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Melanoma is the most serious type of skin cancer, caused by the uncontrolled growth of melanocytes, skin cells that produce the pigment melanin. It can spread from the skin to other parts of the body and is responsible for the majority of skin cancer deaths.


1. Melanomas occur when melanocytes proliferate uncontrollably

All of us have melanocytes or skin cells that produce the pigment melanin. These are found in the epidermis or the outer layer of skin. Melanin protects skin cells by absorbing ultraviolet (UV) radiation. Melanocytes are found in equal numbers in black and white skin, but melanocytes in black skin produce much more melanin. People with dark brown or black skin are very much less likely to be damaged by UV radiation than those with white skin.

Non-cancerous growth of melanocytes results in moles and freckles. The cancerous growth of melanocytes results in melanoma.

2. Melanoma can look very similar to moles but advance rapidly

The first sign of a melanoma is usually an unusual looking freckle or mole. Melanoma may be detected at an early stage when it is only a few millimeters in diameter, but it may grow to several centimeters in diameter before it is diagnosed.

Image of mole vs. melanoma comparison
Mole or potential melanoma?

Cross section illustration comparing mole and melanoma
It is easy to mistake a deadly melanoma for a common mole

Melanoma is classified in three ways:

  • In situ, if the tumor is confined to the epidermis or outer skin layer

  • Invasive, if a tumor has spread into the dermis or inner skin layer

  • Metastatic, if a tumor has spread to other tissues.

Melanoma can aggressively spread to other parts of the body if left untreated. Melanoma can be fatal. The thicker or deeper the melanoma the greater the risk to the patient.

Illustration of melanoma progression
Melanoma can spread rapidly to deep tissues and lymph nodes

3. Melanoma can occur anywhere on the body

The majority of melanoma cases can be associated with exposure to ultraviolet radiation (UV) that causes mutation in the DNA of melanocytes. This exposure can be from natural or artificial light or tanning beds. However, melanoma can present itself in parts of the body not exposed to the sun such as the toe, foot, or back.

4. Some people have a greater risk of developing melanomas

Major risk factors for melanomas include:

  • Signs of sun damage on the skin

  • Fair skin or blue eyes or blond hair

  • Sensitivity towards sun

  • A large number of moles

  • History of sunburn

  • History of long hours spent outdoors for work or recreation

  • Compromised immune system

  • Previous diagnosis of melanoma

5. Detection of melanoma requires vigilance

Melanomas can start with a harmless looking freckle but evolve into a more apparent spot. A melanoma may have a variety of colors including tan, dark brown, black, blue, red and occasionally, light grey. During its horizontal phase of growth, a melanoma is normally flat. As the vertical phase develops, the melanoma becomes thickened and raised. Some melanomas are itchy or tender. More advanced lesions may bleed easily or crust over.

Most melanomas have characteristics described by the Glasgow 7-point checklist

  • Major features

    • Change in size

    • Irregular shape

    • Irregular color

  • Minor features

    • Diameter >7 mm

    • Inflammation

    • Oozing

    • Change in sensation

Dermatologists recommend using a 5-dimensional A-B-C-D-E scale to examine your skin for suspect spots and identify suspect those that could be melanomas.

A: Asymmetry of shape and color B: Border irregularity including smudgy or ill-defined margin C: Color variation and Change D: Diameter (formerly diameter) E: Evolving (enlarging, changing)

Image of ABCDE scale
ABCDE scale for identifying suspect melanomas

Individuals with high risk based on risk factors are advised to get their skin examined by a board-certified dermatologist at least once a year. The dermatologist performs a full body skin exam and pays special attention to suspicious spots using dermascopy. A biopsy may be performed on suspicious lesions.

Physician examining skin using a dermatoscope

6. Surgical excision at an early stage is key

Treatment of melanomas generally involves surgically removing and cutting out malignant cells. These are generally located in the epidermis layer if the melanoma has not matured to a large degree. The aggressiveness of the treatment depends upon the size of the cancer, its location, how long you have had the tumor, and how much scarring is likely to occur with the treatment.

Our dermatologist has years of training, certification, and experience in a variety of minimally invasive surgical dermatology procedures to treat your melanoma. We utilize the latest technology and innovation in skin surgery. Most patients experience a full recovery and minimal scarring and get back to a healthy life.

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