Skin cancer is the most common type of cancer and can develop anywhere on your skin. It’s most common in areas often exposed to the sun, including your scalp.

Approximately 13 percent of skin cancers are on the scalp.

Often referred to as the largest organ in your body, your skin — including the scalp — can be harmed by exposure to the sun’s UV rays, as well as pollutants and chemicals.

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.

Skin cancer on the scalp is more common in males. This may be because males are historically less likely to use preventative habits like putting on sunscreen or wearing a hat.

There are several different types of of skin cancer. The three most common are basal cell carcinoma, squamous cell carcinoma, and melanoma. All of these can develop on your scalp.

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

One of the deadliest forms of skin cancer, melanoma often develops in a mole or other skin growth. It can happen in a new mole, or a mole that you’ve had for years. 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 or “pearly” bump on your skin, often with fine pink or red lines visible on the surface
  • a flat lesion on your skin
  • a sore that won’t heal, or keeps healing and then coming back
  • a scaly patch that’s pink or red and may have fine pink or red lines visible in it
  • a scar-like patch on your skin

Squamous cell carcinoma

  • an open sore on your skin
  • a firm, red bump that grows rapidly and typically has a sore or indented spot in the middle of the bump that’s tender when touched
  • a thick, scaly, crusted, or “warty” patch on your skin

Melanoma

  • a large brown spot on your skin that may look like a mole
  • a mole that changes size, color, itches, 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.
    • Evolving: Have you noticed changes in the mole over time, such as size, shape, or color?

The most common type of melanoma found on the scalp may look:

  • blotchy with uneven borders
  • flat to the skin, or slightly raised
  • blue, black, tan, brown, or dark brown

Other types of melanoma look different. For example, some melanomas that can happen on your scalp may appear clear or pink. Any time you notice a new spot or changing mole, take note. And if you have concerns, be sure to see your doctor to get it checked.

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.
  • Apply sunscreen on exposed areas of 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.

Checking your scalp 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. Some pre-cancerous spots may feel like rougher or thicker patches of skin. They may be tender if picked at.

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 likely ask you about previous skin issues and your family history of cancer. They will also ask about your habits, such as:

  • how much time you spend in the sun
  • how many sunburns you have had in your life
  • if you use protection in the sun, such as sunscreen and protective clothing
  • 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 may completely remove a small cancerous growth, especially basal cell carcinoma. But this isn’t the main purpose of the test.

If a cancer other than basal cell carcinoma is found, your doctor might recommend more testing to see if it has spread. If the spot is melanoma, your doctor may request imaging tests of lymph nodes in your head and neck depending on the depth of the melanoma.

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: If the size of the skin cancer is large, this may be used as a first treatment. It can also be used after surgery, to destroy 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. Traditional chemotherapy is not typically used for skin cnacer.
  • Freezing: This is typically 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 destroy the cells.
  • Immunotherapy: This type of treatment helps your immune system recognize and eliminate cancer cells. It’s usually used to treat melanoma.
  • Curettage and electrodessication: This involves scraping away the spot with a special tool and then applying an electric signal to destroy any remaining cancer cells. But if you have thick hair growing in the area that’s being treated, your doctor may suggest a different approach.

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 5%-23 % depending on how big the carcinoma was.

Squamous cell carcinoma

Squamous cell cancer is generally very treatable and curable when found early, as well. In people who are immunosuppressed, it can sometimes be more problematic and more likely to spread. It can also be serious if it’s not caught early.

The overall five-year recurrence rate for squamous cell carcinoma is around 3%-8%, according to a Dutch study from 2019. Cancers treated with Mohs surgery had a lower recurrence rate than those treated with standard removal surgery (excision). Mors surgery is typically used when this type of cancer appears on your head or neck.

Melanoma

Melanoma is a more serious form of skin cancer, but early detection can still improve the outcomes.

Melanoma on the scalp appears to have a worse prognosis than other types of melanoma. This may be because scalp melanomas are typically more aggressive and more likely to be diagnosed at a later stage.

In a small 2017 study, the median survival time from diagnosis for melanoma on the scalp wass 15.6 months, versus 25.6 months for other melanomas. The five-year recurrence-free survival rate for melanoma on the scalp was 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.