When you do a self-skin check, do you include your scalp? If you are bald, you probably do. If not, the scalp is often a forgotten area. But skin cancer can, and does, develop on the scalp. The majority of cancers found on the head and neck are either basal cell carcinoma or squamous cell carcinoma.
Even though melanoma is not as common on the neck or scalp, these cancers do account for 10 percent of all melanoma deaths.
This might be because these cancers are hidden under your hair. By the time the cancer is discovered, it can develop into stage 3 or stage 4 melanoma. A study completed at the University of North Carolina in 2008 found that people with neck or scalp melanoma die at twice the rate of people with melanoma on other parts of their body [Archives of Dermatology, 2008; 144(4):515-521] The study also found:
- Those with scalp cancer were an average of 59 years old, compared to 55 years old for other types of melanoma
- Men are more likely than women to develop skin cancer on the scalp or neck
- Scalp and neck melanomas are thicker than melanoma on other parts of the body
- The lymph nodes are more likely to be involved than in melanomas on other parts of the body
As with all skin cancers, early detection and treatment is important. It is possible that the high rate of death from cancers on the scalp are simply because they were not detected early. There are ways you can protect yourself:
Wear a Hat
Many people believe that the scalp doesn't need protection from the sun (unless you are bald); they believe that their hair acts as a barrier to the sun's rays. While dark, thick hair does offer more protection than fine, light hair, the sun can still penetrate to the scalp. That€™s why wearing a hat whenever you are outside is so important. The hat should have a wide brim, wide enough to protect your ears.
Talk to Your Barber or Hairdresser
One dermatologist, Neil Fenske, at the University of South Florida, hopes that hairdressers and barbers can help with early identification.  He understands they are not dermatologists but they are in a unique position to notice spots or lesions on the scalp. Many people see the same barber or hairdresser on a regular basis, often every four to six weeks, giving them the chance to notice changes. Any new moles, lesions or spots, or any that begin to change, can be pointed out immediately. You can ask your hairdresser or barber to let you know immediately if they notice anything.
Include Your Scalp in Your Skin Self-Check
You can check your own scalp, however, it is much easier to partner up with someone. Use a hairdryer and a comb and make parts in your hair, a little at a time, starting at one ear and working your way to the other ear. Use a mirror to check the back (this is where having a second person is most helpful as it is difficult to see the back of your head even while using a mirror).
Make Sure Your Dermatologist Checks Your Scalp
It is recommended that everyone have a skin check by a dermatologist on a regular basis. Make sure your dermatologist includes your scalp during these checks. Because skin cancer on the scalp is not as prevalent, some dermatologists forget to include this area in annual skin checks. If your dermatologist doesn't include your scalp, speak up.
 "Skin cancer Can Develop in Unexpected Places," Date Unknown, Irene Maher, University of South Florida News Channel 8
"Skin Cancer of the Head and Neck," 2010, Yn-Hsuan Ouyang, Seminars in Plastic Surgery, v.24(2)