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Scalp Melanoma

Scalp Melanoma

Have You Seen the Recent Story About a Hairstylist Who Saved Her Client's Life?

Kari Phillips, a hairdresser in Ohio, noticed a mole on Eileen Korey's scalp that developed between regular coloring visits. She advised Eileen, a former health news reporter, to see a dermatologist. Early melanoma was diagnosed and Kari saved Eileen's life! Melanoma can develop, or become visible, quickly. In my 30 years of practicing dermatology, I’ve seen this repeatedly. I've also heard of hairstylists saving the day like this. In detecting scalp cancers, hairstylists are often more savvy than healthcare providers in referring people into the office.

How Common is Scalp Melanoma?

Melanoma on the scalp is not common but scalp melanoma is extremely deadly if not caught early. It is difficult for anyone to see their own scalp so the cancers can go undetected – which is where stylists have an unique opportunity. The sun's UV rays play a big part in causing melanoma. Your scalp is exposed to the sun from the first day of your life. Depending on your hair and hairstyle, sun exposure can vary.
  • Exposure may just be at the crown or vertex where your hair whorl is.
  • Part lines that run from hair whorl to forehead are also at risk for people who have natural or defined parts.
  • If you have significant hair thinning then UV exposure may be more extensive.
Most people have experienced sunburn on their scalp at least once. As hair thins with age, it starts at the top. The sun's exposure above is relentless. Intermittent sun exposure versus long term/chronic sun exposure generally influences the risk of getting melanoma. We also know the more moles a person has, the greater their melanoma risk. UV exposure and scalp melanoma means hats are important. But many people balk at the idea of wearing hats. “I’m not a hat person” and “I don’t want hat hair” are common reasons I hear for resisting to wear a proper sun hat when outdoors. My answer is, "Good news, you can use a sun umbrella!" Real sun umbrellas are perfect for times when you will be in the sun but won’t wear a hat. You will still need sunscreen on your scalp though (see below)!

Reduce Your Risk of Scalp Melanoma

Do monthly skin exams that include your scalp. These exams are important for early detection of skin cancer. Doing self exams is easy because you don’t need a special instrument. You may need a partner though. Learn how to detect melanoma. For a scalp exam, a mirror is handy. The goal is to see the entire scalp. Long hair can be parted across all areas of the scalp and examined. Short hair can be moved about by a blow dryer.
What’s the Best Way to Protect Your Scalp from the Sun?
Wear a proper sun hat.
  • That means one with a top that blocks UV rays because it’s made with material that is UPF 50 or greater.
  • You want a full 3 to 5 inch brim to protect the sides of the scalp, face, ears, and upper neck.
When you can’t (won’t) wear a hat, apply sunscreen to the top of your scalp. You will need a thin product and my Sheer Strength Mineral Sunscreen is the best product for this area of the body. Please learn to love sun hats though. I have to admit it took me years but now I’m hooked. I had to try a lot of hats before finding ones that were comfortable, functional, and looked great! You have to check out my favorite sun hat. I have a range of fun colors on my closet shelf. I also give them as gifts! They are economical and will save the lives of your loved ones.
Treating Scalp Melanoma
Melanoma is treated by surgical excision. This is tough on the scalp because the skin does not stretch to close easily. Treatment beyond excision is customized depending on many characteristics such as how the cells look under the microscope, and if the melanoma has spread to the lymph nodes or other parts of the body. Advanced melanoma that has spread was once considered incurable. But now there are state-of-the-art immune therapies that are saving lives. Still, catching melanoma when it is still thin is key. Thickness of the melanoma is not necessarily related to how long the cancer has been present. But the longer it lays in hiding, the greater chance of it spreading. Your hairstylist is that one person in your life who sees the top of your head regularly. When they use a blow dryer, they are able to examine all your scalp as your hair blows around. In my career, I have seen hairstylists save clients' lives all the time. Well done Kari Phillips! References: R. Shashanka , Head and Neck Melanoma, ISRN Surg. 2012; 2012: 948302, Published online 2012 Mar 26. doi:  10.5402/2012/948302 Esther Erdei, A new understanding in the epidemiology of melanoma, Expert Rev Anticancer Ther. 2010 Nov; 10(11): 1811–1823. Lachiewicz AM, Survival differences between patients with scalp or neck melanoma and those with melanoma of other sites in the Surveillance, Epidemiology, and End Results (SEER) program,  Arch Dermatol. 2008 Apr;144(4):515-21. doi: 10.1001/archderm.144.4.515.