Booklet: What You Need to Know about Melanoma

Signs and Symptoms of Melanoma

Often, the first sign of melanoma is a change in the size, shape, color, or feel of an existing mole. Most melanomas have a black or blue-black area. Melanoma also may appear as a new, black, abnormal, or "ugly-looking" mole.

If you have a question or concern about something on your skin, do not use these pictures to try to diagnose it yourself. Pictures are useful examples, but they cannot take the place of a doctor's examination.

Thinking of "ABCD" can help you remember what to watch for:

• Asymmetry--The shape of one half does not match the other.
  
• Border--The edges are often ragged, notched, blurred, or irregular in outline; the pigment may spread into the surrounding skin.
  
• Color--The color is uneven. Shades of black, brown, and tan may be present. Areas of white, gray, red, pink, or blue also may be seen.
  
• Diameter--There is a change in size, usually an increase. Melanomas are usually larger than the eraser of a pencil (5 mm or 1/4 inch).
  

Melanomas can vary greatly in the ways they look. Many show all of the ABCD features. However, some may show changes or abnormalities in only one or two of the ABCD features.

Early melanomas may be found when a pre-existing mole changes slightly--such as forming a new black area. Other frequent findings are newly formed fine scales or itching in a mole. In more advanced melanoma, the texture of the mole may change. For example, it may become hard or lumpy. Although melanomas may feel different and more advanced tumors may itch, ooze, or bleed, melanomas usually do not cause pain.

Melanoma can be cured if it is diagnosed and treated when the tumor is thin and has not deeply invaded the skin. However, if a melanoma is not removed at its early stages, cancer cells may grow downward from the skin surface, invading healthy tissue. When a melanoma becomes thick and deep, the disease often spreads to other parts of the body and is difficult to control.

A skin examination is often part of a routine checkup by a doctor, nurse specialist, or nurse practitioner. People also can check their own skin for new growths or other changes. (The How To Do a Skin Self-Exam section has a simple guide on how to do a skin self-exam.) Changes in the skin or a mole should be reported to the doctor or nurse without delay. The person may be referred to a dermatologist, a doctor who specializes in diseases of the skin.

People who have had melanoma have a high risk of developing a new melanoma. Also, those with relatives who have had this disease have an increased risk. Doctors may advise people at risk to check their skin regularly and to have regular skin exams by a doctor or nurse specialist.

Some people have certain abnormal-looking moles, called dysplastic nevi or atypical moles, that may be more likely than normal moles to develop into melanoma. Most people with dysplastic nevi have just a few of these abnormal moles; others have many. They and their doctor should examine these moles regularly to watch for changes. (Additional information about moles and dysplastic nevi and melanoma risk is available in the NCI booklet What You Need To Know About™ Moles and Dysplastic Nevi.)

Dysplastic nevi often look very much like melanoma. Doctors with special training in skin diseases are in the best position to decide whether an abnormal-looking mole should be closely watched or should be removed and checked for cancer.

In some families, many members have a large number of dysplastic nevi, and some have had melanoma. Members of these families have a very high risk for melanoma. Doctors often recommend that they have frequent checkups (every 3 to 6 months) so that any problems can be detected early. The doctor may take pictures of a person's skin to help in detecting any changes that occur.

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