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Treatment may differ for melanoma on the head or neck

When melanoma, the most serious skin cancer, develops on the head or neck, it can behave differently than on other parts of the body. As a result, you may:

  • Have more aggressive treatment

  • Require frequent follow-up appointments

Why melanoma can behave differently on the head or neck

The anatomy of the head and neck is complex. In these areas, we have more blood vessels and many lymph nodes. Because melanoma cells can spread through the blood and lymph, it may be easier for melanoma to spread when this cancer begins in the head, neck, or scalp.

For this reason, treatment tends to be more aggressive. Your treatment plan may include:

Surgery to remove the cancer: Treatment for melanoma that begins anywhere on the body usually starts with surgery to remove the melanoma. If you have an early melanoma, your dermatologist can often perform this surgery in the office. This may be the only treatment you need.

If the cancer has grown deep, you may be referred a specialized melanoma center for surgery. This surgery is often performed in an operating room. During surgery, your surgeon may also remove lymph nodes nearest the melanoma. Removing the closest lymph nodes helps to find out if the cancer has spread.

Adjuvant treatment: Because it may be easier for melanoma in the head or neck to spread, patients often receive another treatment after surgery. Called adjuvant therapy, this treatment helps to reduce the risk of the cancer returning.

Radiation therapy or interferon may be given as adjuvant therapy. Some patients join a research study and receive medication.

Melanoma can behave differently on the head or neck

Melanoma can develop anywhere on your body, including your face, ears, or scalp.

Woman dermatologist examining a patient's face for melanoma

Realize that reconstructive surgery may be necessary

After cancer surgery on the head or neck, reconstructive surgery is sometimes necessary. Your surgeon may perform the reconstructive surgery immediately after removing the cancer.

You’ll have to wait for reconstructive surgery if you:

  • Have advanced cancer

  • Need to see a different surgeon for reconstructive surgery

If the cancer is advanced, you’ll need to wait for reconstructive surgery because your surgeon will want to know if you need more cancer surgery. To find out, the tissue that your surgeon removed during surgery will be examined under a microscope. You may also need medical testing. It can take a few days to get the results.

Plan for close follow-up

Because melanoma on the head or neck can be aggressive, it’s important to keep all of your follow-up appointments.

During these appointments, you will have a thorough cancer check-up. You may also have testing, such as a MRI or another type of scan and blood tests. Keeping all of your follow-up appointments allows your doctors to find melanoma as soon as possible. The earlier the cancer is found, the better your outcome.

Protect your skin from the sun

Anyone who has had melanoma has a higher risk of getting another skin cancer, including melanoma.

Research shows that people who have had melanoma can decrease their risk of getting another skin cancer by protecting their skin from the sun. Despite this finding, studies have found that many people who have been treated for melanoma don’t protect their skin from the sun.

You can reduce your risk of getting melanoma or another skin cancer by:

  • Wearing sun-protective clothes, such as a long-sleeved shirt, pants, and a wide-brimmed hat, along with UV-protective sunglasses.

  • Staying in the shade while outdoors.

  • Planning outdoor activities so that you avoid being outdoors between 10:00 a.m. and 2:00 p.m., when the sun’s rays are the strongest.

  • Applying a broad-spectrum sunscreen with SPF 30 or higher to all skin that clothing won’t cover, even when it’s cloudy or cold outside.

  • Using sunscreen every day, even when you’ll be outside for a short time, such as when you go to work or run errands.

  • Avoiding tanning, both indoors and outside.

See a board-certified dermatologist

Teaming up with a board-certified dermatologist will help you get the treatment you need. Your dermatologist will give you full-body skin exams, which can help find skin cancer as early as possible.

When necessary, your dermatologist will coordinate with other specialists to help you get comprehensive care.

Find a board-certified dermatologist

Getty Images

Hasney C, Butcher RB II, et al. “Malignant melanoma of the head and neck: A brief review of pathophysiology, current staging, and management.” Ochsner J. 2008; 8(4): 181–5.

Nahar VK, Ford A, et al. “Skin cancer prevention practices among malignant melanoma survivors: A systematic review.” J Cancer Res Clin Oncol. 2016; 142(6):1273-83.

Terakedis BE, Anker CJ, et al. “Patterns of failure and predictors of outcome in cutaneous malignant melanoma of the scalp.” J Am Acad Dermatol. 2014; 70(3):435-42.

Zenga J, Nussenbaum B, et al. “Management controversies in head and neck melanoma: A systematic review.” JAMA Facial Plast Surg. 2017;19(1):53-62.

Ferrucci LM, Cartmel B, et al. “Cross-sectional assessment of ultraviolet radiation-related behaviors among young people after a diagnosis of melanoma or basal cell carcinoma.” J Am Acad Dermatol. Published online: December 29, 2017 (doi: 10.1016/j.jaad.2017.12.056.)