Skin cancer of the head and neck

Written by: Professor Kavin Andi
Published: | Updated: 14/09/2021
Edited by: Karolyn Judge

Skin cancer, specifically on the head and neck, can come in many different forms; some you may not be aware of. Despite this, it’s still important to recognise their severity and by staying informed, it gives people the confidence to act if they have any doubts or queries.    

 

In light of this, award-winning consultant oral and maxillofacial, and head and neck surgeon Professor Kavin Andi has written an informative article about the topic. He highlights the various types of head and neck cancer, signs to look out for and how they are treated.

 

Young woman with two moles on her neck, touching her neck with her opposite hand

 

What is skin cancer of the head and neck?

Skin cancers of the head and neck incorporate a wide range of different cancer types. The major skin cancers are:

 

 

Other rare types such as Merkel cell carcinoma, sebaceous gland carcinoma and atypical fibroxanthoma may also present in the head and neck clinic.

 

 

What are skin cancer of the head and neck symptoms?

 

Basal cell carcinoma

These occur in sun-exposed areas such as your face, neck and ears. You may have noticed a pearly or waxy bump that scabs or bleeds easily, which heals and then returns. There may be associated itching in the area and/or more prominent blood vessels.

 

Squamous cell carcinoma

Again, these occur in sun-exposed areas however, people with darker skin are more likely to develop aquamous cell carcinomas in areas which are not often exposed to the sun. They may appear as a firm red nodule or a flat lesion with scaly, crusted surface.

 

Melanoma

These can develop anywhere in the body and may develop in an existing mole. The skin doesn't necessarily need to have been exposed to the sun. People of any skin tone can be affected by melanoma and in people with darker skin tones, it has a tendency to occur on the soles of the feet and palms of the hands, as well as under the toenails or fingernails.

 

You may notice:

  • A mole which has changed in size shape or colour
  • A brownish spot with darker spots within it
  • A small lesion with irregular borders with portions which appear red, white, pink or blue-black
  • Dark lesions on the soles of your feet, under your palms or under the fingernails/toenails

 

 

Can these sores disappear and then regrow, or do they remain until a doctor removes them?

Some lesions may appear to disappear as the body tries to heal but importantly, they tend to come back in the same area. All suspected skin cancers of the head and neck should be reviewed by a maxillofacial surgeon to determine whether a biopsy will be required to give a definitive diagnosis.

 

 

What are the risk factors?

UV radiation exposure is by far the most important risk factor. However, patients who have had localised immunosuppression due to radiotherapy or chemotherapeutic drugs are also at increased risk.

 

 

How is skin cancer of the head and neck treated?

Surgical removal with clear margins is the mainstay of treatment. On the face, this will often require reconstruction with local skin flaps to provide the best results for cosmesis. Occasionally, depending on the size and position of the defect skin,  a local skin graft or artificial skin substitutes can be used to restore the defect.

 

For very large areas which require extensive removal and reconstruction, microvascular flaps (e.g radial forearm free flap, antero-lateral thigh flap, latissimus dorsi free flap) represent the gold standard of care.

 

 

For an expert consultation regarding skin cancer of the head and neck, Professor Andi is a go-to specialist. Visit his Top Doctors profile here to arrange a visit. 

By Professor Kavin Andi
Oral & maxillofacial surgery

Professor Kavin Andi is an award-winning consultant oral and maxillofacial surgeon and head and neck surgeon based in London who specialises in head and neck cancer.

Once his dual qualifications in medicine and dentistry had been completed at Bart’s and The London Schools of Medicine and Dentistry, Professor Andi undertook his basic surgical training in Essex. He then went back to the London Deanery Higher Surgical Training Programme in Oral and Maxillofacial surgery at The Royal London Hospital, St Bartholomew’s Hospital, Luton and Dunstable Hospital, University College London and Guy’s and St Thomas’ Hospital.

He was ranked first among the highest level maxillofacial, ENT, and plastic surgeons in the UK by the joint committee for Higher Surgical Training following the reception of his FRCS award. This allowed Professor Andi to successfully complete a highly competitive Advanced Head and Neck Interface Training Fellowship at Guy’s Hospital. He did this in conjunction with a Fellowship of The Higher Education Academy award.

Professor Andi’s areas of interest include augmented reality, robotic surgery, and 3D virtual surgical planning, for which he was award the prestigious Norman Rowe Clinical Prize by the British Association of Oral and Maxillo-Facial Surgeons (2012). Among his interests and research, Professor Andi has also been published and has written original software on a variety of platforms which were user-friendly tools to collect data on clinical and outcomes research.

Other awards Professor Andi has been the recipient of the J.N. Kidd award from the Institute of Reconstructive Sciences (2016), a Clinical Excellence Award from St George's University Hospitals NHS Foundation Trust (2015), the Annual College Prize in Clinical Dentistry awarded by the University of London (1997), and many more in between.

Carrying out pioneering research at St George's, University of London Medical School and Crandfield University Centre for Digital Engineering, Professor Andi was appointed as a Visiting Professor in 2020. In addition to being a faculty member of The London Deanery School of Surgery and Regional Speciality Advisor to The Royal College of Surgeons, he is a core member of the Head & Neck and Skin Cancer tumour boards and previous President of The Institute of Reconstructive Sciences.

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