first is due to a delay in their diagnosis because of their location. They are usually hidden by hair and the scalp is an area in which they are very unlikely to be spotted by patients themselves.
The second reason is that the scalp provides the right environment for melanoma to spread quickly because this area of the body has more blood vessels and lymph nodes, where cancerous cells travel. This means they grow quicker than melanomas elsewhere on the body.
Signs and symptoms of scalp melanoma
The appearance of the cancer can vary, depending on the type of skin cancer. Early warning signs and symptoms to be on the lookout for include the following:
- A new or changing growth, lump, bump, mass or spot on the skin of the scalp. They are most often dark - brown, blue, black or purple - but can also appear pink, red, skin coloured or white.
- A sore that bleeds or is itchy or takes a long time to heal.
- Rough or scaly patches on the surface of the scalp that may itch.
- A mole that changes in size or colour, is a strange shape or has an irregular border.
- A wart-like growth could be a sign of nodular melanoma. These can be translucent, pink or white.
To detect melanoma at an early stage, it's recommended you use the ABCDE method to check for changes in moles or skin growths.
- Asymmetry: Two halves do not match
- Border irregularity: The mole edges or border appears ragged or blurred
- Colour: The mole or growth has different shades from one area to another
- Diameter: The mole is larger than 6 millimetres
- Evolving: The mole or lesion looks different from others and its size, shape, or colour is changing
What scalp melanomas look like
Melanoma on the scalp can appear in different ways. While some melanomas can grow from preexisting skin growths or moles, many do not. They may appear as a black or brown spot, have irregular colours and borders or may appear as a firm pink or purple lump.
Melanomas can sometimes be mistaken for warts, moles, freckles, sores or ulcers, age or sunspots (actinic keratosis).
Common risk factors for scalp melanomas
One of the leading causes of all skin cancer is exposure to UV radiation. Other risk factors for melanoma scalp cancer include:
- A family history of melanoma
- A personal history of skin cancer
- Use of tanning beds
- Fair hair and skin tone.
- Having a large number of moles
- Pre-cancerous lesions such as an actinic keratosis (sunspot)
People with darker skin tones are less likely to develop skin cancers but have been found more likely to die from them compared to people with fairer skin. This may be because a suspicious spot is harder to detect on darker skin or it could be that those with darker skin tones are less likely to perform regular skin checks.
Men suffering from hair loss have also been found to have an increased risk of developing scalp cancer, including melanoma.
How to detect melanoma skin cancer on your scalp
You should check your scalp as part of your regular skin self-exam. However, it can be tricky to see all parts of your scalp, even when using a mirror. Therefore, having a trusted friend to help you check your scalp is a great idea. Get them to use a comb and hair dryer to part your hair, looking for any suspicious skin growths, bumps or unusual or new moles.
Your hairdresser can also be a valuable resource when it comes to spotting melanomas on the scalp, as Queensland politician Yvette D'Ath found out. Ask them to point out any unusual skin growths, spots or moles on your scalp during your regular appointments so you can have them checked further.
How to protect your scalp from melanoma and other skin cancers
Skin cancer on the scalp develops from sun exposure in most cases. So it's essential to protect your head by wearing a hat whenever you're out in the sun. Choose a hat with a broad brim to help protect your face and neck, too. Keeping a spare hat in your car along with your sunglasses is a great way to ensure you're never without one. Don't forget to protect your hair from the sun.
Also, try to seek shade during the hottest parts of the day and wear clothing such as long-sleeved shirts and pants to protect the rest of your skin.
You can also wear SPF sunscreen on your scalp to further reduce your skin cancer risk. Powder sunscreens are a great option, especially if you have a bald patch or thin hair.
Put your health first and make an appointment with a doctor
Because melanomas on the scalp can spread so quickly, making treatment more difficult, early detection is important to achieving the best outcome possible.
The team at SunDoctors skin cancer clinics are a wealth of information when it comes to sun protection and your skin. The doctors are trained in skin cancer detection and treatment and can provide you with advice on taking care of your skin, to keep you looking and feeling your best.
They recommend having annual skin checks and more frequently if you are in a high-risk category for skin cancer. Book online or call 13SKIN (13 75 46) to make an appointment today.