Siavash Siv Eftekhari, M.D., DMD


Scalp Cancer: Signs, Symptoms, and Treatment

Scalp Cancer: Signs, Symptoms, and Treatment

Scalp cancer can be a frightening prospect, even if you aren’t sure that’s what you or someone you know could be showing the signs of.

In this guide, you will learn more about what it looks like, what the general symptoms are, and how doctors currently treat this condition.

What Is Scalp Cancer?

Scalp cancer and scalp cancer symptoms do not exist as a formal medical diagnosis.

Rather, this term generally refers to skin cancer on the scalp, and there are three distinct, common types of cancer this could be.

These include:

  • Squamous Cell Carcinoma: Squamous cells are essentially the inner lining of the skin. These sit below the dead outer surface and act as a protective barrier for deeper cells.
  • Basal Cell Carcinoma: Basal cells sit directly beneath squamous cells. These produce new skin cells.
  • Melanoma: Melanoma on the scalp is caused by problems with the melanocytes, which produce the pigment for your skin.

There are also other, rarer types of skin cancer, including Kaposi sarcoma (in the skin’s blood vessels), Merkel cell carcinoma (which creates firm nodules), and sebaceous gland carcinoma (which occurs in the oil glands, generally on the eyelids).

Skin cancers are often visually distinct, so when attempting to identify them, it’s essential to understand all of the possibilities. Only a doctor can tell you if something is skin cancer or another condition that is visually similar, but not scalp cancer symptoms.

What Are The Signs Of Skin Cancer On The Scalp?

There are many possible signs of skin cancer on the scalp.

These include, but are not limited to:

  • Pearl-colored or waxy bumps
  • Flat, fleshy or brown-hued lesions, similar to scars
  • Sores that continue to heal and return
  • Firm, reddish nodules
  • Brown spots with dark speckles
  • Moles that change in feel, size, and color, or that are bleeding
  • Lesions that feel itchy, burning, or otherwise painful

Most signs of skin cancer on scalp areas include some discoloration, but this is not a universal sign. In particular, lesions can be flesh-colored, though this is relatively rare. Some occupations, ancestries, and foods can increase your risk of cancer.

The risks of developing specific types of skin cancer change with age. Among younger people, melanoma on scalp areas is the most common, especially between the ages of 25 and 29. In older people, squamous and basal cell skin cancers on the head are more common.

Skin cancer is not the only possible cause of changes on the scalp.

Here are some other common conditions that people often mistake for skin cancer:

  • Psoriasis (red, scaly patches of itchy skin)
  • Freckles (darker spots that typically appear after exposure to UV light)
  • Skin tags (simple growth of skin; harmless)
  • Hemangioma (small growths of blood vessels; normally red, but occasionally rupture and turn darker)
  • Dermatofibroma (small, firm bumps that occasionally change color)

To the untrained eye, it can be hard to distinguish some of these from genuine scalp cancer symptoms and scalp cancer treatment. At the risk of repeating ourselves, only a trained doctor can determine whether or not someone has skin cancer on the head.

Can skin cancer on the scalp spread to the brain?

Yes. If left untreated, skin cancer on the scalp can spread from your scalp to other areas of your body, including your brain.

This is known as metastatic cancer or, in some areas, stage IV cancer. Spreading to the brain is a relatively common form of metastatic skin cancer, especially with melanoma, which is part of why early treatment is essential.

Can you die from skin cancer on your head?

Yes. You can (and probably will) die from untreated skin cancer on your head.

However, do not panic yet. Most skin cancer on the head or skin cancer on the scalp is highly treatable, especially during the early stages.

If you are still in the earliest stages of treatment, such as for Stage I melanoma, there is a low risk of metastasis or recurrence.

According to Healthline and other sources, the five-year survival rate for the earliest stages of melanoma on the scalp (assuming scalp cancer treatment at that stage) is as high as 97%.

How do you treat skin cancer on the scalp?

The methods for treating skin cancer on the scalp vary depending on the type of cancer. The earlier it is, the better.

The most common form of treatment for basal cell and squamous cell cancers, as well as some types of melanoma, is minor surgery to cut out the cancerous portion of skin. NextGen OMS offers comprehensive head and neck surgery options, which are ideal for removing many types of early-stage skin cancer on the head.

This is why the five-year survival rate for many types of skin cancer is so high when they’re treated early. When it reoccurs, it’s usually because it went through metastasis before removal, in which case you’ll need further treatment.

If surgery is not available as an option, your doctor may suggest radiation therapy instead. This isn’t used very often on the scalp because surgery is almost always possible for skin cancer on head and scalp areas, but doctors occasionally use it for skin cancer on nearby regions like the nose and ears.

Are There Any Other Types Of Treatment?

Yes. There are three other relatively common types of treatment for scalp cancers.

These are usually not the preferred treatments because surgery to remove the cancerous area genuinely is the best option in most cases, but if your cancer develops further, you may need more aggressive treatment.


Immunotherapy is a treatment that focuses on stimulating the immune system in the hope that it can destroy cancerous cells on its own. This is an effective treatment for some people, so doctors often prefer to try it before suggesting chemotherapy.

The most common types of immunotherapy involve drugs that target PD-1 proteins. These proteins are located on T cells and help prevent them from attacking the other cells in your body. By removing these, T cells become more aggressive and often start shrinking tumors.

Other drugs may target CTLA-4 proteins or interleukin proteins, although these aren’t as popular as targeting PD-1. Alternatively, doctors may suggest oncolytic virus therapy, which involves creating viruses that primarily attack cancer cells and alert the immune system to focus on the region.

Doctors often give drugs of these types as injections over the course of several months.

For extremely mild cases (Stage 0 melanoma, which is a kind of pre-cancerous state), doctors may use a special cream that stimulates local immune system responses. This is particularly popular when surgery might be disfiguring and is not yet required. These creams are usually applied several times a week for several months.

Except for the creams, doctors only prefer immunotherapy for more serious stages of scalp cancer. The main reason for this is that many of the treatments have additional effects as your body’s immune system reacts.

Negative effects can include itching, rashes, diarrhea, fatigue, chills, fevers, and low blood cell counts. Doctors only give some types of immunotherapy in hospitals due to the need to monitor for these additional effects.

Targeted Therapy Drugs

Targeted therapy drugs are an alternative to regular chemotherapy.

Melanoma cells, in particular, have some aspects that make them different from regular cells. By targeting these specific gene changes, these drugs can reduce their impact on the rest of your body while improving success rates against the cancer itself.

Approximately half of all melanomas have changes to what’s known as the BRAF gene.

When this is altered, it helps cancer grow faster, but it also stands out as a target for attack. Doctors can determine if the melanoma has this trait through a simple biopsy.

A smaller percent of melanomas have changes in the C-KIT gene area. This is most common in areas that get chronic sun exposure, which can include the scalp. This is particularly true for partially or wholly bald individuals, where the scalp may get more sun exposure than anywhere else on the body.

If you have any changes in your skin cancer that make the cells stand out, you could be a candidate for targeted drugs. This includes participating in clinical trials, which offer the possibility of new treatments.

If your doctor is considering immunotherapy treatment, be sure to ask them if you are a good fit for any clinical trials.


Chemotherapy is seldom the first treatment option for scalp cancers.

Immunotherapy and targeted drugs are typically more effective than generic chemotherapy, and what’s more, skin cancers tend to resist chemotherapy. The reason for this is that many parts of the skin are a bit isolated from the rest of the body, so it’s hard for chemotherapy to reach it and work.

Most doctors use chemotherapy in cycles, giving the body time to recover between each treatment. The common goal is to provide enough chemotherapy to damage and shrink cancer, let the body rest, and then give the next treatment before cancer can return to its previous size.

Important Note About Side Effects

If you experience any side effects from your scalp cancer treatments or changes to side effects, tell your doctor immediately.

They need to have this information in case those side effects impact treatment or need additional care. Do not hold back any information, no matter how small or unimportant you think it is.

Contact NextGen OMS

If you think you or someone you know could be showing the signs of skin cancer, do not wait to watch it develop.

Contact NextGen today at (817) 349-9122 and schedule an appointment with a specialist who can give you the answers and, if needed, the treatment you deserve.