Melanoma
Melanoma is one of the most serious types of skin cancer. One of the reasons that melanoma is classified as serious skin cancer is that it can spread to other parts of the body.
Your skin is made up of three layers:
- Epidermis – the outermost layer of skin
- Dermis – the middle layer containing blood vessels and connective tissue
- Hypodermis – the bottom layer of fat
The outer layer of the skin (epidermis) contains specialized cells called melanocytes that produce our skin's pigment (natural coloring). Melanoma occurs when these melanocytes begin multiplying out-of-control and form a cancerous tumor.
Facts about Melanoma
Patients can develop melanoma from an existing non-cancerous mole — you would begin to notice changes in your mole's appearance. But you may also see a new mole that looks different from your other moles.
Did you know that melanoma can occur anywhere on your body? Not only does melanoma develop on your arms and legs, but it can also develop on your scalp, under your fingernails, your genital area, and even on the soles of your feet.
Melanoma may rarely develop in the body's mucous membranes, including the eye, anus, and vagina.
Just over 100,000 people will develop melanoma in the United States in the coming year.
Risk Factors for Melanoma
If you have one of these risk factors for melanoma, it's sensible to begin skin self-exams. Just as with other kinds of cancer, early detection saves lives. Here are some of the risk factors for melanoma.
- Sun exposure. Living at higher altitudes or in areas where the sun shines brightly throughout the year puts you at a higher risk for any skin cancer. People who regularly work outdoors are at increased risk too.
- Sunburns. Just five sunburns in your life double your risk for melanoma.
- Indoor tanning. Tanning beds puts you at a greater risk for developing melanoma and other skin cancers.
- Moles. If you have lots of moles or moles called dysplastic nevi, you are at increased risk for melanoma.
- Fair skin. People with fair skin, blue or green eyes, blond or red hair, freckles, or skin that burns easily have a higher risk for melanoma.
- Family history. If you have a first-degree relative (mother, father, brother, sister, or child) who has melanoma, you have a 2-to-3 higher risk than average to develop melanoma. This risk might be due to where you live — higher elevation or near the equator. And if you have close family members who live in different places that develop melanoma, your risk is increased more.
- Previous history of skin cancer. If you've had basal cell or squamous cell skin cancer, you are at increased risk for melanoma.
- Race. The rate of melanoma in white people is twenty times more than in black people.
Age is sometimes considered a risk factor. However, the truth is that melanoma happens in every age group, even teenagers. Half of the people diagnosed with melanoma are over 50 — so that means that adults under 50 are just as likely to develop melanoma. Melanoma is more common in young adults than in many other kinds of cancer. Before age 50, melanoma is more common in women; after 50, it's more common in men.
Tips for Skin Self-Exams
Experts recommend a monthly skin exam. A monthly self-exam allows you to become familiar with your moles' appearances so that you can detect changes. The monthly exam also will enable you to see new moles.
The ABCDE guidelines are an easy and convenient way to conduct your monthly skin exam. Watch the video to learn about the warning signs of melanoma.
- A – Asymmetry. If you look at a melanoma mole, the halves don't match. The left edge may be shaped differently than the right edge, or one side of your mole might be darker than the other side.
- B – Border. Melanomas have an irregular-shaped border; the border may be blurred, jagged, notched, or scalloped.
- C- Color. Moles that contain different colors may be melanoma. You might see several shades of brown or tan mixed with patches of black. Larger melanomas can develop patches of blue, pink, red, or white.
- D – Diameter or Dark. Moles that are larger than one-quarter inch (the diameter of a pencil eraser) could be melanoma. Be on the alert if one mole is significantly darker than your other moles.
- E – Evolving. Evolving means changing or progressing — in size, shape, or color, or it becomes itchy or begins bleeding.
Take notice, too, of an Ugly Duckling — a mole that is significantly different from nearby moles. A melanoma may stand out from other moles because it's darker, lighter, bigger, or smaller. A single mole on a large area of your skin with no other moles is considered an "ugly duckling," too.
About one-quarter of melanomas develop from existing moles. An astonishing 75% appear as new growths on the skin.
People of color are more likely to develop melanomas in areas that aren't exposed to the sun. They are more likely to have melanoma on the palm of their hand, the sole of their foot, or beneath a fingernail or toenail.
Early detection is key — the five-year survival rate is 99% when melanoma is detected early.
Four Apps That Can Help You Track Skin Changes
There are several ways that you could keep track of your moles and other skin changes. The old-school way was to have a paper “body map” that you used to mark moles, growths, or other suspicious spots. Many people choose to continue using the paper method and that’s perfectly fine. However, there are also other options if you’d prefer to keep your records digitally -- including smartphone apps.
Several smartphone apps can help you keep track of skin changes and changes in specific moles. These apps are helpful, but they do not take the place of seeing a dermatologist when you detect moles that look suspicious. Always remember that it's better to err on the side of getting a dermatologist to look at any skin growth that looks different or pops up and quickly grows.
These apps are available for both Apple and Android phones.
- Miiskin. Miiskin is a paid "aka premium" app. It uses high-res photography to take photos of large parts of your body. The app allows the user to compare individual moles over time to detect changes.
- MoleMapper. MoleMapper is the result of a cancer biologist's efforts to help his wife. Oregon Health & Science University collaborated with Apple and Sage Bionetworks to develop this app. It's available at no cost. OHSU guides physicians to help monitor suspicious lesions without monthly in-person visits.
- MoleScope. Users must purchase a device that attaches to their smartphone. Photos taken with the attachment are sent to a dermatologist for an online opinion.
- SkinVision. A board of dermatologists developed this paid app. The app uses a deep learning algorithm to analyze your mole photo and assess whether it is high-risk within a minute.
Early detection of suspicious moles saves lives and helps prevent disfigurement from a patient who waited too long to see a dermatologist. Be sure to incorporate a monthly skin self-exam into your routine.
Originally published November 2020. Updated October 2024.
