Head and neck skin cancer risks: What you need to know

You might not give much thought to soaking up a bit of sun, but that radiant glow you’re chasing could be doing more harm than good by raising your risk for skin cancer.

Skin cancer is the most frequently diagnosed cancer, with ultraviolet (UV) exposure being the main culprit. Over time, repeated sun exposure adds up, increasing your chances of developing skin cancer.

“For skin cancer, prevention is key,” said Dr. Samantha Tam, an otolaryngologist (ear, nose and throat specialist) at Henry Ford Health. “Be diligent about protecting yourself from the sun. Don’t ignore areas on your skin that just aren’t healing. The sooner the skin cancer is detected, the more likely we are able to treat it with minimal side effects.”

Identifying Skin Cancer on the Head and Neck

“While skin cancers can occur anywhere on the body, one-third develop on the head and neck,” Tam said. “Each time you head outside, your head and neck are exposed to the sun. If you spend a lot of time in the sun or live in a warm climate, your exposure is even greater.”

While anyone can be affected by skin cancer, certain risk factors make it more likely: genetics, using tanning beds, a history of sunburns or lighter skin tone.

“You can reduce skin cancer risk by knowing the signs to spot it early, when treatment is most effective,” Tam said.

There are four main types of skin cancers that may appear on the head and neck:

1. Basal cell carcinoma: The most prevalent cancer in the United States, basal cell carcinoma usually appears on areas exposed to the sun like the face, neck or ears. This type tends to grow slowly and rarely spreads. Watch for:
   1. Elevated spots with a shiny white or pinkish hue and a central indentation.
   2. Flat patches that look scaly.
2. Squamous cell carcinoma: The second most frequently diagnosed cancer in the U.S., this form often arises on sun-exposed skin and may spread elsewhere in the body. Warning signs include:
   1. Lumps or patches that are red, scaly or crusted.
   2. Skin growths like moles or warts that change in size or shade.
   3. Persistent scabs or sores.
3. Melanoma: Though not as common, melanoma is the deadliest form. It can develop on the head or neck and may move to nearby lymph nodes. Its likelihood of spreading depends on its thickness. Tam recommended using the ABCDE method to spot melanoma early. Check moles or lesions for these characteristics:
   1. Asymmetry.
   2. Border irregularities.
   3. Color variations within the lesion.
   4. Diameter larger than a pea.
   5. Evolution in appearance over time.
4. Merkel cell carcinoma: A rare but aggressive skin cancer linked to a viral infection, Merkel cell carcinoma tends to affect individuals over the age of 70. It often shows up as a painless red or purple lump in sun-exposed areas and can grow quickly.

Treating skin cancer

“Left untreated, some skin cancers can spread to other areas of the body, requiring more complex care, but when skin cancer is detected early, removing it can often be a cure,” Tam said.

Small lesions can often be removed in a dermatologist’s office. Mohs surgery -- a method that removes and examines layers of skin one at a time -- is frequently used to precisely eliminate cancer while preserving healthy tissue.

Larger or more invasive cancers might require referral to a head and neck surgical oncologist. A sentinel lymph node biopsy may be performed to assess whether the cancer has spread (metastasized).

“If skin cancer has spread to other areas of your body, you may need more intensive treatments like more extensive surgery, radiation or even immunotherapy,” Tam said.

Staying ahead with prevention

The most effective way to guard against skin cancer on the head and neck is by taking precautions in the sun:

• Use a wide-brimmed hat, UV-blocking sunglasses, broad-spectrum sunscreen and clothing designed to protect against UV rays.
• Try to avoid direct sunlight between 10 a.m. and 2 p.m., when UV radiation peaks.
• Be mindful of medications or skincare products that could heighten sun sensitivity.

If you’re at greater risk, Tam recommended routine skin evaluations. Prior to your appointment, note any areas you want your dermatologist to take a closer look at.

“Pay attention to any skin changes on your head and neck. Ask your partner, hairdresser or barber to check your scalp for changes you can’t see,” she said. “You can take an active role in reducing your skin cancer risk.”