Skin cancer is the most common type of cancer and can develop anywhere on your skin. It’s most common on areas often exposed to the sun, and your scalp is one of those. Approximately 13 percent of skin cancers are on the scalp.

Skin cancer can be hard to spot on your scalp, but don’t forget to check your head as you check the rest of your body for growths. And if you spend a lot of time outdoors, you should check your scalp and the rest of your body regularly.

There are three types of skin cancer, all of which can develop on your scalp. All types of skin cancer on the scalp are more common in males.

Basal cell carcinoma

The most common type of skin cancer, basal cell carcinoma is more common on the head and neck than on other body parts. According to a 2018 review of studies, basal cell carcinomas on the scalp account for between 2 and 18 percent of all basal cell carcinomas.

Squamous cell carcinoma

Squamous cell carcinoma is the second most common type of skin cancer. It’s more common in people with fair skin and on areas of skin heavily exposed to the sun, including the scalp. Squamous cell carcinomas on the scalp account for between 3 and 8 percent of all squamous cell carcinomas.

Melanoma

The deadliest and rarest form of skin cancer, melanoma often develops in a mole or other skin growth. Scalp melanomas account for approximately 3 to 5 percent of all melanomas.

Symptoms of skin cancer on your scalp depend on the type of skin cancer.

Basal cell carcinoma

Symptoms include:

  • a flesh-colored, waxy bump on your skin
  • a flat lesion on your skin
  • a sore that keeps healing and then coming back

Squamous cell carcinoma

  • a firm, red bump on your skin
  • a scaly or crusted patch on your skin

Melanoma

  • a large brown spot on your skin that may look like a mole
  • a mole that changes size, color, or bleeds
  • Remember “ABCDE“:
    • Asymmetry: Are two sides of your mole different?
    • Border: Is the border irregular or jagged?
    • Color: Is the mole one color or varied throughout? A melanoma may be black, tan, brown, white, red, blue, or a combination of any.
    • Diameter: Is the mole over 6mm? This is common for a melanoma, but they can be smaller.

The main cause of all types of skin cancer is sun exposure. Your scalp is one of your body parts exposed most to the sun, especially if you are bald or have thin hair. That means it’s one of the more common spots for skin cancer.

Other potential causes of skin cancer on your scalp include using a tanning bed and having had radiation treatment on your head or neck area.

The best way to prevent skin cancer on your scalp is to protect your scalp when you go into the sun:

  • Wear a hat or other head covering whenever possible.
  • Spray sunscreen on your scalp.

Other ways to help prevent skin cancer on your scalp are:

  • Avoid using tanning beds.
  • Limit your time in the sun.
  • Check your scalp regularly to spot any potential cancerous spots early. This can help stop precancerous lesions from turning into cancer or stop skin cancer from spreading. You can use a mirror to look at the back and top of your scalp more thoroughly.

You might go to your doctor if you notice a suspicious spot on your scalp, or a doctor might notice it during a skin check. No matter how the spot is found, skin cancer diagnosis will happen roughly the same way.

First, your doctor will ask you about your family history of cancer, if you spend a lot of time in the sun, use protection in the sun, and if you use tanning beds. If you noticed the lesion, your doctor may ask if you’ve noticed any changes over time or if it’s a new growth.

Then your doctor will do a skin exam to look more closely at the lesion and determine if you need further testing. They’ll look at its size, color, shape, and other features.

If your doctor thinks it might be skin cancer on your scalp, they’ll take a biopsy, or small sample, of the growth for testing. This testing can tell your doctor if you have cancer, and if you do, what type. A biopsy might be enough to completely remove a small cancerous growth, especially basal cell carcinoma.

If the spot is cancerous but not basal cell carcinoma, your doctor might recommend more testing to see if it has spread. This will usually include imaging tests of lymph nodes in your head and neck.

Potential treatments for skin cancer on your scalp include:

  • Surgery. Your doctor will remove the cancerous growth and some of the skin around it, to make sure that they removed all the cancer cells. This is usually the first treatment for melanoma. After surgery, you may also need reconstructive surgery, such as a skin graft.
  • Mohs surgery. This type of surgery is used for large, recurring, or hard-to-treat skin cancer. It’s used to save as much skin as possible. In Mohs surgery, your doctor will remove the growth layer by layer, examining each one under a microscope, until there are no cancer cells left.
  • Radiation. This may be used as a first treatment or after surgery, to kill remaining cancer cells.
  • Chemotherapy. If your skin cancer is only on the top layer of skin, you might be able to use a chemotherapy lotion to treat it. If your cancer has spread, you might need traditional chemotherapy.
  • Freezing. Used for cancer that doesn’t go deep into your skin.
  • Photodynamic therapy. You’ll take medications that will make cancer cells sensitive to light. Then your doctor will use lasers to kill the cells.

The outlook for skin cancer on your scalp depends on the specific type of skin cancer:

Basal cell carcinoma

In general, basal cell carcinoma is very treatable – and often curable – if caught early. However, basal carcinoma on the scalp is often harder to treat than other basal cell carcinomas. They are also more likely to recur after being treated.

The five-year recurrence rate for scalp basal cell carcinomas treated with curettage and electrodesiccation – one of the most commonly used treatments – is approximately five to 23 percent depending on how big the carcinoma was.

Squamous cell carcinoma

The overall five-year survival rate for squamous cell carcinoma on the scalp is 59 percent. The five-year progression-free survival rate, in which the cancer doesn’t spread, is 51 percent.

Approximately 11 percent have a local recurrence (on the scalp) and 7 percent have a regional recurrence (in nearby lymph nodes) within five years.

Melanoma

Melanoma on the scalp generally has a worse prognosis than other types of melanoma.

The median survival time from diagnosis for melanoma on the scalp is 15.6 months, versus 25.6 months for other melanomas. The five-year recurrence-free survival rate for melanoma on the scalp is 45 percent, versus 62.9 percent for other melanomas.

Skin cancer can happen on any part of your skin, including your scalp. It may be harder to see on your scalp, and often has a worse prognosis than other types of skin cancer, so it’s important to do as much as you can to prevent skin cancer on your scalp.

Avoid the sun as much as possible, and wear a hat or head covering when you do go out in the sun.