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What Does a Melanoma Look Like?

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Our skin is a phenomenal organ in the body and also one of the most complex. It carries out a multitude of roles in the maintenance of health, but it can also harbour many problems, including skin cancer. 

It can be difficult to discern what a new mole, bump or growth means. There are various skin cancer types and they can each present differently. Melanoma is often an evolving spot that is irregular in shape, changes size or texture and can have different shades of colour.

Checking your own skin regularly and having an annual skin check by your doctor will help safeguard your health from melanoma. Early detection and cancer care is instrumental when it comes to successful treatment options.

In this article, we will help identify melanoma, the warning signs and the best course of action to take. 

Doctor inspecting man for skin cancer

What is melanoma?

Melanoma is the deadliest form of skin cancer that develops in cells referred to as melanocytes. Although less common than basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), melanoma has the capacity to spread to other areas and organs of the body if not treated early. 

Melanocytes produce melanin, which is the pigment that is responsible for skin colour. When the skin is over exposed to UV radiation, it results in mutations within the DNA of the melanocytes. These changes trigger uncontrolled cellular growth and consequently, melanoma. 

The main cause of melanoma is over exposure to sunlight or tanning beds. With this in mind, it's important to consider other factors which can also increase the risk of melanoma: 

  • Unprotected UV exposure during outdoor activities such as work or leisure.
  • A large number of existing moles, growths or freckles on the body.
  • Fair skin and light eye colour ( blue or green ) as well as light or red hair.
  • Family history of melanoma or other skin cancers.
  • History of tanning and sunburn.
  • Weakened immune system.
  • Previous diagnosis of melanoma or skin cancer. 
  • A history of cancers such as breast cancer, prostate cancer and others.

Types of melanoma

What many people don't realise is that there are four main types of melanoma. To make matters more confusing, they can all be different in appearance. Look out for the characteristics of each and seek the advice of health professionals who can identify whether the spot is normal or a cancerous mole.  

  1. Superficial spreading melanoma: The most common type of melanoma. It can present as an existing or new mole and can occur at any age. Even though it can arise anywhere on the body, it typically forms on the torso, growing slowly and can invade the dermis. Look for a mole or lesion that is flat or slightly raised and begins changing shape, colour or size. Colours can comprise of tan, brown, black, red, pink, purple, blue or white. Some also lack pigment and can be flesh-toned or pink.
  2. Nodular melanoma: The most aggressive and invasive melanoma. The tumour digs deeper into the skin faster than other types of melanoma. It mostly affects people over 65 and is found commonly on the head and neck. Often identified as a blue-black bump on the skin or a pink to red bump. The lump or nodule feels firm and can be crusting, scabbing and bleeding.
  3. Lentigo maligna: The slowest growing melanoma. A superficial spreading type of melanoma, it usually develops on sun-damaged skin on the scalp, face, ears and neck. It resembles a blotchy patch with ragged edges that can be flat or slightly raised. The colours can include black, purple, any shade of tan to dark brown.
  4. Acral lentiginous: One of the rare melanomas. They appear in difficult to find areas such as the soles of the feet, palms of the hands or under finger/toe nails. Often mistaken as a bruise, it develops as either a colourless or lightly pigmented swath of skin.
fingers pinching mole on skin

What melanoma looks like during various stages

Skin doctors utilise a number of tests, a biopsy, criteria and pathology reports to help with cancer diagnosis. This information will also help your doctor identify if it has spread to other parts of the body. This is referred to as staging and will offer the optimum way to determine a treatment plan.  

Stage 0: This is the early stage and often referred to as melanoma in situ. Despite cancer cells being present, they haven't spread yet and are only on the outer layers of the skin or surface.The mole or freckle can typically be small, relatively flat and less than 0.1 mm thick. 

Stage 1: Similar to stage 0, but there are clear signs of progression. The mole or lesion is yet to move out of its primary site, but may have experienced growth, become slightly raised and may have started itching. It will be less than 2 mm in thickness.

Stage 2: The growth phase where you'll observe the spot definitively getting bigger. Ulcerating can begin as the colours can become variegated, borders become blurred and the asymmetry is further compromised. It will be at least 2 mm thick but yet to move beyond the primary site. 

Stage 3: This is the phase where the melanoma begins to spread often to the lymph nodes and the tissue near the original site of the spot. Surgery and comprehensive cancer care is inevitable.

Stage 4: Once in this stage, the cancer cells have metastasised and spread to distant parts of the body such as the bones, lungs, liver or brain. Targeted therapy incorporating immunotherapy, surgery and radiation may be used to alleviate pain, tackle side effects or other symptoms. 

The importance of knowing what to look for

There is nothing more important than prevention and early detection when it comes to melanoma. This will offer the best outcome for a patient who is diagnosed with any form of skin cancer. 

Different skin types may experience the disease differently. For example, people with darker skin who rarely get sunburned have less risk of developing melanoma, but it doesn't mean they are risk free. That is why any changes to the integrity of an existing mole, freckle or spot is a sign that it should be taken seriously. 

It's worthwhile noting that not all melanomas originate from moles. If you have a number of moles, getting routine examinations should be part and parcel of your health routine. Monthly skin self exams are also encouraged.

Signs & Symptoms of Melanoma

Australia has one of the highest prevalences of skin cancer in the world. Following expert guidelines for skin protection and skin health is essential to keep cancerous lesions at bay. 

Additionally, familiarise yourself with some of the signs of skin cancer and melanoma so that you can get expeditious support and treatment if necessary.

Common signs of melanoma

  • A new spot, mole, lesion, bump or skin growth.
  • A change in an existing spot, freckle, mole, bump or growth.
  • Itching.
  • A lesion that is repeatedly bleeding, crusting and failing to heal.
  • Change in the elevation of a mole or spot.
  • Increase or change in size and shape of moles.
  • A mole that changes colour, becomes blotchy or displays different colour shades.

Uncommon signs of melanoma

  • A mole that really stands out from the other spots on the body.
  • Pain or burning sensation.
  • Oozing and scabbing from the mole.
  • Darker lesions materialising on palms, soles of the feet, fingertips or within the lining of your mouth or nose. 
  • A small lesion or mole that has an irregular border with areas that are red, pink, white, purple, blue or black. 
  • A brown or black spot, patch or streak under a nail.

The ABCDE rule for identifying suspicious moles

The best guide to remembering the critical warning signs of melanoma is the ABCDE rule:

Asymmetry: Where the shape of one-half of the spot or mole doesn't match the other half. 

Border: Review the border closely to see if the edges become uneven, ragged or blurred.

Colour: Variegatedand a difference in colour within the lesion. Shades of black, brown, and tan along with patches of white, red, blue or gray may be visible. 

Diameter: The diameter has grown in size and is usually larger than the size of a pencil eraser or about 6 mm. Melanoma is smaller when initially detected.

Evolving: One of the most significant characteristics of a melanoma mole is that it is changing. From the size, shape and colour to the mole developing in a new area of the body. Moreover, when the melanoma grows within an existing mole, the texture of the mole may alter and feel firm or lumpy. Some spots may begin to itch or bleed.

Skin doctor chatting to client in office

Other factors to consider when examining moles

As a generalisation, the most common location for melanoma for men is the chest or back, whilst in women it is in the legs. However, these cancer cells can also be found even in areas not exposed to the sun and especially on the neck and face. They occur mainly in adults, but children also benefit from regular skin checks.

It's wise to keep in mind that some melanomas may not fit into the usual guidelines. Any new mole should be treated with suspicion. If in doubt, see your skin doctor immediately and, if necessary, they will take a skin biopsy and ask you a number of questions. 

When to see a doctor for suspected melanoma

Not all moles or lesions are cancerous. A normal mole is found with a smooth, more defined border, usually lies flatter to the skin and is one colour. There isn't a section with patches of different shades and most are less than the size of a pencil eraser or 6 mm. 

However, see your GP or skin doctor if you find something out of the ordinary. Follow the ABCDE rule and take pictures of what you find. Your doctor will not only take a biopsy specimen and confirm the melanoma diagnosis, but they may also engage the services of a melanoma cancer care team. 

Some patients choose to see a doctor at a skin cancer clinic. These are usually staffed by GPs with a greater interest in and experience with skin cancer, like our doctors at SunDoctors. 

The SunDoctors have the resources and expertise to detect all types of skin cancers, including all melanomas. Your health and safety is our primary concern. Get in touch today on 13 SKIN ( 13 75 46) or Drop us a message online.

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