Dr. Kundlas
Most moles on the scalp are harmless, but because hair hides them, changes are easy to miss. Check your scalp once a month using the ABCDE signs below, and have a doctor look at any mole that is new, changing, bleeding or different from your other moles. Do not try to remove or treat a mole at home. A doctor can remove it safely and send it to a lab to make sure it is not skin cancer.
What a scalp mole is
A mole (nevus) is a cluster of pigment cells. On the scalp, moles can be flat or raised, tan, brown, pink or skin colored, and some have hair growing from them. Hair growing out of a mole is common and is not a sign of cancer by itself.
Most people have 10 to 40 moles on their body, and a few of them may be on the scalp. Moles that appear in childhood and stay the same for years are almost always benign.
Why scalp moles deserve a closer look
- They are hard to see, so changes can go unnoticed for a long time.
- The scalp gets a lot of sun, especially along the part and on thinning or bald areas.
- Melanoma on the scalp can be found later than melanoma in other places because hair hides it, so regular checks matter.
Other spots that can look like a mole
Not every dark or raised spot on the scalp is a mole. In adults over 50, these are common:
- Seborrheic keratoses: waxy, brown or black spots that look stuck on. They are harmless and very common with age.
- Cysts (pilar cysts): smooth, firm, skin colored lumps under the skin. They are usually harmless.
- Actinic keratoses: rough, scaly, pink patches on sun damaged skin, often on a bald scalp. These are precancerous and should be treated by a doctor.
- Basal cell and squamous cell skin cancers: a pearly bump, a sore that bleeds and does not heal, or a scaly, growing bump, most often on bald or thinning areas.
A doctor can usually tell these apart with a quick look and a magnifying light (dermoscope). Sometimes a small biopsy is needed.
The ABCDE signs of melanoma
Use these five signs when you check any mole:
- A for Asymmetry. One half does not match the other half.
- B for Border. The edge is ragged, notched or blurred.
- C for Color. The mole has more than one color or uneven shades of brown, black, red, white or blue.
- D for Diameter. It is larger than 6 millimeters, about the size of a pencil eraser. Melanomas can be smaller.
- E for Evolving. It is changing in size, shape, color or height, or it starts to itch, crust or bleed.
Two more warning signs:
- The “ugly duckling” sign. A mole that looks different from your other moles deserves a check.
- A new or changing mole after age 40. New moles are less common in older adults, so have it checked within a few weeks.
Some melanomas are pink or red instead of dark. Any spot that is growing or changing counts, whatever the color.
How to check your scalp
- Pick one day a month, for example the first of the month.
- Sit in a bright room with a handheld mirror and a wall mirror.
- Use a comb or a blow dryer on the cool setting to part your hair in rows about an inch apart, from front to back and side to side.
- Look at your part lines, your hairline, behind your ears and the back of your neck.
- Ask a spouse, family member, barber or hairstylist to look at the areas you cannot see. Barbers and hairstylists often notice scalp spots first.
- Take clear photos of any moles you want to track, with a coin or ruler next to them for size. Compare the photos each month.
When to get a skin check
Make an appointment if:
- A mole shows any of the ABCDE signs
- A mole looks different from your others
- You notice a new mole, especially after age 40 to 50
- A mole itches, hurts, crusts or bleeds without being scratched
- A sore on the scalp does not heal within about four weeks
- A mole keeps getting caught on your comb or brush and you want it removed
I would much rather look at a mole that turns out to be nothing than miss one that has changed.
You may need regular skin checks with a doctor if you have had melanoma or other skin cancer, have a parent, sibling or child with melanoma, have more than 50 moles or several unusual looking moles, had blistering sunburns or used tanning beds, have fair skin that burns easily, or have a weakened immune system. Ask your doctor how often you should have one.
Why you should not treat a mole at home
You may see creams, “mole removal” pens, apple cider vinegar, garlic, or tying off a mole with thread sold as home remedies. Please do not use them. They can burn the skin, cause infection and scarring, and leave part of the mole behind. The bigger problem is that they can destroy a melanoma without removing it for testing, which can delay the diagnosis.
If a mole needs to come off, a dermatologist can remove it with numbing medicine and send the tissue to a lab, so you know what it was. Picking or scratching a mole also causes bleeding and irritation, so leave it alone and get it checked if it bothers you.
Protecting your scalp from the sun
- Wear a wide brimmed hat outdoors. Baseball caps leave the ears and neck exposed.
- Put sunscreen with SPF 30 or higher on your part line and any thinning areas. Spray, gel or powder sunscreens are easier to use in hair.
- Try to stay in the shade between 10 a.m. and 4 p.m., when Florida sun is strongest.
- Avoid tanning beds.
CALL 911 OR GET HELP RIGHT AWAY IF:
- A mole or spot is bleeding heavily and does not stop after 15 minutes of firm, steady pressure, especially if you take a blood thinner
- You hit your head and have confusion, vomiting, severe headache, drowsiness or trouble walking
MAKE A PROMPT APPOINTMENT (WITHIN A FEW WEEKS) FOR ANY MOLE WITH THE ABCDE SIGNS:
- A: Asymmetry, one half unlike the other
- B: Border that is ragged or blurred
- C: Color that is uneven or has several shades
- D: Diameter larger than a pencil eraser
- E: Evolving, meaning it is changing, itching, crusting or bleeding
Frequently asked questions
Is a mole on the scalp normal?
Yes. Moles on the scalp are common and most are harmless. They are harder to see than other moles, so it helps to check your scalp once a month or ask someone to look.
Are moles on the head more dangerous?
Most are not. Melanoma on the scalp is less common than on the back, legs or arms, but it can be found later because hair hides it. That is why monthly checks and a doctor visit for any change matter.
Can I remove a mole on my scalp at home?
No. Home removal can cause burns, infection and scarring, and can hide a skin cancer. Your doctor can examine it and refer you to a dermatologist for a biopsy if needed.
What does a cancerous mole on the scalp look like?
Warning signs follow ABCDE: an uneven shape, a ragged border, more than one color, a size larger than a pencil eraser, or a mole that is changing. Bleeding, crusting or a sore that will not heal are also reasons to get checked.
Why does my scalp mole bleed when I comb my hair?
A raised mole can get scraped by a comb or brush. One small bleed after a scrape is usually not a worry, but a mole that bleeds without injury, keeps bleeding, or is changing should be checked.
Getting checked in Sebring or Lake Wales
I can look at a scalp mole and check the rest of your skin. Your doctor can examine it and refer you to a dermatologist for a biopsy if needed.
Shield Medical Group has two offices:
- Sebring: 4597 Casablanca Cir, Sebring FL 33870. Phone (863) 236-9550. Monday to Friday 8 a.m. to 5 p.m., Saturday 10 a.m. to 1 p.m.
- Lake Wales: 23607 US Highway 27 N, Lake Wales FL 33859. Monday to Friday 8 a.m. to 5 p.m.
You can book an appointment, and walk-ins are welcome for new and established patients. We accept many Medicare Advantage plans, so call to ask about yours.
Medical disclaimer
This article is for general education only and is not medical advice. It does not replace an exam by your own doctor. If you think you are having a medical emergency, call 911.
