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Melanoma can appear anywhere on the body, even on areas that are not exposed to the sun. The most frequent locations for melanoma are the trunk (torso), legs, and arms. However, melanoma can also develop under the fingernails or toenails; on the palms, soles, or tips of fingers and toes; or on mucous membranes, such as skin that lines the mouth, nose, vagina, and anus.
Melanoma can appear in a number of different ways. Many melanomas are dark brown/black and are often described as changing, different, unusual, or “ugly looking.” However, any skin abnormality that is growing or changing quickly and does not go away, whether colored or not, should be examined by a doctor. Bleeding may be a sign of more advanced melanoma.
Changes in the size, shape, color, or feel of a mole is often the first warning sign of melanoma. These changes can occur in an existing mole, or melanoma may appear as a new or abnormal-looking mole. The "ABCDE" rule is helpful in remembering the warning signs of melanoma:
Asymmetry. The shape of one half of the mole does not match the other.
Border. The edges are ragged, notched, uneven, or blurred.
Color. Shades of black, brown, and tan may be present. Areas of white, gray, red, or blue may also be seen.
Diameter. The diameter is usually larger than 6 millimeters (mm) (1/4 inch; the size of a pencil eraser) or has grown in size. Melanoma may be smaller when first detected.
Evolving. The mole has been changing in size, shape, color, or appearance, or growing in an area of previously normal skin. Also, when melanoma develops in an existing mole, the texture of the mole may change and become hard or lumpy. Although the skin may feel different and may itch, ooze, or bleed, melanoma usually does not cause pain.
In addition, the appearance of a new and unusual mole is more likely to be melanoma.
If you are concerned about a symptom or sign on this list, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.
If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.
Early detection of melanoma
Earlier detection and recognition of melanoma is the key to improving the chance for successful treatment and overall survival. Recognizing early warning signs of melanoma and doing regular self-examinations of your skin will help find melanoma early when the disease is highly curable.
Self-examination of skin. Self-examinations should be performed in front of a full-length mirror in a brightly lit room. It helps to have another person check the scalp and the back of the neck. Include the following steps in a skin self-examination:
- Examine the front and back of the entire body in a mirror, then the right and left sides, with arms raised.
- Bend the elbows and look carefully at the outer and inner forearms, upper arms (especially the hard-to-see back portion), and hands.
- Look at the front, sides, and back of the legs and feet, including the soles and the spaces between the toes.
- Part the hair to lift it, and examine the back of the neck and scalp with a hand mirror.
- Check the back, genital area, and buttocks with a hand mirror.
Talk with your doctor if you find any of the following:
- A growth on the skin that matches any feature on the ABCDE rule list (see above)
- New growth on the skin
- A suspicious change in an existing mole or spot
- An unusual sensation in a mole, such as itching or tingling
Medical tests for early detection. A painless medical technique being used for early detection of melanoma is epiluminescence microscopy, or dermoscopy, which allows a doctor to evaluate the patterns of size, shape, and pigmentation in pigmented skin lesions using a handheld device. Among trained, experienced medical professionals, the use of dermoscopy may reduce the number of biopsies (see the Diagnosis section) of pigmented lesions to rule out melanoma, although more research is needed. Meanwhile, confocal scanning laser microscopy is another new technology to better examine possible melanoma lesions, but it is only available in a few major facilities.
The next section helps explain what tests and scans may be needed to learn more about the cause of the symptoms. Use the menu on the side of your screen to select Diagnosis, or you can select another section, to continue reading this guide.