What are the most common types of scalp tumors. How are scalp tumors diagnosed. What treatment options are available for scalp tumors. Are scalp tumors usually benign or malignant. Can scalp tumors be prevented.

Understanding Scalp Tumors: Types, Causes, and Prevalence

Scalp tumors are growths that develop on the skin covering the head, extending from the eyebrows to the back of the head. These tumors can be either benign (non-cancerous) or malignant (cancerous), with the vast majority being benign.

Research indicates that approximately 93-99% of scalp tumors are benign, while only 1-2% are malignant. However, it’s important to note that malignant scalp tumors account for about 13% of all malignant skin tumors, highlighting the need for vigilance in monitoring scalp health.

Common Types of Benign Scalp Tumors

• Cysts (40-50% of benign scalp tumors)
• Lipomas (approximately 30%)
• Melanocytic nevi (28%)
• Seborrheic keratoses
• Actinic keratoses

Most Prevalent Malignant Scalp Tumors

1. Basal cell carcinoma (approximately 41%)
2. Squamous cell carcinoma (about 17%)
3. Cutaneous metastases
4. Adnexal tumors
5. Angiosarcomas
6. Lymphomas

The causes of scalp tumors vary depending on the type and underlying tissue of origin. They can arise from cells in the epidermis, dermis, or deeper tissue layers. In some cases, scalp tumors may even be metastases from other parts of the body.

Clinical Features and Diagnosis of Scalp Tumors

Identifying scalp tumors can be challenging, as their appearance can vary significantly based on the type and origin of the growth. Healthcare professionals use a combination of visual examination, patient history, and diagnostic tests to accurately identify and classify scalp tumors.

Characteristics of Common Benign Scalp Tumors

Understanding the typical features of benign scalp tumors can help in early identification:

• Epidermoid cysts: Firm, flesh-colored or yellow papules/nodules, often with a central punctum
• Dermoid cysts: Firm, dough-like lumps composed of epidermal/dermal tissue components
• Seborrheic keratoses: Flat or raised lesions with a “stuck-on” appearance, varying in color and size
• Melanocytic nevi: Flat or raised localized proliferation of melanocytes
• Trichilemmal cysts: Keratin-filled nodules derived from the outer hair root sheath

How are scalp tumors diagnosed. Diagnosis typically involves a thorough physical examination, dermoscopy, and in some cases, biopsy for histopathological analysis. Advanced imaging techniques such as CT or MRI may be employed for deeper or more complex tumors.

Treatment Options for Scalp Tumors

The treatment approach for scalp tumors depends on various factors, including the type of tumor, its size, location, and whether it’s benign or malignant. Here are some common treatment options:

Surgical Excision

Surgical removal is often the primary treatment for both benign and malignant scalp tumors. The procedure involves removing the tumor along with a margin of healthy tissue to ensure complete eradication.

Cryotherapy

This technique uses extreme cold to destroy abnormal tissue and is particularly effective for small, superficial tumors like actinic keratoses or seborrheic keratoses.

Topical Treatments

For certain types of tumors, such as actinic keratoses or superficial basal cell carcinomas, topical medications like imiquimod or 5-fluorouracil may be prescribed.

Radiation Therapy

In cases where surgery is not feasible or for adjuvant treatment of aggressive malignant tumors, radiation therapy may be recommended.

Chemotherapy and Immunotherapy

For advanced or metastatic malignant tumors, systemic treatments like chemotherapy or immunotherapy may be necessary.

What factors influence the choice of treatment for scalp tumors. The decision depends on the tumor type, size, location, patient’s overall health, and potential for recurrence or metastasis.

Prevention and Risk Factors for Scalp Tumors

While not all scalp tumors can be prevented, understanding risk factors and taking preventive measures can significantly reduce the likelihood of developing certain types of tumors, particularly those related to sun exposure.

Key Risk Factors

• Prolonged sun exposure
• Fair skin
• Age (increased risk with advancing age)
• Personal or family history of skin cancer
• Weakened immune system
• Exposure to certain chemicals or radiation

Preventive Measures

Can scalp tumors be prevented. While complete prevention is not always possible, these steps can help reduce risk:

1. Sun protection: Use broad-spectrum sunscreen on exposed scalp areas, wear hats or use umbrellas
2. Regular self-examinations: Check your scalp regularly for any new or changing lesions
3. Professional skin checks: Schedule annual skin examinations with a dermatologist
4. Avoid tanning beds: These increase UV exposure and skin cancer risk
5. Maintain a healthy lifestyle: A balanced diet and regular exercise support overall health and immune function

By implementing these preventive strategies, individuals can significantly reduce their risk of developing certain types of scalp tumors, particularly those associated with UV exposure.

Complications and Prognosis of Scalp Tumors

The prognosis for scalp tumors varies widely depending on the type, stage, and treatment approach. Understanding potential complications and long-term outlook is crucial for patients and healthcare providers alike.

Potential Complications

• Infection: Open or ulcerated tumors may become infected, requiring antibiotic treatment
• Disfigurement: Large tumors or extensive surgical excisions may lead to cosmetic concerns
• Recurrence: Some tumors, particularly malignant ones, may recur even after treatment
• Metastasis: Malignant tumors have the potential to spread to other parts of the body
• Neurological symptoms: Tumors pressing on nerves or invading the skull may cause neurological issues

What factors influence the prognosis of scalp tumors. The prognosis depends on several factors, including:

1. Tumor type (benign vs. malignant)
2. Stage at diagnosis
3. Extent of spread (for malignant tumors)
4. Patient’s overall health and age
5. Response to treatment

Generally, benign scalp tumors have an excellent prognosis with proper treatment. For malignant tumors, early detection and appropriate treatment significantly improve outcomes. Regular follow-up care is essential for monitoring recurrence and managing any long-term effects of treatment.

Innovations in Scalp Tumor Research and Treatment

The field of scalp tumor research and treatment is continuously evolving, with new technologies and approaches emerging to improve diagnosis, treatment efficacy, and patient outcomes.

Advanced Diagnostic Techniques

Emerging diagnostic technologies are enhancing the accuracy and speed of scalp tumor identification:

• Confocal microscopy: Provides high-resolution imaging of skin lesions without the need for biopsy
• Artificial intelligence-assisted diagnosis: Machine learning algorithms are being developed to aid in the classification of skin lesions
• Genomic profiling: Helps in identifying genetic markers associated with certain tumor types, guiding personalized treatment approaches

Novel Treatment Approaches

What are some innovative treatments being developed for scalp tumors. Several promising approaches are under investigation or in early clinical use:

1. Targeted therapies: Drugs designed to target specific molecular pathways involved in tumor growth
2. Immunotherapy: Harnessing the body’s immune system to fight cancer cells
3. Photodynamic therapy: Using light-sensitive drugs and specific wavelengths of light to destroy tumor cells
4. Nanotechnology-based treatments: Developing nanoparticles to deliver drugs more effectively to tumor sites
5. 3D-printed prosthetics: Improving cosmetic outcomes for patients requiring extensive tumor removal

These advancements hold promise for improving treatment efficacy, reducing side effects, and enhancing quality of life for patients with scalp tumors.

Living with Scalp Tumors: Psychosocial Aspects and Support

The impact of scalp tumors extends beyond physical health, often affecting patients’ emotional well-being and quality of life. Understanding and addressing these psychosocial aspects is crucial for comprehensive patient care.

Emotional and Social Challenges

Patients with scalp tumors may face various emotional and social challenges, including:

• Anxiety and depression related to diagnosis and treatment
• Body image concerns, especially with visible or disfiguring tumors
• Fear of recurrence or progression
• Social isolation or withdrawal
• Impact on personal relationships and professional life

Coping Strategies and Support Systems

How can patients cope with the emotional impact of scalp tumors. Several strategies and support systems can help:

1. Professional counseling or psychotherapy
2. Support groups for individuals with similar experiences
3. Educational resources to better understand the condition and treatment options
4. Mind-body techniques such as meditation or yoga for stress reduction
5. Open communication with healthcare providers about concerns and quality of life issues

Healthcare providers play a crucial role in addressing these psychosocial aspects, ensuring that patients receive holistic care that addresses both their physical and emotional needs. By integrating psychosocial support into the treatment plan, patients can better navigate the challenges associated with scalp tumors and maintain a higher quality of life throughout their journey.

Future Directions in Scalp Tumor Management

As our understanding of scalp tumors continues to grow, the field of dermatology and oncology is poised for significant advancements in tumor management. These developments promise to revolutionize how we approach prevention, diagnosis, and treatment of scalp tumors.

Precision Medicine and Personalized Treatment

The future of scalp tumor management lies in tailoring treatments to individual patients based on their unique genetic and molecular profiles. This approach, known as precision medicine, holds great promise for improving treatment efficacy and reducing side effects.

• Genetic profiling to predict tumor behavior and treatment response
• Customized immunotherapy based on individual immune system characteristics
• Targeted drug delivery systems designed for specific tumor types

Non-Invasive Diagnostic Tools

Advancements in imaging and molecular diagnostics are paving the way for less invasive diagnostic procedures:

1. Advanced spectroscopy techniques for real-time, non-invasive tumor analysis
2. Liquid biopsies to detect circulating tumor DNA for early diagnosis and monitoring
3. AI-powered image analysis for more accurate and efficient tumor classification

What role will technology play in future scalp tumor management. Emerging technologies are set to transform various aspects of care:

• Telemedicine platforms for remote monitoring and follow-up care
• Virtual reality simulations for surgical planning and patient education
• 3D bioprinting for creating personalized tissue grafts for reconstruction
• Wearable devices for continuous monitoring of high-risk patients

These advancements hold the potential to significantly improve early detection rates, treatment outcomes, and overall patient experiences in scalp tumor management. As research progresses, we can expect to see a shift towards more personalized, efficient, and less invasive approaches to tackling scalp tumors.

In conclusion, the field of scalp tumor management is rapidly evolving, with promising developments on the horizon. From advanced diagnostic techniques to innovative treatment modalities, these advancements offer hope for improved outcomes and quality of life for patients affected by scalp tumors. As we look to the future, continued research and collaboration among healthcare professionals, researchers, and patients will be crucial in driving progress and shaping the landscape of scalp tumor care.

Scalp Tumours and Cysts: A Complete Overview

Authors: Rajan Ramji, Clinical Medical Education Fellow, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; Jenny Chung, Dermatology Registrar, Middlemore Hospital, Auckland, New Zealand. Copy edited by Gus Mitchell. February 2022

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What are scalp tumours?

The scalp comprises the area from the back of the head (beginning at the superior nuchal lines) to the eyebrows (supraorbital margin). Scalp tumours are benign or malignant cutaneous lesions which arise on the scalp.

Scalp tumours

Pilar scalp cysts

An ulcerated atypical fibroxanthoma on a bald scalp

Giant neglected basal cell carcinoma ulcerated down to the skull

Sclap and forehead tumour due to B cell lymphoma

Superficial spreading malignant melanoma on the scalp with recent development of nodular component

Angiosarcoma

Who gets scalp tumours?

Scalp tumours occur worldwide. Most scalp tumours (93–99%) are benign as opposed to malignant.

Approximately 40–50% of benign scalp tumours are cysts with an estimated 20% incidence in Western populations. Trichilemmal (or pilar) cysts are especially common and it is estimated 80% of these cysts occur on the scalp. The remaining proportion of benign scalp tumours primarily comprises lipomas (~30%) and melanocytic naevi (28%). Seborrhoeic keratoses and actinic keratoses are increasingly common with age and the latter develop particularly as the hair thins.

Although only 1–2% of scalp tumours are malignant, they comprise approximately 13% of malignant cutaneous tumours. The most common (in decreasing order of commonality) malignant scalp tumours include basal cell carcinoma (~41%), squamous cell carcinoma (~17%), cutaneous metastases, adnexal tumours, angiosarcomas, and lymphomas.

What causes scalp tumours?

The causes of both benign and malignant scalp tumours are varied and can depend on the underlying tissue of origin and associated co-morbidities. Scalp tumours can arise from cells in both the skin (epidermis and dermis) and deeper tissue layers. It may also originate from other cells in the body due to metastases.

What are the clinical features of scalp tumours? 

Both benign and malignant scalp tumours can occur elsewhere on the body but may have different physical features. The exact features displayed are dependent on the originating site and cells of the tumour, summarised in Table 1 and 2.

Table 1. Benign scalp tumours

Epidermoid cyst	Keratinocytes	Firm, flesh-coloured or yellow papules/nodules which may have a central punctum that exudes foul smelling debris.
Dermoid cyst		Firm dough-like lumps consisting of epidermal/dermal tissue components.
Seborrhoeic keratosis		Flat or raised lesions with a stuck-on appearance, variable coloration and diameter. Commonly seen in adults over 60 years of age.
Melanocytic naevus	Melanocytes	Flat or raised localized proliferation of melanocytes. Higher propensity for scalp variants to display dysplastic histological features.
Blue naevus		Flat or raised localized proliferation of spindle shaped or ovoid naevus cells in the dermis.
Trichilemmal cyst	Hair follicles	Keratin filled nodules derived from the outer hair root sheath and lacking a central punctum. Rarely develops into benign proliferating trichilemmal tumours although this occurs more commonly on the scalp — especially in older women.
Pilomatricoma		Skin coloured or purplish irregular papules derived from hair matrix cells which commonly become hard and bony due to calcification.
Sebaceoma	Sebaceous glands	Sebaceous cell proliferations that manifest as skin coloured or yellow nodules originating from deeper in the skin than sebaceous adenomas.
Sebaceous adenoma		A more superficially located form of sebaceomas manifesting as skin coloured or yellow papules or nodules.
Hidrocystoma	Apocrine/eccrine glands	Apocrine or eccrine derived skin coloured or blue cysts which may arise as solitary multiple lesions. Typically seen on the scalp or face – particularly the eyelid margins (Moll gland cysts).
Syringoma		Firm skin coloured or yellow papules millimetres in diameter and commonly occurring in clusters.
Eccrine poroma		Papules, plaques, or nodules derived from the epithelial terminal duct which histologically differentiate into poroid (glandular duct) cells.
Lipoma	Adipocytes	Smooth round collection of subcutaneous fat with a rubbery texture to palpation.
Infantile haemangioma	Vascular	Bright red, blue or flesh-coloured, non-tender and non-pulsatile papules/plaques representing a vascular malformation in the dermis or subcutaneous tissue.
Cavernous haemangioma		Infantile haemangiomas representing vascular malformations in the lower dermis or subcutaneous tissue.
Venous malformation		Skin coloured, blue or purple swellings of variable size that represent malformed veins and are a form of vascular naevi.
Lymphangioma	Lymphatic	Malformed lymph ducts of variable size that are a form of vascular naevi and most prominent in infancy or childhood
Leiomyoma	Myocytes	Proliferations of myocytes which can develop from both smooth and skeletal muscle. Typically present as firm, smooth, and tender hyperpigmented or red-brown nodules.
Dermatofibroma	Collagen(fibrous)/histiocytes	Solitary, firm papules or nodules of variable coloration that may dimple on pinching.
Hypertrophic scar		A growth of fibrous tissue that develops as part of wound healing processes. Typically begins as red and prominent before becoming flat and pale.
Keloid scar		Firm smooth fibrous tissue that characteristically extends beyond the site of the precipitating injury.
Infantile myofibromatosis		Firm or rubbery circular nodules formed from the proliferation of myofibroblasts in the dermis or subcutaneous tissue.
Neurofibroma	Neural	Well circumscribed soft or firm growths derived from Schwann cells, fibroblasts, mast cells, and vascular components of underlying nerves. Occurs in association with Café-au-lait macules in Neurofibromatosis 1 (NF1).
Schwannoma		Smooth, soft, and solitary skin-coloured or yellow papules or nodules originating in the dermis or subcutaneous tissue and derived from Schwann cells forming the myelin sheath of nerves.
Langerhans cell histiocytosis	Haematologic	Overactive accumulation of Langerhans cells in the epidermis with a spectrum of clinical manifestations typically seen in childhood or adolescence. May appear as pink or reddish-brown papules, pustules, vesicles, or blisters with crusting, scale, or impetiginisation.
Rosai-Dorfman disease		Unprovoked histiocyte proliferation disorder characterized by massive cervical lymphadenopathy. Less than 10% of cases may manifest with multiple macules, papules, nodules, and plaques of red, red-brown or yellow coloration.
Juvenile xanthogranuloma		A non-Langerhans cell histiocytosis that typically manifests as domed red-brown or yellow papules or nodules in children or adolescents. Typically manifests in skin but may also develop in eyes or internal organs.

Table 2. Malignant scalp tumours

Squamous cell carcinoma	Keratinocytes	A malignant proliferation of keratin producing cells extending beyond the epidermis. Scalp variants more frequently present with ulceration and have a higher propensity for recurrence.
Intraepidermal squamous cell carcinoma		Also known as Bowen’s disease. A malignant proliferation of keratin producing cells localized within the epidermis.
Basal cell carcinoma		A malignant proliferation of keratin producing cells extending beyond the epidermis. Scalp variants more frequently present with ulceration and have a higher propensity for recurrence. Pigmented or nodular subtypes are also more commonly seen and are more likely to demonstrate a melanocytic pattern on dermoscopy.
Keratoacanthoma		Rapidly growing firm circular nodule with a keratin core. A variant of squamous cell carcinoma.
Malignant melanoma	Melanocytes	Indistinct presentation of variously pigmented or nonpigmented lesions derived from a malignant proliferation of melanocytes. Scalp melanomas are more commonly seen in older men and are associated with alopecia. Compared to other body areas, there may be a higher propensity to present as recurrent desmoplastic or amelanotic melanoma. Lesions are also more likely to develop ulceration and have a greater Breslow thickness.
Malignant proliferating trichilemmal tumour	Hair follicles	Keratinized nodules or cysts derived from outer hair root sheath cells with low potential for metastasis. May develop from trichilemmal cysts.
Pilomatrix carcinoma		A low grade adnexal carcinoma derived from hair matrix cells that may manifest as skin coloured or purplish irregular papules.
Sebaceous carcinoma	Sebaceous glands	A form of adnexal carcinoma where the cells demonstrate a differentiation into sebaceous cells. Lesions lack distinguishing features but may appear as yellow nodules or plaques with ulceration or crusting.
Apocrine carcinoma	Sweat glands	An adenocarcinoma derived from apocrine glands. Lesions may manifest as ulcerating or bleeding nodules but otherwise have an indistinct presentation and are usually diagnosed histologically.
Porocarcinoma		An adenocarcinoma derived from eccrine (sweat) glands. As with apocrine carcinomas, lesions have a nondescript appearance but may appear as ulcerating or bleeding nodules that are diagnosed histologically.
Atypical lipomatous tumour	Adipocytes	Malignant proliferation of adipocytes that rarely develops in the skin but can resemble an enlarging lipoma. Differentiated from liposarcoma on the basis of histology findings.
Liposarcoma		Malignant proliferation of adipocytes that can present identically to an atypical lipomatous tumour or an enlarging lipoma.
Angiosarcoma	Vascular	Aggressive tumours that uncommonly develop from endothelial cells in blood (haemangiosarcoma) or lymphathic (lymphangiosarcoma) vessels May manifest as painful rapidly growing bruises, blue-black nodules, or persistent ulcers.
Leiomyosarcoma	Myocytes	Malignant proliferation of smooth muscle cells that may also develop in the dermis or subcutaneous tissue.
Dermatofibrosarcoma protuberans	Collagen(fibrous)/histiocytes	Slow growing tumours derived from collagen that develop in the dermis. Typically manifests as red-brown to skin coloured painless lichenified plaques or fixed, firm nodules.
Fibrosarcoma		Malignant proliferation of spindled fibroblasts or myofibroblasts which are typically firm and spherical but otherwise nondescript in appearance. Generally carries a poor prognosis.
Merkel cell carcinoma	Neural	Aggressive tumours with high metastatic potential, thought to be derived from pressure receptors (Merkel cells) in the skin. Approximately 80% of cases are found to have concomitant Merkel cell polyomavirus. The most common site of development is the head and neck region. Scalp lesions are typically larger and have an even higher risk of metastasis.
Malignant peripheral nerve sheath tumour		Proliferations of one or more types of cells that compose peripheral nerve sheaths – typically originate from perineural or endoneurial fibroblasts. Associated with plexiform neurofibromas.
Lymphoma	Haematologic	A malignant proliferation of lymphocytes. Multiple cutaneous and non-cutaneous variants exist. The most commonly occurring variants on the scalp include primary cutaneous follicle centre and/or marginal zone lymphomas.
Metastases	Various	Secondary malignant proliferations that develop from the spread of a primary malignancy beyond its site of origin. The scalp can both develop malignancies which metastasize and act as a site for metastases from other body sites. Metastases commonly associated with the scalp include: Melanoma Papillary thyroid carcinoma Breast cancer Pulmonary adenocarcinoma Colorectal adenocarcinoma Hepatocellular carcinoma Cholangiocarcinoma Renal cell carcinoma Langerhans cell histiocytosis

How are scalp tumours diagnosed?

Some scalp tumours may be diagnosed through a clinical examination alone. A biopsy or radiologic workup may be necessary to confirm the diagnosis.

What are the treatments for scalp tumours?

Treatment options are dependent on the nature of the tumour, anatomical location, and underlying diagnosis. Given that malignant scalp tumours carry a worse prognosis than lesions in other anatomic areas, radical surgical excision is more likely to be recommended. Excision can be complicated by the relative lack of scalp skin mobility. Mohs micrographic surgery may be a preferable option in these cases.

Other treatments may include:

• Cryotherapy
• Electrodessication and curettage
• Photodynamic therapy
• Topical therapy (i.e. 5% imiquimod)
• Radiotherapy.

What is the outcome for scalp tumours?

Malignant scalp tumours tend to carry a worse prognosis than equivalent tumours elsewhere on the body. The exact prognosis is dependent on the specific tumour involved and the degree of invasion beyond the skin. Scalp metastases (either originating from scalp tumours or elsewhere) typically carry a poor prognosis.

References

• Augsburger D, Nelson PJ, Kalinski T, Udelnow A, Knösel T, Hofstetter M, et al. Current diagnostics and treatment of fibrosarcoma –perspectives for future therapeutic targets and strategies. Oncotarget. 2017 Aug 10;8(61):104638–53. PubMed
• Dika E, Patrizi A, Veronesi G, Manuelpillai N, Lambertini M. Malignant cutaneous tumours of the scalp: always remember to examine the head. J Eur Acad Dermatol Venereol. 2020;34(10):2208–15. PubMed
• Kawaguchi M, Kato H, Matsuo M. CT and MRI features of scalp lesions. Radiol Med (Torino). 2019 Oct 1;124(10):1049–61. PubMed
• Prodinger CM, Koller J, Laimer M. Scalp tumors. JDDG J Dtsch Dermatol Ges. 2018;16(6):730–53. PubMed
• Xie C, Pan Y, McLean C, Mar V, Wolfe R, Kelly JW. Scalp melanoma: Distinctive high risk clinical and histological features. Australas J Dermatol. 2017;58(3):181–8. PubMed

On DermNet

• Epidermoid cyst
• Dermoid cyst
• Seborrhoeic keratosis
• Melanocytic naevus
• Blue naevus
• Trichilemmal cyst
• Pilomatricoma
• Syringoma
• Venous malformation
• Lymphatic malformation
• Leiomyoma
• Neurofibromatosis
• Juvenile xanthogranuloma
• Merkel cell carcinoma

Books about skin diseases

• Books about the skin
• Dermatology Made Easy book

What’s This Velvety Brown Growth on My Skin? Is It a Seborrheic Keratosis?

Written by WebMD Editorial Contributors

Medically Reviewed by Poonam Sachdev on May 08, 2023

• What Does It Look and Feel Like?
• What Are the Causes?
• When Should I See My Doctor?
• What’s Removal Like?
• Do Self-Tanners Affect It?

A seborrheic keratosis is a common, harmless growth on your skin. Doctors call it “benign,” which means it isn’t a sign of cancer. Like moles, a seborrheic keratosis happens when extra skin cells bunch up together on the top layer of skin. Unlike a mole, it won’t become cancerous. It can appear later in life, after about age 40. It’s most likely to happen on your face, scalp, chest, shoulders, belly, or back. It can show up anywhere except your palms and soles.

A seborrheic keratosis looks much like a mole. They’re both caused by a cluster of skin cells. But a seborrheic keratosis never becomes cancerous. (Photo credit: Ian Redding/Dreamstime)

Often, your doctor can tell what a seborrheic keratosis is just by looking at it. If you’re worried that it could be cancer, or your doctor isn’t sure, they’ll do a biopsy to remove the growth and study it more closely.

Normally, it has a round or oval shape. It ranges from light tan to black in color. At first it looks and feels soft and smooth, like velvet. It might be about the size of a dime.

Over time, a seborrheic keratosis becomes scaly and thick, like melted candle wax that’s stuck to your skin. It can grow to be as large as a half-dollar coin.

It’s not painful. It can feel greasy, rough, or soft when you touch it.

It might itch. Sometimes it can rub against your clothes and get in the way of shaving and other things you do. Even though it can be annoying, it’s important not to scratch, pick, or rub the area. That can cause it to swell, bleed, or get infected. 

Doctors aren’t sure what causes seborrheic keratoses. So there’s no real way to prevent them.

The condition tends to run in families. It almost always happens later in life, especially after age 50. You’re more likely to have one if other people in your family have it too. It’s most common in people with light skin. It can appear during pregnancy, or if you’ve had hormone replacement therapy.

Some studies show sunlight might play a part. But these growths can show up with or without exposure to the sun, so we need more research to know exactly why they form.

They aren’t contagious. If you have one, it won’t spread to other people or to other parts of your body, though it is common to have not just one, but many. They usually don’t go away on their own.

Most of the time, a seborrheic keratosis won’t cause problems. But make an appointment if you notice any of the following:

• It bothers you a lot, or becomes irritated or inflamed.
• You notice lots of growths at once. Normally, they appear one or two at a time and increase in number.
• It seems to change, or grow quickly.
• It bleeds and doesn’t heal.

If any of these things happen, or if you just don’t like how a growth looks or feels on your skin, you can have it removed.

Start with your main doctor. They might refer you to a dermatologist – a skin specialist.

They’ll choose one of the following, simple ways to remove the growth, usually in their office or clinic.

• Burning. This uses an electric current to burn away the seborrheic keratosis. It can take longer than other ways.
• Freezing. Doctors called this “cryosurgery.” It uses super-cold liquid nitrogen to remove the growth. It might require several treatments if it’s very large or thick.
• Laser. A harmless beam destroys the physical structure of the area.
• Scraping. The doctor uses a special tool to raze it off. This is often done along with freezing or burning.

Most seborrheic keratoses don’t return after they’re removed. But a new one can still appear somewhere else on your body.

Sometimes removing one can make your skin a little lighter at that spot. It usually blends in better over time, but not always.

It’s normal for seborrheic keratoses to grow darker over time. But if you use an artificial tanning product that contains DHA, an omega-3 acid, it can change the color of the growths as well as the skin around them.

Some people who’ve used these products have seen seborrheic keratoses grow darker quickly. That’s because the skin absorbs the artificial tan pigments. Doctors have found that this kind of color change isn’t a sign of cancer.

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What do the growths on the head say?

Neoplasms can appear anywhere on the body. The scalp is no exception. However, this is a rather difficult place to independently determine the type of neoplasm that has appeared. Therefore, we have prepared a list of the most common growths on the head, dividing them into three groups: malignant, borderline and benign.

In one of our articles “Skin growths: benign, malignant and borderline”, we have already talked about skin growths and classified them according to the danger to human health. Today we will analyze those that are most often found on the head and, sometimes, are invisible under the hair. Experts recommend regularly probing and, if possible, examining the head for the presence of neoplasms, since the proximity of a malignant neoplasm to the brain can lead to irreparable consequences. If you notice a strange growth on your head, contact your dermatologist or oncologist immediately.

The scalp is also the most traumatized and exposed area. Many people use combs with hard teeth, which can easily rip off the build-up. In addition, we wash our hair, dye, apply masks that can corrode the neoplasm and provoke its degeneration into a malignant tumor. Another risk factor is long exposure to the sun without a hat. As you know, many moles tend to become malignant with prolonged and strong exposure to ultraviolet radiation.

That is why, if you find or feel a growth in your hair that:

• hurts;
• bleeds;
• itches;
• peeling off;
• festering

Need to see a specialist urgently.

Types of neoplasms on the head

First, let’s consider malignant neoplasms on the scalp.

1. Melanoma.

First of all, malignant neoplasms include melanoma – skin cancer. You can learn more about it in our special article “Skin Cancer: Melanoma.”. The neoplasm looks like a small light brown or black plaque with a rough surface. Melanoma is dangerous, it metastasizes and can lead to irreparable consequences. Therefore, if it is found on the scalp, you should immediately consult a doctor. One of the most effective treatments for melanoma is laser therapy, which helps skin cells regenerate faster while killing all harmful cells.

2. Basalioma.

The second reason not to waste time and go for an examination to an oncologist may be a neoplasm similar to a nodule with a crust, light pink or red – this is a basalioma. It develops from the cells of the basal layer of the skin and is often accompanied by the formation of ulcers and erosions. You can learn more about this neoplasm in our special article “Basalioma. Skin cancer: basal cell carcinoma.”. The advanced method of treating basalioma is photodynamic therapy (for more details, see PDT), this is a sparing method of exposure, which already after several sessions gives visible results.

3. Epithelioma.

Skin epithelioma is a tumor that develops on the surface layer of the epidermis. Also, epithelioma of the sebaceous gland is distinguished – a neoplasm that occurs on the scalp, with inflammation of the sebaceous glands. Epithelioma looks like a growth of pink or light brown color, can reach 5 cm in diameter. This neoplasm is dangerous because it metastasizes to the lymph nodes very quickly. It can occur against the background of previous dermatological diseases, as well as strong UV radiation.

Borderline neoplasms on the scalp

1. Keratosis.

Keratosis of the scalp is the keratinization of the upper layer of the skin. Most often found on the face and scalp, it can be located both on a small area of ​​\u200b\u200bthe skin and affect the entire surface of the head. The neoplasm looks like multiple warts, from light to dark brown. Specialists also detect seborrheic keratosis of the scalp, its appearance indicates pathologies occurring in the body. With such a diagnosis, a thorough examination is necessary, since this may be evidence of cancer of the internal organs. Treatment of keratosis of the scalp is prescribed by an oncologist or dermatologist, after receiving all the tests. Treatment options may include medication and peeling, massage, and laser therapy.

2. Keratoacanthoma.

Keratoacanthoma of the scalp is a benign tumor of the hair follicles, most often seen in the elderly. It is a spherical dense neoplasm affecting the scalp. Keratoacanthoma and its multiple form, has a flesh color, and can grow rapidly, reaching 2-3 cm. In some cases, the neoplasm can degenerate into a malignant one, especially if it is often injured. Treatment of keratoacanthoma is possible only with its complete excision with a scalpel, electric current or laser.

Benign tumors on the scalp

1. Moles.

A mole is a small pigmented formation on the skin that can appear at any age and on any part of the skin, even on the head in the hair. In large numbers, moles can grow during puberty, with hormonal failure or pregnancy, which you can read more about in our special article. According to statistics, a mole on the scalp is not dangerous, the likelihood of degeneration into skin cancer is extremely small. However, it is necessary to check moles, RTM-diagnostics is the best way to cope with this. Based on the results of the check, you may be shown the removal of a mole.

2. Warts.

Perhaps the most common neoplasms on the scalp are warts and papillomas. They appear due to the human papillomavirus, which is most often activated with reduced immunity, with severe stress, infectious diseases, and a lack of vitamins in the body. Learn more about what HPV is and how it manifests on the body in our article “Human papillomavirus”. Warts are classified as benign neoplasms, however, if the wart on the head in the hair is often injured, then it must be removed. The most effective method in such cases is laser removal.

3. Hemangioma.

Scalp hemangioma is a vascular tumor that appears due to abnormal development of blood vessels. It manifests itself in infancy and most often forms on the face, neck or scalp. This is a benign neoplasm that does not harm the body, except for aesthetic imperfection. Hemangioma of the scalp is a racemose hemangioma, it is a bumpy pink, burgundy or red formation, reaching up to 5 cm in size, rising above the skin, and does not cause discomfort or pain when pressed. Removal of hemangioma can be performed at any age, but first you need to consult a doctor. Since the removal of a hemangioma on the head may have a number of contraindications.

When treating any neoplasm on the head and hair, the most important thing is to contact a specialist in time. This will allow not only to identify a malignant tumor in the early stages, but to save life and health.

Benign skin lesions – health articles

11/10/2022

Skin neoplasms are benign or malignant tumor lesions of the skin as a result of pathological proliferation of tissue cells. Benign neoplasms include: warts, moles, nevi, papillomas, lipomas, angiomas, adenomas, etc.

Benign neoplasms are characterized by slow growth, during which their cellular elements remain within the tumor without growing into neighboring tissues. The neoplasm, evenly increasing, pushes and squeezes healthy tissues, as a result of which the latter, as it were, play the role of a capsule. Although benign tumors are atypical, their cells do not metastasize.

Under the influence of unfavorable external or internal stimuli, they (especially nevus) can transform into malignant tumors.

Causes

Many factors can provoke the launch of an uncontrolled process of cell division, but perhaps the most predisposing ones include frequent cases of skin injury, in which cells are forced to renew themselves too often and actively, as a result, control over this process is lost. In addition, any type of irradiation (including solar radiation) stimulates the appearance of skin neoplasms. Genetic predisposition and light skin with numerous moles are also provoking factors for the development of a tumor, which in the future can easily degenerate into a malignant neoplasm.

Significantly increase the risk of various formations on the skin can also be factors such as frequent aggressive effects on the skin, skin infections, skin diseases in a chronic form. In rare cases, metastases of cancer cells from any other organ can cause a skin neoplasm.

Symptoms

Fibroma – a nodule appears on the skin, more often in those areas that are open. The tumor originates in the connective tissue. Mosquito bites or injury to a skin area can serve as a provocation. The nodes are pigmented and usually do not progress in development.

Seborrheic wart is a small bump on the skin that has a bumpy surface. The color of the tumor is brownish or black. They are also called senile warts because they often appear in older people.
The formation occurs due to a violation of the localization of the cells of the basal layer. Appear on the scalp, scalp and in areas that are hidden by clothing.

Keratoacanthoma – a tumor often occurs on the hands and face. A node appears, increases within a month, can reach three centimeters in diameter.
Keratoacanthoma looks like a plaque with a depression in the center filled with keratinized cells. Education itself is able to resolve itself in about a year after the appearance.

Papilloma – the formation can be of any shape, similar to a wart. The surface of the neoplasia is uneven, villous, without hair. May have horny masses that are easily removed. Papilloma consists of epidermal cells. The color of the formation is brownish or grayish. Differ in slow growth.

Nevus pigmentosa – composed of melanocytes or nevus cells. Appearance – pigment spots of black or brownish color. Flat papules can appear anywhere on the skin.

These neoplasias are dangerous by degeneration into melanomas. The nevi localized on the genitals, palms and soles are most disposed to such a transformation.

Lipoma – a tumor is born from lipocytes – cells of adipose tissue. Skin on neoplasia of unchanged color. The texture is soft to the touch.

Can grow up to ten centimeters in size. Lipoma can be as a single or multiple tumor-like formation under the skin.

Angioma – refers to vascular tumors. A neoplasm occurs in the vessels of the lymphatic or circulatory system. These are difficult cases for early diagnosis. Because neoplasia duplicates the structure of the vessel and is not very noticeable at first.
Such neoplasms can occur in the internal organs, and on the skin they settle on its surface or in the fatty layer. The tumor is dangerous because its presence in the vessel impairs its functioning and thus affects overall health.

Angiomas often appear on the face. They look like spots of pinkish, red or bluish color with a flat or bumpy surface.

Diagnostics

Self-diagnosis and regular dispensary examinations are of great importance in early diagnosis. The attentiveness of the doctor during a visual examination allows you to diagnose pathological conditions and skin neoplasms and refer the patient for further examination.

Attentiveness to one’s health and to the health of one’s loved ones makes it possible to notice changes in moles, pigmentation and birthmarks in time. And, if skin changes occur without objective reasons, then you should be examined by a dermatologist or an oncodermatologist, where, based on visual examination, histological studies and studies of the general condition of the body, the tumor-like nature of skin neoplasms will be confirmed or excluded.

Treatment

Treatment of common benign tumors is often surgical. Radiation therapy with soft x-rays is also used. Physiotherapy is aimed at the destruction and death of tumor cells and their removal.

Separate seborrheic warts, for cosmetic reasons or at the risk of malignancy, are subjected to cryodestruction with liquid nitrogen or destroyed by other methods.