Melanoma, a serious form of skin cancer, can develop on the scalp. This location presents unique challenges for detection, often leading to a more advanced stage at diagnosis. Awareness and early identification are therefore important. Approximately 5% of all melanoma cases occur on the scalp, despite the head and neck region accounting for only about 9% of the body’s total surface area.
Why the Scalp is a Unique Site
The scalp is a challenging area for melanoma detection. Hair can obscure lesions, making self-examination and professional visual checks difficult. This often results in delayed diagnosis. The scalp is also frequently exposed to ultraviolet (UV) radiation, especially in individuals with thinning hair or baldness, increasing vulnerability to sun damage. Its rich vascular and lymphatic networks may contribute to the aggressive nature of these melanomas, potentially facilitating faster growth and spread. Scalp melanomas are more common in older men, particularly those with androgenetic alopecia, which further increases UV exposure.
Recognizing Scalp Melanoma
Identifying potential scalp melanoma involves vigilance for skin changes. The ABCDEs of melanoma provide a helpful guide for recognizing suspicious lesions:
Asymmetry: One half of the mole does not match the other.
Border irregularity: Edges are uneven, notched, or blurred.
Color variation: Multiple colors within the same mole (e.g., brown, black, tan, red, white, blue).
Diameter: Typically larger than 6 millimeters, though melanomas can be smaller.
Evolution: Any change in size, shape, color, elevation, or new symptoms like bleeding, itching, or crusting over time.
Other signs to watch for include red or scaly patches, pink blemishes, raised moles, or non-healing sores.
Diagnosing Scalp Melanoma
A medical professional begins the diagnostic process with a thorough visual examination. They may use a dermoscope, a specialized magnifying tool, to inspect the lesion for subtle features. If a suspicious area is identified, a biopsy is necessary to confirm the diagnosis.
An excisional biopsy, which involves removing the entire suspicious growth along with a small margin of healthy skin, is often the preferred method. This allows for comprehensive microscopic analysis to determine if cancer cells are present and assess the depth of invasion. If an excisional biopsy is not practical due to the lesion’s size or location, an incisional or punch biopsy may be performed to obtain a tissue sample.
Preventing Scalp Melanoma
Preventing scalp melanoma involves consistent sun protection. Wearing wide-brimmed hats effectively shields the scalp, face, and neck from harmful UV rays. Baseball caps offer less comprehensive protection. Applying broad-spectrum sunscreen with an SPF of at least 30 to exposed scalp areas, especially if hair is thinning or absent, is also important. Sunscreen sprays or powders designed for the hair and scalp can offer lightweight protection without making hair greasy. Seeking shade, particularly during peak sun hours (10 a.m. to 4 p.m.), further reduces UV exposure.
Treatment Approaches
Treatment for scalp melanoma primarily involves surgical removal of the cancerous lesion. The extent of surgery, known as wide local excision, depends on the melanoma’s thickness and aims to remove the tumor along with a margin of healthy tissue to minimize recurrence risk. For very early melanomas, this surgical procedure may be the only treatment required.
Depending on the melanoma’s stage and characteristics, additional treatments may be recommended. These include radiation therapy, which uses high-energy beams to destroy cancer cells. Immunotherapy and targeted therapy, which leverage the body’s immune system or target cancer cells with specific genetic mutations, are options for advanced cases or if the cancer has spread. Treatment plans are individualized, determined by an oncology team based on patient and disease factors.