What are the most common types of scalp tumours. How are scalp tumours diagnosed and treated. What are the risk factors for developing scalp tumours. When should you see a doctor about a scalp growth. How can you prevent scalp tumours from developing.

Understanding Scalp Tumours: Types, Causes, and Prevalence

Scalp tumours are growths that develop on the skin covering the skull, extending from the back of the head to the eyebrows. These lesions can be either benign (non-cancerous) or malignant (cancerous). Understanding the nature of these growths is crucial for proper diagnosis and treatment.

Are all scalp tumours cancerous? No, the vast majority of scalp tumours are benign. Studies indicate that 93-99% of scalp growths are non-cancerous. However, it’s important to note that even benign tumours may require medical attention if they cause discomfort or cosmetic concerns.

Common Types of Benign Scalp Tumours

• Cysts (40-50% of benign scalp tumours)
• Lipomas (approximately 30%)
• Melanocytic naevi (28%)
• Seborrhoeic keratoses
• Actinic keratoses

Among cysts, trichilemmal (or pilar) cysts are particularly prevalent, with an estimated 80% occurring on the scalp. These keratin-filled nodules develop from the outer hair root sheath and can be hereditary.

Malignant Scalp Tumours

While only 1-2% of scalp tumours are malignant, they account for about 13% of all malignant cutaneous tumours. The most common types include:

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

Causes and Risk Factors for Scalp Tumours

What causes scalp tumours to develop? The etiology of scalp tumours varies depending on the type of growth and can be influenced by several factors:

• Genetic predisposition
• Prolonged sun exposure
• Age (certain tumours become more common as we get older)
• Immunosuppression
• Previous radiation therapy to the scalp
• Chronic inflammation or irritation

For instance, actinic keratoses are more likely to develop on scalps with thinning hair due to increased sun exposure. Seborrhoeic keratoses, on the other hand, become increasingly common with age, regardless of sun exposure.

Clinical Features and Diagnosis of Scalp Tumours

How can you identify different types of scalp tumours? While a definitive diagnosis often requires professional medical evaluation, certain characteristics can help distinguish between various scalp growths:

Benign Scalp Tumours

• 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
• Seborrhoeic keratoses: Flat or raised lesions with a “stuck-on” appearance, varying in color and size
• Melanocytic naevi: Flat or raised localized proliferations of melanocytes
• Blue naevi: Flat or raised localized proliferations of spindle-shaped or ovoid naevus cells in the dermis
• Trichilemmal cysts: Keratin-filled nodules derived from the outer hair root sheath

Malignant Scalp Tumours

• Basal cell carcinoma: Pearly, flesh-colored papules or nodules, sometimes with ulceration
• Squamous cell carcinoma: Scaly, red patches or nodules that may ulcerate
• Melanoma: Irregularly shaped, multi-colored moles that change over time
• Merkel cell carcinoma: Rapidly growing, firm, red or purple nodules

When should you see a doctor about a scalp growth? It’s advisable to consult a healthcare professional if you notice any new or changing growths on your scalp, especially if they exhibit rapid growth, bleeding, or other concerning symptoms.

Diagnostic Approaches for Scalp Tumours

How are scalp tumours diagnosed? Medical professionals employ various techniques to accurately identify scalp tumours:

1. Visual examination: A dermatologist or other specialist will carefully inspect the growth, often using a dermatoscope for enhanced visualization.
2. Biopsy: A small sample of the tumour is removed and examined under a microscope to determine its nature.
3. Imaging studies: In some cases, CT scans or MRI may be used to assess the extent of the tumour and its potential impact on underlying structures.
4. Blood tests: These may be performed to check for markers associated with certain types of tumours or to assess overall health status.

Is a biopsy always necessary for scalp tumours? While not all scalp growths require a biopsy, it is often the most reliable method to definitively diagnose the nature of the tumour, especially if there’s any suspicion of malignancy.

Treatment Options for Scalp Tumours

What are the available treatments for scalp tumours? The approach to treating scalp tumours depends on various factors, including the type of tumour, its size, location, and whether it’s benign or malignant. Common treatment options include:

For Benign Tumours

• Observation: Some benign growths may not require treatment if they’re not causing symptoms or cosmetic concerns.
• Surgical excision: Complete removal of the tumour, often used for larger cysts or lipomas.
• Cryotherapy: Freezing the tumour with liquid nitrogen, commonly used for seborrhoeic keratoses.
• Laser therapy: Can be effective for certain types of benign growths.
• Topical medications: Used for some types of benign lesions, such as actinic keratoses.

For Malignant Tumours

• Mohs micrographic surgery: A specialized technique that removes the tumour layer by layer, preserving as much healthy tissue as possible.
• Wide local excision: Removal of the tumour along with a margin of healthy tissue.
• Radiation therapy: May be used alone or in combination with surgery, especially for certain types of skin cancers.
• Chemotherapy: Systemic treatment that may be necessary for advanced or metastatic cases.
• Immunotherapy: Emerging treatments that harness the body’s immune system to fight cancer cells.

How is the most appropriate treatment determined? The choice of treatment depends on several factors, including the type and stage of the tumour, the patient’s overall health, and personal preferences. A multidisciplinary approach involving dermatologists, oncologists, and surgeons is often beneficial in developing the most effective treatment plan.

Prevention and Early Detection of Scalp Tumours

Can scalp tumours be prevented? While not all scalp tumours are preventable, there are steps you can take to reduce your risk:

• Sun protection: Use sunscreen on exposed areas of the scalp, wear hats, and seek shade during peak sun hours.
• Regular self-examinations: Familiarize yourself with the appearance of your scalp and note any changes.
• Professional skin checks: Schedule regular check-ups with a dermatologist, especially if you have risk factors for skin cancer.
• Maintain a healthy lifestyle: A balanced diet, regular exercise, and avoiding tobacco use can contribute to overall skin health.

How often should you check your scalp for unusual growths? It’s recommended to perform a self-examination of your scalp monthly. Use a mirror or ask a family member to help you inspect areas that are difficult to see.

Living with Scalp Tumours: Psychological and Social Aspects

How do scalp tumours affect a person’s quality of life? The impact of scalp tumours extends beyond physical health and can significantly influence an individual’s psychological well-being and social interactions. Consider the following aspects:

Psychological Effects

• Anxiety about the nature of the growth and potential for malignancy
• Concerns about appearance, especially for visible or large tumours
• Stress related to treatment decisions and procedures
• Fear of recurrence after treatment

Social Considerations

• Self-consciousness in social situations, particularly if the tumour is noticeable
• Potential impact on personal relationships
• Workplace concerns, especially in professions where appearance is emphasized

What support is available for individuals dealing with scalp tumours? Many healthcare providers offer comprehensive care that addresses both the physical and emotional aspects of living with scalp tumours. This may include:

• Counseling services to help cope with anxiety and stress
• Support groups for individuals with similar experiences
• Educational resources to better understand the condition and treatment options
• Cosmetic solutions, such as wigs or scalp micropigmentation, for those concerned about appearance

Emerging Research and Future Directions in Scalp Tumour Management

What advancements are being made in the field of scalp tumour treatment? The landscape of scalp tumour management is continuously evolving, with several promising areas of research:

Targeted Therapies

Researchers are developing drugs that target specific genetic mutations associated with certain types of skin cancers. These targeted therapies aim to be more effective and have fewer side effects than traditional chemotherapy.

Immunotherapy Innovations

New immunotherapy approaches are being explored to enhance the body’s natural ability to fight cancer cells. This includes checkpoint inhibitors and CAR T-cell therapy, which have shown promising results in treating various types of skin cancers.

Non-Invasive Diagnostic Tools

Advanced imaging techniques and artificial intelligence are being developed to improve the accuracy of non-invasive diagnosis. These tools could potentially reduce the need for biopsies in some cases.

Combination Therapies

Studies are investigating the effectiveness of combining different treatment modalities, such as surgery with immunotherapy or targeted drugs with radiation therapy, to improve outcomes for patients with advanced scalp tumours.

How might these advancements change the future of scalp tumour treatment? As research progresses, we can expect more personalized treatment approaches based on the specific characteristics of each patient’s tumour. This could lead to improved cure rates, reduced side effects, and better quality of life for individuals affected by scalp tumours.

The Role of Genetics in Scalp Tumour Development

How do genetic factors influence the development of scalp tumours? Genetic predisposition plays a significant role in the occurrence of certain types of scalp tumours. Understanding these genetic factors can help in early detection and prevention strategies:

Hereditary Syndromes

• Gorlin syndrome (Basal Cell Nevus Syndrome): Associated with a higher risk of developing multiple basal cell carcinomas, including on the scalp
• Xeroderma pigmentosum: A rare inherited condition that increases sensitivity to UV radiation and the risk of skin cancers
• Familial atypical multiple mole melanoma (FAMMM) syndrome: Increases the risk of developing melanoma, including on the scalp

Genetic Mutations

Certain genetic mutations can increase susceptibility to scalp tumours. For example:

• BRCA1 and BRCA2 mutations: Known for their association with breast and ovarian cancers, these mutations may also increase the risk of melanoma
• PTCH1 gene mutations: Associated with basal cell carcinoma development
• CDKN2A mutations: Linked to increased melanoma risk

Can genetic testing help in managing scalp tumour risk? For individuals with a strong family history of skin cancers or those who have had multiple skin cancers, genetic testing may be recommended. This can help identify those at higher risk and guide more intensive screening and preventive measures.

Epigenetic Factors

Beyond inherited genetic variations, epigenetic changes – alterations in gene expression that don’t involve changes to the DNA sequence – may also play a role in scalp tumour development. These changes can be influenced by environmental factors and lifestyle choices.

How does understanding genetic factors impact treatment approaches? Identifying specific genetic mutations associated with scalp tumours can inform more targeted treatment strategies. For instance, certain targeted therapies are designed to address tumours with specific genetic profiles, potentially leading to more effective and less toxic treatments.

As research in this area continues to advance, we may see an increasing role for genetic and epigenetic information in both the prevention and treatment of scalp tumours. This could lead to more personalized approaches to managing these conditions, ultimately improving outcomes for patients.

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.