Skin cancer on the scalp may take the form of growths such as ulcers, moles, and sores. These growths can change in color, size, and shape. Treatment options vary depending on the type of skin cancer.

Skin cancer is the most common type of cancer in the United States. Skin cancer on the scalp may look like a mole, an ulcer, a sore, or another type of growth. Growths on the scalp can change in shape, color, or size and may itch or bleed, which may be concerning for skin cancer.

Treatment for skin cancer depends on the type and severity of the cancer. Treatment is more effective if a doctor diagnoses cancer early.

This article discusses the different types of skin cancer that can develop on the scalp and their symptoms, diagnosis, and treatment.

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The type of skin cancer a person has will determine the kind of treatment they receive and influence their outlook. Doctors determine the skin cancer type using a physical examination, blood tests, biopsies, and imaging scans.

There are three main types of skin cancer that affect the scalp:

Melanoma

Of the three types, melanoma is the most serious form of skin cancer. It can be unpredictable and often develops suddenly with no warning. It can also grow from or near an existing skin lesion.

Melanoma can spread to other parts of the body, such as the lymph nodes and internal organs. This makes treatment more complicated. However, the American Academy of Dermatology (AAD) states that melanoma is highly treatable when detected early and treated properly.

Although melanoma can affect any part of the body, it spreads more quickly when it develops in the head or neck region. This is because these body parts have more blood vessels and lymph nodes than others, and cancerous cells travel extensively through the blood and lymph.

Learn more about melanoma here.

Squamous cell cancer

Doctors often refer to this type of skin cancer as “nonmelanoma cancer.” Squamous cell cancer (SCC) develops in the squamous cells, which are present throughout the body. Their main role is to protect the tissues that lie underneath them.

People with lighter skin tones are more likely to develop this type of skin cancer than People of Color. In People of Color, SCC tends to develop in areas that receive little sun exposure, such as the mouth, genitals, and anus.

SCC symptoms include:

  • a rough, scaly patch on the scalp that may be discolored
  • an open sore, often with a raised border
  • a brown spot that looks like an age spot
  • a firm, dome-shaped growth
  • a wart-like growth
  • a hard, conical projection growing from the skin
  • a sore developing on an existing scar

SCC can be aggressive and spreads quickly. It can be asymptotic or have minor symptoms.

People with this type of skin cancer may require extensive surgery or other interventions if the cancer grows to include the nerves.

Learn more about SCC.

Basal cell cancer

This type of cancer develops in the lower part of the epidermis, known as the basal cell layer. About 8 out of 10 skin cancers are basal cell carcinomas (BCC), making it the most common type of skin cancer.

Unlike melanomas and SCC, BCC grows slowly and rarely spreads to other parts of the body. However, if a person does not receive treatment, this cancer may grow into nearby areas of the body, such as the bone and other tissues beneath the skin.

People with BCC may develop the same type of cancer again even after treatment. If a healthcare professional does not remove BCC completely, it may come back in the same place on the skin. People who have had BCC are also more likely to develop this cancer in other areas of the body.

Learn more about carcinoma here.

It is important to regularly examine the skin and scalp to check for signs of cancer. Some early signs and symptoms include:

  • a new or changing growth, bump, or spot on the skin
  • a sore that bleeds and takes a long time to heal
  • rough and scaly patches that may crust, bleed, or be discolored
  • a wart-like growth
  • a mole that changes in appearance or has an odd shape or irregular border

For melanoma, the AAD recommends using the ABCDE method to look for early symptoms that moles may be cancerous, such as:

  • Asymmetry: Two halves of the same mole do not match each other.
  • Border irregularity: The mole edges appear ragged, notched, or blurred.
  • Color: The mole has different shades that vary from one area to another.
  • Diameter: The mole is larger than 6 millimeters in diameter.
  • Evolving: The mole or skin lesion looks different from others on the skin and appears to be changing in size, shape, or color.

Learn more about skin cancer symptoms here.

In most cases, skin cancer on the scalp develops from sun exposure. People can also develop cancer from frequent exposure to tanning beds or radiation treatment to the head and neck area.

People who have undergone transplant surgeries and those taking immunosuppressive medicines have an increased risk of developing skin cancer.

According to the National Cancer Institute, people are also at a higher risk of skin cancer if they experience exposure to arsenic or have skin inflammation that lasts for long periods.

Disparities in mortality risk

People of Color have a lower likelihood of developing skin cancers but are more likely to die from them compared with white people. According to a 2017 article, Hispanic, American Indian, and Black people in the U.S. have a two- to threefold higher risk of mortality from malignant melanoma compared with white people.

There is a higher incidence of malignant melanoma appearing under nail beds and on areas of skin not exposed to the sun among People of Color.

People of Color also have a disproportionately higher risk of morbidity and complications from SCC. The article suggests these differences may relate to delays in diagnosis.

Generally, healthcare professionals such as dermatologists diagnose skin cancer on the scalp through a physical exam and a biopsy. They may recommend additional tests to determine the cancer stage.

There are four main types of skin biopsy:

  • a shave biopsy, which involves shaving off the growth
  • a punch biopsy, which involves using a special tool to remove a circular sample from the growth
  • an incisional biopsy, which involves using a scalpel to remove a portion of the growth
  • an excisional biopsy, which involves using a scalpel to remove all of the growth

Sometimes, such as in the case of melanoma, a regular biopsy may not be enough to determine the stage of cancer. In such cases, healthcare professionals may conduct a sentinel node biopsy, a surgical procedure that checks for cancer spreading to the lymph nodes.

Depending on the type and extent of cancer, treatment may involve one or a combination of treatments, including:

Reconstructive surgery may sometimes be necessary for skin cancers on the scalp. This is especially true in the case of advanced cancers.

Although it is not possible to fully prevent most skin cancers, people can reduce their risk through a few lifestyle changes. These include:

  • staying in the shade, especially between 10 a.m. and 2 p.m. when the sun’s rays are at their hottest
  • wearing sun-protective clothing such as hats, long-sleeved shirts, and sunglasses with UV protection
  • using sunscreen with an SPF of 30 or higher, reapplying every two hours or after swimming and sweating
  • avoiding tanning beds
  • performing regular self-exams for cancer

Skin cancer is common and affects millions of people globally. The signs and symptoms may resemble other conditions, so it is important to perform self-examinations regularly and consult a specialist if a person has a concerning growth.

Treatment may include surgery, chemotherapy, radiation therapy, and other methods. Doctors may combine multiple treatments if necessary.