Warning Signs of Melanoma

Melanoma is a type of skin cancer that develops when cells that produce melanin (melanocytes) begin to grow out of control. The American Cancer Society estimates that nearly 100,000 Americans will be diagnosed with melanoma this year. 

As with most cancers, finding melanoma at an early stage is crucial for beating the disease. When caught before it spreads, the 5-year survival rate of melanoma is 99%. 

The risk of melanoma increases as we age, so it’s especially important for older adults to be aware of the early signs and symptoms of the disease to catch it when it is most treatable. Read on to learn more about melanoma warning signs, and how to perform a skin self-examination. 

Melanoma risk factors

A risk factor is anything that increases your chance of developing melanoma. Although anyone can develop the disease, certain risk factors can increase the likelihood that you will be affected.

Factors that increase the risk of melanoma include: 

  • Unprotected exposure to ultraviolet (UV) rays. Prolonged exposure to the sun or tanning beds and lamps plays a major role in the development of melanoma, particularly if you have not used sunscreen. 
  • A weakened immune system. May be caused by existing medical conditions or medications you are taking. 
  • Many moles. The more moles on your body, the higher your risk. Large moles that are bigger than a pencil eraser also increase the risk. 
  • Fair skin. People with fair skin, red or blonde hair, and/or freckles are at a higher risk. This is especially true if you tend to burn after sun exposure, rather than tan. 
  • Genetics. Having a close family member (parent, sibling, child) who has been diagnosed with melanoma, your risk of developing the disease is 2-3 times higher than average. 
  • Age. As we age, our skin changes. It gets thinner, takes longer to heal, and is more likely to get damaged from pollution and/or a weakened immune system. The average age of people with melanoma at the time of diagnosis is 65 years old.

Signs and symptoms of melanoma: ABCDE rule

The first warning signs of melanoma are often visual because many people with this type of cancer do not have other symptoms until the disease has progressed. Looking for new spots or spots that have changed in color, shape or size on every area of the body can help detect melanoma in its early stages. 

The ABCDE rule can be used as a guide to help you identify signs of melanoma. Look at for any features that fit the following: 

  • Asymmetry. When one half of a mole or spot on the skin does not match the other. 
  • Border. The edges are blurred, irregular, notched, or ragged. 
  • Color. The color is not the same all over and may include shades of black or brown with blue, pink, red, tan or white patches. 
  • Diameter. The spot is larger than 6 millimeters (about ¼ of an inch) in size. 
  • Evolving. The mole is changing in color, size, or shape. 

Other warning signs include: 

  • “Ugly duckling” — a spot that looks different from the other spots on your skin
  • Sore or wound that doesn’t heal 
  • Pigment (color) from the border of a mole that spreads into the surrounding skin 
  • Redness or swelling surrounding the border of the mole
  • Itchiness, tenderness or pain 
  • Changes to the surface of a mole, including bleeding, oozing or scaliness

How to perform a skin self-exam

Keep in mind that melanoma can develop anywhere on the skin, even if that part of the body has not been exposed to the sun. Aim to do a skin self-exam once a month after a bath or shower. 

Follow these steps to perform a thorough skin self-exam. 

Step 1. Examine your body in front of a full-length mirror. 

Stand in front of a full-length mirror and thoroughly examine your body — both the front and back. Raise your arms to look at the left and right sides, too. 

Step 2. Examine your underarms, forearms, and palms. 

Raise your hands to look at your underarms, and bend your elbow to look at your forearms and palms. 

Step 3. Examine your legs, soles of your feet and in between toes. 

Sit in a chair to look at your legs (including the back of your legs) and feet, the space between your toes, and the soles of your feet. 

Step 4. Use a hand mirror to examine your neck, scalp, back and buttocks. 

Use a hand mirror to examine the back of your neck and scalp. Part your hair to thoroughly look at each area of your scalp. A hand mirror can be helpful for looking at your back and buttocks, too. If you have a partner or trusted family member, you can ask them to help you examine these hard-to-see areas, too. 

You may want to keep a journal to keep a record of any moles you spot and take note of their color, shape and size. You can reference these notes the next time you do a self-exam to check for any changes you may not remember. It can also be helpful to take your notes to your doctor at your routine wellness appointment or if you notice any suspicious spots. 

When to see a doctor

Once you’ve done your self-exam, you may wonder, “When do I need to see a doctor?” Make an appointment to see your healthcare provider if: 

  • You see a spot or mole that fits one of the ABCDE rules
  • You notice changes to your skin, such as new spots 
  • You notice a spot that is different from the others 
  • A spot or mole is bleeding, itching, or changing 

The American Academy of Dermatologists recommends you see a dermatologist once a year for a full-body skin exam, or more often if you are at a higher risk of melanoma or other skin cancers. 

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