Melanoma is a potentially life-threatening form of skin cancer and can be especially dangerous when it appears on the head and neck. About 30 percent of melanomas develop on the head and neck, with many appearing on the face. Recognizing early signs of melanoma is important because it can improve your chances for successful treatment. If you notice any unusual changes on the skin of your face, it’s essential to see a dermatologist (skin specialist) as soon as possible to have it checked.

In this article, we’ll cover key facts about melanoma on the face, which symptoms you should watch for, and how this type of skin cancer is treated. Knowing these details can make a difference in catching melanoma early and preserving your health.

Who’s at Risk for Melanoma on the Face?

Melanoma happens when melanocytes — the skin cells that produce melanin (skin pigment) — start growing uncontrollably. While melanoma can appear anywhere on the body, the face is especially at risk because it’s often exposed to ultraviolet (UV) rays from the sun and tanning beds. Prolonged UV exposure is one of the top risk factors for melanoma, according to the American Academy of Dermatology.

The following are certain risk factors that may increase a person’s chance of developing melanoma skin cancer.

Fair Skin Tones

People with lighter skin tones, freckles, and those who burn easily are more likely to develop melanoma. This is because lighter skin has less melanin, which means less natural protection against harmful UV rays.

History of Sunburns

Severe or repeated sunburns, especially in childhood or adolescence, can significantly increase the risk of developing melanoma later in life.

Older Age

Melanoma tends to be more common in people over 50, though it can develop at any age. Over time, the effects of cumulative sun exposure make the skin more susceptible to cancer.

Family History of Skin Cancer

If someone in your family has had melanoma or another form of skin cancer, your risk is higher. This could be due to inherited genes that increase sensitivity to UV damage or other genetic factors.

Which Types of Melanoma Develop on the Face?

Melanoma can take on different forms, with some types more likely to appear on the face due to its frequent exposure to the sun. Here’s a breakdown of the main types of melanoma that may develop on facial skin.

Superficial Spreading Melanoma

This is the most frequently diagnosed type of melanoma. It often starts as a new mole or changes to an existing mole. Superficial spreading melanoma grows slowly at first and is usually found in its early stages.

Nodular Melanoma

Nodular melanoma is more aggressive and often appears as a fast-growing bump on the skin. It tends to grow deeper into the skin more quickly, making early detection crucial. Although nodular melanoma is the second-most commonly diagnosed type of melanoma overall, it’s the most commonly diagnosed type on the head and neck.

Lentigo Maligna Melanoma

Typically seen in older individuals, lentigo maligna melanoma appears as a large, flat lesion with irregular borders and varying shades of brown. This type of melanoma often develops in areas with significant sun exposure, such as the face.

Lentigo maligna more commonly develops on the scalp, ear, and neck in men and on the central face or the cheek in women, according to research in the Journal of the European Academy of Dermatology and Venereology.

Acral Lentiginous Melanoma

This rare type of melanoma usually develops on the palms or soles, but it can occasionally occur on the face. Unlike most melanomas, acral lentiginous melanoma is not linked to sun exposure and can appear on sun-protected areas of the body.

Rarer Types of Melanoma

Desmoplastic and mucosal melanomas are rare and more often occur on the face than on other areas of the body. Desmoplastic melanoma usually lacks pigment. Mucosal melanoma develops in mucus membranes such as those inside the nose, mouth, and throat.

Symptoms of Melanoma on the Face

Recognizing the early symptoms of melanoma on the face is essential to catching the disease before it metastasizes (spreads) to other parts of the body. Many facial moles are benign (harmless), especially those that are lumpy and either match the skin’s color or are dark brown. Some benign moles may even have hairs growing from them, which is typically not a concern.

Melanoma signs can appear in various ways, so it's important to be familiar with the changes to look for.

Asymmetry, Borders, and Color

A common way to identify possible melanoma skin cancer is to use the ABCDE rule:

• Asymmetry — One half of the spot doesn’t match the other.
• Border — The borders of the spot may be uneven, notched, or blurred.
• Color — Most facial melanomas are dark, but melanoma lesions often have a variety of colors, including shades of brown, black, and even red or white.
• Diameter — Lesions larger than the size of a pencil eraser (about 6 millimeters) are concerning.
• Evolving — Any freckle, mole, or spot that changes in shape, size, or color over time could be a sign of melanoma and should be checked by a dermatologist.

Other Symptoms

Beyond the ABCDE rule, there are additional warning signs of melanoma on the face to watch for:

• Oozing or bleeding from a lesion, particularly without injury
• Itchiness, tenderness, or pain in a mole or spot that wasn't there before.
• New moles suddenly appearing, especially if they look different from your other normal moles (often called the “ugly duckling” sign)
• Pigment spreading beyond the border of the lesion into the surrounding skin
• Changes in the surface texture of a mole, such as becoming rough or scaly or starting to ooze

If you notice any of these symptoms, see a dermatologist right away. Early evaluation can make all the difference. Your doctor may perform a biopsy (removal of a small sample of tissue) to confirm the diagnosis and determine the melanoma’s stage. Your doctor may also recommend imaging scans to check whether melanoma has spread to other parts of your body.

How Is Melanoma on the Face Treated?

Treating melanoma on the face often requires surgery, with the goal of removing all cancer cells while preserving as much healthy tissue as possible. The type of surgery used depends on the melanoma’s stage and location.

Surgical Options

• Excision — For early-stage melanoma, the lesion and a small margin of healthy skin are removed in a procedure called wide excision.
• Mohs surgery — This specialized technique is used to remove melanoma layer by layer while preserving as much healthy skin as possible. This method is commonly used for melanoma on the face due to its precision.

In more advanced cases, treatments may include:

• Immunotherapy — Medications that help your immune system attack cancer cells
• Radiation therapy — High-energy beams used to target and kill cancer cells
• Lymph node removal — Surgery to remove affected lymph nodes
• Chemotherapy — Rarely used but may be necessary for certain advanced melanomas

Scarring and Reconstruction

Since melanoma can spread quickly, it’s important for the surgeon to ensure that all cancer cells have been removed. This can result in larger scars after melanoma surgery compared with other types of skin cancer. This may mean a larger scar than initially anticipated, but reconstructive options are available.

It can take months to fully heal after melanoma surgery, but there are many steps you can take to ensure proper healing and minimal scarring, including:

• Eating a balanced diet
• Avoiding sun exposure on the treated area
• Refraining from smoking

There are also reconstructive techniques available. These may include dermabrasion, laser treatment, and injection of fillers into sunken areas to improve appearance and texture.

Cosmetic Concerns and Emotional Support

Surgery on the face can be particularly difficult for people because of the potential impact on appearance. Even with reconstructive surgery, there can be emotional challenges in adjusting to changes in how you look. Some people may even be reluctant to get treatment.

“My husband skipped his doctor's appointment because he doesn’t want his face and ear treated. He is worried it will ‘look bad,’” one MyMelanomaTeam member shared.

Reconstruction can often help with scars. Another member replied to the post above, encouraging reassurance and open communication: “With the advent of Mohs surgery, they are better able to remove the cancer without having to take a lot of skin/tissue around it. You would never know I had any surgery. Your husband should talk to his doctors about his concerns so that they can explain what they can do to get a better cosmetic effect.”

In a different conversation, another member shared a positive experience: “It’s been about one and half years since my Mohs surgery and reconstruction. Very little scar on my face.”

For those with visible scars, members are quick to provide empathy and encouragement. As one member put it: “They’re just battle wounds. It means you're fighting to stay alive. I too have many scars. Keep on fighting!”

Prognosis for Melanoma on the Face

Melanoma on the head and neck is more likely to have a worse prognosis (outlook) than melanoma that develops in other regions. Outcomes tend to vary depending on the specific location. For instance, melanoma on the scalp has the poorest prognosis. Next comes ear, followed by cheek, and finally the neck.

The five-year survival rate represents the percentage of people who live at least five years after their diagnosis. These rates vary significantly based on melanoma stage, which reflects how far it has progressed at the time of diagnosis. Melanoma stages are often represented using Roman numerals, such as “stage III” instead of “stage 3.” Here are the average five-year survival rates for melanoma:

• Stage 1 — More than 90 percent
• Stage 2 — 45 percent to 77 percent
• Stage 3 — 27 percent to 70 percent
• Stage 4 (cancer has spread to distant parts of the body) — Less than 20 percent

No matter your prognosis, it’s important to remember you’re not alone. Support can come from family, spiritual communities, in-person groups, or online networks like MyMelanomaTeam. Connecting with others can help you navigate the challenges of a facial melanoma diagnosis and treatment.

Talk With Others Who Understand

MyMelanomaTeam is the social network for people with melanoma and their loved ones. On MyMelanomaTeam, members come together to ask questions, give advice, and share their stories with others who understand life with melanoma.

Have you been diagnosed with melanoma on your face? Share your experience in the comments below, or start a conversation by posting on your Activities page.