Three Cases of Scalp Melanomas Discovered by Hairdressers

Studies have demonstrated that patients are able to identify melanoma in many cases. A limitation to using self-examination as a means of melanoma detection is the fact that in certain areas of the body, such as the scalp, self-examination is difficult to adequately perform. This may be one of the reasons why scalp melanomas carry a worse prognosis than melanomas detected in other areas of the body. The authors present three cases of scalp melanomas that were detected by the patient’s hairdressers and suggest that with minimal training, hairdressers could become a valuable resource in assisting dermatologists in the early diagnosis of scalp melanoma.Melanoma has high cure rates when diagnosed early, but poor survival when found at an advanced stage. Most melanomas are visible on the skin, which allows for self-detection. In fact, in one report based on a population-based survey, 53 percent of melanomas were detected by patients, 26 percent by physicians, 17 percent by family, and three percent by others.1 Further, self-examination leads to decreased melanoma thickness in comparison to patients who do not perform self-examinations, with variable sensitivity data ranging from 25 to 93 percent, but high specificity of 83 to 97 percent.2 Despite the benefits of self-examination in early melanoma detection, this is often very difficult on the scalp. Most patients visit a hairdresser more frequently than they see a dermatologist, so there may be a role for training hairdressers in melanoma detection as they are likely to see the entire scalp in the course of their work. The authors present three cases of scalp melanomas in which the patients presented to outpatient clinics at the University of Pittsburgh Department of Dermatology after their hairdressers initally detected the melanomas.1-4