How to Spot Melanoma


Understanding Melanoma

Melanoma is a type of skin cancer that is born of cells that make the skin’s pigment. These cells are called melanocytes and all people have the same number of them; it is how much pigment they make that determines our natural skin color.  Our melanocytes will start mass producing pigment to try to defend us from the sun’s ultraviolet (UV) rays - this is what is happening when our skin becomes tan. If your skin is becoming burned or tan, it is a sign that your cells have been exposed to UV radiation, which can cause skin cancer of all types, including melanoma.  Melanocytes also cluster in the skin naturally at some sites to make brown dots in the skin that a dermatologist will call pigmented nevi or “moles”. Melanocytes are busy cells that do a lot for our body, but when one of these cells turns to cancer called malignant melanoma, or melanoma, it is life-threatening; and there are some important things to know about melanoma, including what to look for and how to decrease your risk.  

Evaluating a Spot

If you are someone who has many moles on your skin, it is important to have them evaluated by a board-certified dermatologist to see if any of them appear atypical. Atypical moles have a higher risk of developing melanoma within them. One-third of melanomas arise from a pre-existing mole on the skin and two-thirds will start as a new spot.

Dermatologists use criteria like ABCDE and the “ugly duckling” sign to evaluate moles. ABCDE acronym reminds us to look for asymmetry, irregular borders, color variation, large diameter and evolution. Evolution, or change, in a mole is an important sign that can indicate that a mole may be melanoma and is reason enough for someone to make an appointment to see a dermatologist for an evaluation.  The ugly-duckling sign is when one of the moles or spots does not look like the others on the skin. One mole that doesn’t quite fit in with the rest can be an indication that it is atypical, or even melanoma, and should also prompt an evaluation by a dermatologist.  

  • If melanoma is detected early, it can be cured with a wide local surgical excision.
    • This is a procedure that is done with local anesthesia, in the office, by a dermatologist.
  • If melanoma has an opportunity to grow deeper into the skin, it can become metastatic, which means the cancer has spread through the body to lymph nodes and other organs.
    • Metastatic melanoma cannot be cured with surgery and requires treatment by an oncologist.

What does Melanoma Look Like?

A classic example of melanoma will look very dark brown to blue--black and at times have color variation; but melanoma can also present as a pink spot on the skin. The most important thing to remember is that if you notice a new spot on your skin or an old spot that is changing, do take it seriously and please have it evaluated by a dermatologist. Identifying melanoma early can save your life!

Decrease Your Risk 

It is easy to make melanoma prevention part of your daily routine. In order to prevent overexposure to sun, you can take the following steps to prevent skin cancer:

  • Wear broad-spectrum, SPF 30+ sunscreen and reapply every 2 hours
  • Wear a hat
  • Do not use a tanning-bed
  • Seek shade
  • Avoid peak hours (10 am – 2 pm) in the sun

By:  Eleni Moraites, MD, FAAD