What should you know about melanoma on the scalp?

Melanoma is a cancer of pigment-producing cells. On the scalp it may appear as a new dark spot, a mole that changes in colour or outline, or a lesion with several shades. It can also itch, crust, bleed, become tender, or grow. A suspicious scalp mark is not automatically melanoma; examination and testing are needed to tell the difference.

A clinician may inspect the scalp with magnification and feel nearby lymph nodes. If the appearance is concerning, a biopsy removes tissue for laboratory diagnosis. The result helps determine whether melanoma is present and how deeply it extends.

Arrange a skin examination promptly, especially if someone who can see the scalp has noticed a recent change. Do not pick a crust, shave over the area repeatedly, or apply a strong treatment before it is assessed. Take a clear photograph with a date if this can be done without delaying care, and mention any previous skin cancer or changing moles.

If melanoma is confirmed, treatment commonly starts with surgical excision that includes a margin of surrounding skin. Further planning may involve skin cancer surgery, tumour removal surgery, or a sentinel lymph node biopsy. More advanced disease may lead to discussion of immunotherapy.

Book an urgent dermatology or medical appointment for a scalp spot that is new, changing, asymmetrical, repeatedly crusting, or bleeding. Seek prompt care if bleeding does not settle with gentle pressure, or if there is a rapidly enlarging lump, spreading redness, marked pain, or a new swollen node in the neck.

Ask whether the lesion needs a biopsy, what type of biopsy is suitable for its scalp location, and how the result will guide treatment. You can also ask whether nearby lymph nodes need assessment, how to protect the wound under hair, and what follow-up schedule is appropriate.