What is Melanoma? Symptoms, Causes, & Treatment

Melanoma is a type of skin cancer that develops when melanocytes, the cells that produce pigment in your skin, grow abnormally and become cancerous. While it's less common than other skin cancers, melanoma is more serious because it can spread to other parts of your body if not caught early.

The good news is that when melanoma is detected in its early stages, it's highly treatable with excellent survival rates. Understanding what to look for and taking preventive steps can make all the difference in protecting your health.

What is melanoma?

Melanoma starts in melanocytes, which are special cells that make melanin, the pigment that gives your skin its color. These cells can be found throughout your skin, but melanoma most commonly appears on areas that have been exposed to the sun.

Unlike other skin cancers that tend to stay in one place, melanoma has the ability to spread through your lymph system and bloodstream to other organs. This makes early detection and treatment crucial for the best possible outcome.

Melanoma can develop from an existing mole or appear as a new spot on your skin. It can occur anywhere on your body, including areas that don't get much sun exposure like the soles of your feet, palms of your hands, or under your nails.

What are the symptoms of melanoma?

The most important thing to watch for is any change in your skin, especially in existing moles or new spots that appear. Your body is constantly sending you signals, and paying attention to these changes can help catch melanoma early when it's most treatable.

The ABCDE rule is a helpful way to remember what changes to look for:

• Asymmetry: One half of the mole doesn't match the other half
• Border irregularity: The edges are uneven, scalloped, or poorly defined
• Color variation: The color isn't uniform and may include shades of brown, black, red, white, or blue
• Diameter: The spot is larger than 6 millimeters (about the size of a pencil eraser)
• Evolving: The mole is changing in size, shape, color, or feel

Beyond the ABCDE signs, you might notice other symptoms that warrant attention. A mole that becomes itchy, tender, or painful can be concerning. Sometimes melanomas bleed, ooze, or develop a crusty surface.

In rare cases, melanoma can develop in places you might not expect. Under your fingernails or toenails, it might appear as a dark streak. On the palms of your hands or soles of your feet, it could look like a dark spot that doesn't fade.

Some people experience what's called amelanotic melanoma, which lacks the typical dark pigmentation. These lesions might appear pink, red, or flesh-colored, making them harder to recognize as potential melanomas.

What are the types of melanoma?

There are several types of melanoma, each with distinct characteristics. Understanding these differences can help you know what to watch for and what your doctor might be evaluating.

Superficial spreading melanoma is the most common type, accounting for about 70% of all melanomas. It typically starts as a flat or slightly raised discolored patch that grows slowly outward along the skin surface before penetrating deeper.

Nodular melanoma appears as a raised bump or nodule and tends to grow more quickly than other types. It often looks like a firm, dome-shaped growth that can be black, blue, or red in color.

Lentigo maligna melanoma usually develops in older adults on sun-damaged skin, particularly on the face, neck, or arms. It often starts as a large, flat, brown patch that slowly grows larger over months or years.

Acral lentiginous melanoma is less common but particularly important to recognize because it affects areas without much sun exposure. This type appears on the palms, soles, or under the nails and is more frequently seen in people with darker skin tones.

There are also rare forms like amelanotic melanoma, which lacks pigment and appears pink or red, and desmoplastic melanoma, which can look like a scar and tends to occur in sun-damaged areas of older adults.

What causes melanoma?

Melanoma develops when DNA damage occurs in melanocytes, causing them to grow and divide uncontrollably. While the exact trigger isn't always clear, researchers have identified several factors that contribute to this DNA damage.

Ultraviolet radiation from the sun is the primary cause of melanoma. Both UVA and UVB rays can damage the DNA in your skin cells, and this damage can accumulate over time. Intense, intermittent sun exposure that leads to sunburns appears to be particularly harmful.

Artificial UV sources like tanning beds significantly increase your risk of developing melanoma. The concentrated UV radiation from these devices can cause the same type of DNA damage as natural sunlight, but often more intensely.

Your genetic makeup also plays a role. Some people inherit gene mutations that make them more susceptible to developing melanoma when exposed to UV radiation. Having many moles, especially atypical or dysplastic moles, can increase your risk.

Fair skin that burns easily is another risk factor because it contains less protective melanin. However, people with darker skin can still develop melanoma, particularly in areas like the palms, soles, and nail beds where sun exposure isn't the primary factor.

Previous skin cancer, including both melanoma and non-melanoma skin cancers, increases your risk of developing additional skin cancers. A weakened immune system, whether from medical conditions or medications, can also make you more vulnerable.

When to see a doctor for melanoma concerns?

You should see a doctor if you notice any new spots on your skin or changes in existing moles. Early detection is your best defense against melanoma, and healthcare providers are trained to spot concerning features that might not be obvious to you.

Don't wait if you observe any of the ABCDE warning signs in a mole or spot. Even if you're not sure whether something looks concerning, it's always better to have it checked by a professional who can properly evaluate it.

Schedule an appointment if you have a spot that looks different from your other moles, sometimes called the "ugly duckling" sign. A mole that stands out as unusual compared to your other moles deserves medical attention.

Seek medical care promptly if you have a mole that bleeds, itches persistently, or becomes tender to touch. These symptoms can indicate changes that need professional evaluation.

If you have risk factors like a family history of melanoma, many moles, or previous skin cancer, consider regular skin checks with a dermatologist even if you haven't noticed specific changes. They can establish a baseline and monitor your skin over time.

For urgent concerns like a rapidly changing lesion or one that's bleeding significantly, don't hesitate to seek immediate medical attention. Your peace of mind and health are worth the visit.

What are the risk factors for melanoma?

Understanding your risk factors can help you take appropriate preventive measures and stay vigilant about skin changes. Some risk factors you can control, while others are part of your natural characteristics or family history.

Here are the key risk factors that increase your likelihood of developing melanoma:

• Fair skin, light hair, and light eyes: Less melanin means less natural protection from UV radiation
• History of sunburns: Especially severe burns or those that occurred during childhood
• Excessive sun exposure: Both chronic exposure and intense, intermittent exposure
• Tanning bed use: Any use of artificial UV radiation increases risk
• Many moles: Having more than 50 moles or having atypical moles
• Family history: Having relatives with melanoma or other skin cancers
• Personal history: Previous melanoma or other skin cancers
• Age: Risk increases with age, though melanoma can occur at any age
• Weakened immune system: From medications, medical conditions, or organ transplants

Some people have rare genetic conditions that dramatically increase their melanoma risk. These include xeroderma pigmentosum, which makes the skin extremely sensitive to UV radiation, and familial atypical multiple mole melanoma syndrome.

Living at high altitudes or in sunny climates can also increase your exposure to UV radiation. Even factors like having freckles or being unable to tan can indicate higher susceptibility to UV damage.

What are the possible complications of melanoma?

When caught early, melanoma is highly treatable with excellent outcomes. However, understanding potential complications helps you appreciate why early detection and proper treatment are so important for your long-term health.

The most serious complication occurs when melanoma spreads beyond the original site. This process, called metastasis, can happen through your lymphatic system or bloodstream, allowing cancer cells to reach distant organs.

Common sites where melanoma may spread include:

• Lymph nodes: Usually the first place melanoma spreads, often to nodes near the original tumor
• Lungs: Can cause breathing difficulties, persistent cough, or chest pain
• Liver: May lead to abdominal pain, nausea, or changes in liver function
• Brain: Can cause headaches, seizures, or neurological symptoms
• Bones: Might result in pain, fractures, or other bone-related problems
• Other skin areas: New melanoma spots can appear distant from the original site

Treatment-related complications can also occur, though they vary depending on the specific treatments you receive. Surgery might leave scars or, in extensive cases, require skin grafts or reconstructive procedures.

The emotional impact shouldn't be overlooked either. A melanoma diagnosis can cause anxiety, depression, or fear about the future. Many people find support groups or counseling helpful in managing these feelings.

In rare cases, people develop multiple primary melanomas, meaning new, unrelated melanomas appear over time. This is why ongoing surveillance and skin protection remain important even after successful treatment.

How can melanoma be prevented?

Many melanomas are preventable through smart sun protection habits and regular skin monitoring. The key is protecting yourself from UV radiation while staying aware of changes in your skin over time.

Sun protection forms the foundation of melanoma prevention. Use broad-spectrum sunscreen with at least SPF 30 every day, not just during beach trips. Apply it generously and reapply every two hours or after swimming or sweating.

Seek shade during peak UV hours, typically between 10 AM and 4 PM. When you're outdoors, wear protective clothing including wide-brimmed hats, long-sleeved shirts, and sunglasses that block UV rays.

Avoid tanning beds completely. No amount of artificial UV exposure is considered safe, and the risk of melanoma increases significantly with tanning bed use, especially when started at a young age.

Perform regular skin self-examinations monthly. Get familiar with your moles and spots so you can notice changes. Use a mirror or ask a partner to help check areas you can't see easily.

Consider professional skin screenings, especially if you have risk factors like fair skin, many moles, or family history of skin cancer. Your dermatologist can recommend an appropriate screening schedule based on your individual risk.

Protect children's skin carefully since childhood sun exposure and burns significantly increase later melanoma risk. Children's skin is more sensitive, and good sun safety habits established early can last a lifetime.

How is melanoma diagnosed?

Melanoma diagnosis typically begins with a visual examination of your skin by a healthcare provider. They'll look at the concerning spot and examine your entire skin surface to check for other suspicious areas.

If a spot looks suspicious, your doctor will likely perform a biopsy. This involves removing all or part of the suspicious tissue so it can be examined under a microscope by a specialist called a pathologist.

There are different types of biopsies depending on the size and location of the spot. An excisional biopsy removes the entire lesion with a small margin of normal skin. A punch biopsy uses a circular tool to remove a small, deep sample of tissue.

The pathologist examines the tissue sample to determine if cancer cells are present and, if so, what type of melanoma it is. They also measure how deep the melanoma has grown, which is called the Breslow depth and helps determine the stage.

If melanoma is confirmed, additional tests might be needed to determine if it has spread. These could include imaging studies like CT scans, MRI, or PET scans, depending on the characteristics of your specific melanoma.

Your doctor might also check nearby lymph nodes, either by feeling them during examination or through a procedure called sentinel lymph node biopsy. This helps determine if cancer has begun to spread beyond the original site.

Some advanced techniques like dermoscopy allow doctors to examine skin lesions with magnification and special lighting. However, a biopsy remains the only definitive way to diagnose melanoma.

What is the treatment for melanoma?

Treatment for melanoma depends on several factors including the stage, location, and your overall health. The good news is that many effective treatments are available, and outcomes are generally excellent when melanoma is caught early.

Surgery is the primary treatment for most melanomas. For early-stage melanomas, wide local excision removes the tumor along with a margin of healthy tissue around it. This helps ensure all cancer cells are removed.

The size of the margin depends on the thickness of the melanoma. Thinner melanomas require smaller margins, while thicker ones need wider margins to reduce the risk of leaving behind cancer cells.

For melanomas that may have spread to nearby lymph nodes, your surgeon might recommend sentinel lymph node biopsy. This procedure identifies and removes the first lymph nodes that drain the area where the melanoma was located.

Advanced melanomas may require additional treatments beyond surgery. Immunotherapy helps your immune system recognize and fight cancer cells. These medications have dramatically improved outcomes for people with advanced melanoma.

Targeted therapy uses drugs that attack specific genetic mutations found in some melanomas. If your melanoma has certain mutations like BRAF or MEK, these targeted drugs can be very effective.

Radiation therapy might be recommended in specific situations, such as after surgery to reduce the risk of recurrence or to treat melanoma that has spread to other areas.

Clinical trials offer access to new treatments that aren't yet widely available. Your oncologist can help you determine if participating in a trial might be beneficial for your specific situation.

How to manage melanoma at home during treatment?

While medical treatment is essential, there are many things you can do at home to support your healing and overall well-being during melanoma treatment. Taking an active role in your care can help you feel more in control and potentially improve your outcomes.

After surgery, follow your doctor's wound care instructions carefully. Keep the surgical site clean and dry, change dressings as directed, and watch for signs of infection like increased redness, warmth, or drainage.

Protect your skin more vigilantly than ever. Use sunscreen daily, wear protective clothing, and avoid peak sun hours. Your skin may be more sensitive during treatment, making sun protection even more critical.

Maintain a healthy lifestyle to support your immune system. Eat a balanced diet rich in fruits and vegetables, stay hydrated, and get adequate sleep. These basics help your body heal and cope with treatment.

Stay physically active as your energy allows. Gentle exercise like walking can help reduce fatigue, improve mood, and maintain strength during treatment. Always check with your healthcare team about appropriate activity levels.

Monitor your skin regularly and report any new or changing spots to your healthcare team immediately. Keep a skin diary or take photos to track changes over time.

Manage side effects proactively. If you're receiving immunotherapy or other systemic treatments, work with your healthcare team to address side effects like fatigue, skin reactions, or digestive issues.

Consider joining support groups or connecting with other melanoma survivors. Sharing experiences and coping strategies can provide emotional support and practical advice during your journey.

How should you prepare for your doctor appointment?

Preparing for your appointment helps ensure you get the most out of your time with your healthcare provider. Being organized and informed allows for more productive discussions about your concerns and treatment options.

Write down all your questions before the appointment. Include concerns about symptoms, treatment options, side effects, and what to expect. Don't worry about having too many questions - your healthcare team wants to address your concerns.

Bring a complete list of your medications, including prescription drugs, over-the-counter medications, and supplements. Also note any allergies or adverse reactions you've had to medications in the past.

Gather your medical history, including previous skin cancers, biopsies, or treatments. If you have medical records from other providers, bring copies or arrange for them to be sent to your current doctor.

Document any skin changes you've noticed. Take photos of concerning spots if possible, and note when you first noticed changes and how they've evolved over time.

Consider bringing a trusted friend or family member to the appointment. They can provide emotional support, help you remember information discussed, and assist with asking questions you might forget.

Prepare to discuss your family history of cancer, particularly skin cancers. Information about relatives who've had melanoma or other cancers can be relevant to your care.

Think about your goals and preferences for treatment. Consider factors like your lifestyle, work situation, and personal values that might influence treatment decisions.

What's the key takeaway about melanoma?

The most important thing to remember about melanoma is that early detection saves lives. When caught in its earliest stages, melanoma has excellent cure rates, often approaching 99% with appropriate treatment.

Prevention through sun protection and regular skin monitoring gives you powerful tools to reduce your risk and catch any problems early. Simple habits like daily sunscreen use, avoiding tanning beds, and monthly skin self-exams can make a significant difference.

If you do develop melanoma, remember that treatments have improved dramatically in recent years. Even advanced melanomas that would have had poor outcomes just a decade ago now have effective treatment options that can provide good long-term control.

Trust your instincts about skin changes. If something looks different or concerning to you, don't hesitate to have it evaluated by a healthcare provider. You know your body better than anyone, and your observations are valuable.

Stay connected with your healthcare team and follow their recommendations for ongoing monitoring. Melanoma surveillance is typically lifelong, but this ongoing care helps ensure that any new developments are caught as early as possible.