Skin Cancer on Face, Nose & Scalp: What to Know

Your face is exposed to the sun every day you go outside. Unlike arms and legs, which are often covered by clothing, the face receives year-round UV exposure. The nose, ears, forehead, and lower lip are especially vulnerable because they project outward and catch direct sunlight. Years of cumulative exposure damage DNA in skin cells, eventually leading to cancer in some people.

The nose is the single most common site for basal cell carcinoma. BCC on the nose typically appears as a pearly or translucent bump, sometimes with tiny visible blood vessels. It may bleed with minor trauma and seem to heal, then bleed again.

Treatment usually involves Mohs surgery because preserving as much nasal tissue as possible is important for both function and appearance. Small BCCs on the nose have excellent outcomes when treated early.

Scalp melanoma is particularly dangerous - it has worse outcomes than melanoma on other body sites, partly because it is often detected later. Scalp skin cancers can hide under hair and go unnoticed for months or years.

Check your scalp regularly by parting your hair in sections. Ask a partner to help examine areas you cannot see. Any new spot, scaly patch, or sore on the scalp that does not heal deserves evaluation.

The ears - especially the tops and rims - are highly sun-exposed. SCC on the ear carries a higher risk of metastasis than SCC on many other sites. BCC on the ear is also common. Any persistent scaly patch, non-healing sore, or new bump on the ear should be checked.

Mohs surgery is the preferred treatment for most facial skin cancers because it maximizes tissue preservation while achieving the highest cure rates. The surgeon removes one thin layer at a time, examining each layer microscopically before deciding whether to remove more. This means only cancerous tissue is removed - critical on the face where every millimeter matters for appearance.

Reconstruction after Mohs may involve direct closure, a local flap, or a skin graft depending on the size and location of the defect.

Daily broad-spectrum sunscreen (SPF 30+) on the face, even on cloudy days. Reapply every 2 hours during extended outdoor time. Wear a wide-brimmed hat. UV-protective sunglasses protect the skin around the eyes. Avoid peak sun hours (10am-4pm) when possible. These habits reduce lifetime UV exposure and significantly lower skin cancer risk on the face.