Site-specific analyses of the skin melanoma incidence show marked differences between men and women by site and over time. The aim of our study was to analyze long-term population-based incidence time trends of skin melanoma in Finland over a period of more than 50 years, with special emphasis on sex- and subsite-specific changes over time. We analyzed incidence data of the Finnish Cancer Registry from 1953 through 2003 including overall 16,414 cases. We calculated age-standardized incidence rates per 100,000 person years using the European Standard Population. From 1953 through 2003, the incidence of skin melanoma increased from 1.5 to 12.8 per 100,000 among men and from 1.8 to 10.4 per 100,000 among women. Incidence rates showed a constant increase from 1953 through the mid of the 1980s. Thereafter, the rate of increase leveled off. The highest relative incidence increases occurred on the trunk among men and on the legs and hips among women. Within the skin area of the head, melanoma of the ear showed the highest relative increase among both men and women. Subsite-specific sex differences in the early registration period tended to become more pronounced in the most recent period. The highest body surface adjusted incidence rates occurred on the head. Only skin melanoma of the head showed an exponential age-specific incidence pattern and the aetiology of these skin melanomas may differ from skin melanoma on other subsites. © 2006 Wiley-Liss, Inc.