Why we shouldn't rely on patients' hairdressers to check their scalp
A GP or dermatologist can be highly trained, have the best equipment and consult with patients according to guidelines, but all of that might achieve nothing if the encounter does not uncover a concealed lesion.
Anecdotally, there is a common practice whereby patients undergoing a “complete” skin examination are advised to have their hairdresser check their scalp, that responsibility being informally delegated, and thus trivialised.
Of possible relevance to this is an untested observation by the authors that a significant number of younger women with metastatic melanoma have had the primary discovered on their scalp under thick hair. This is worthy of specific research.
Examination of a scalp covered by hair, especially if thick and long, is challenging. However, if it is performed with the patient in the recumbent position, sequentially rolling to present the four quadrants, it is not