Early symptoms of melanoma

Melanoma Symptoms

The most important of early symptoms of melanoma is any change in the size, shape, color, or feel of an existing mole, as well as the appearance of new and unusual moles or sores, lumps, blemishes, markings, changes, or any skin abnormality or growth that changes rapidly and does not go away, whether it is dark brown or black – as many melanomas are – or not colored. The majority of people develop between 10-45 harmless moles by age 40. Normal moles can be birthmarks or appear during early years. They usually are uniformly brown, tan, or black in color; round or oval in shape; flat or raised in texture; and less than ¼ inch (6mm) in size. Though some moles may disappear in time, these characteristics will remain unchanged for many years.

The acronym ABCDE can help you watch out for the early signs of melanoma:

·         Asymmetry

The shape of one half of the mole is different than the other half.

·         Border

Irregular, ragged, notched, uneven, blurred, scalloped borders.

·         Color

Multicolored moles including shades of brown, black, pink, red, white, blue, and gray.

·         Diameter

Larger than 6mm or smaller but growing in size.

·         Evolving

Changes in size, shape, color, appearance, or texture.

These changes can affect both existing moles and newly-formed melanomas, and appear in areas that have or not have been exposed to the sun like the torso, legs, arms, face, palms, and tips of fingers, where they can be more easily spotted and monitored. Unfortunately, melanomas can also develop anywhere else in the body, including hard-to-see areas such as under fingernails and toenails, toes, soles, and mucous membranes like the lines that line the mouth, nose, vagina, anus esophagus, and urinary tract.

Nevertheless, early detection of melanoma is possible. You should check your own skin at least once monthly to become acquainted with the pattern of moles, blemishes, freckles, and other marks, and be able to recognize new moles and changes in existing ones. Self-examination requires a well-lit room, a full-length mirror, and a hand mirror, and involves the following steps:

  1. Raise your arms and examine the front and back and right and left sides of the entire body.
  2. Bend your elbows and carefully look at the outer and inner forearms, upper arms, and hands.
  3. Check the front, sides, and back of the legs and feet, without neglecting the soles and the space between the toes.
  4. Parting the hair to lift it, look at the back of the neck and scalp on a hand-held mirror (a friend or relative can help you here).
  5. Examine the back, genitals, and buttocks with a hand-held mirror.

Additionally, a skin exam by a healthcare provider should be part of a regular cancer-related checkup. These exams are particularly important for individuals at an increased risk of melanoma. Risk factors include:

·         Exposure to ultraviolet B and ultraviolet A radiation from the sun.

·         Artificial tanning at tanning salons and from tanning booths and beds and sunlamps. 

·         Fair complexion that freckles or sunburns easily, blond or red hair, light-colored eyes.

·         A history of sunburn.

·         A history of skin cancer.

·         A parent, brother, sister, child, another close relative who has been diagnosed with melanoma.

·         Hereditary conditions such as xeroderma pigmentosum, retinoblastoma, Li-Fraumeni syndrome, Werner syndrome, and hereditary breast and ovarian cancer syndrome.

·         A weakened immune system.

·         A condition called dysplastic nevi characterized by unusual moles.

·         Having more 50 moles.

·         Race.

Caucasians are more likely to experience the early symptoms of melanoma than African-Americans and Hispanics – though the rates among the latter are increasing. Conversely, melanomas are harder to identify in people with darker skin. The truth is, however, that melanoma does not discriminate skin colors, and since one of the risk factors is so ubiquitous – though a more accurate term would be omnipresent, even in winter and through clouds –, prevention is essential, including:

Avoiding or limiting any and all exposure to the sun between 10 in the morning and 4 in the afternoon.

·         Wearing sunscreen all year long.

·         Wearing protective clothing such as hats and sunglasses.

·         Avoiding all forms of indoor tanning.

Keep in mind that ultraviolet radiation does not cause all melanomas. Those that develop in parts of the body that are not exposed to the sun are indicative that other factors are involved, for instance genetics. In cases of hidden melanomas or when the condition is not obvious to the naked eye, a biopsy is the most precise method for diagnosis. During a biopsy the skin lesion is removed and assessed by a pathologist. If it is indeed a melanoma, the pathology report will include some or all of the information below:


·         Superficial spreading melanoma,

·         Lentigo maligna melanoma,

·         Nodular melanoma, or

·         Acral lentiginous melanoma.


Measured in millimeters or fractions of millimeters to calculate the risk of spread.


Loss of the surface of the skin increases the risk of spread and recurrence.

Mitotic rate

The speed at which the tumor cells divide.

Other tests such as ultrasound, CT scan, MRI, or PET scan can aid in determining the size and extent of the tumor; in other words, they are useful in staging the cancer.

Melanoma stages



5-year survival rate

10-year survival rate


Melanoma cells are only in the skin’s outer layer. Unlikely to spread.




Still only in the skin and very thin.




Melanoma is less than 1.0mm thick, is not ulcerated and has a mitotic rate of less than 1/mm2.




Less than 1.0mm thick, mitotic rate at least 1/mm2, or between 1.01-2.0mm and not ulcerated.




Thicker than stage I, extending into the skin’s dense inner layer. Slightly more likely to spread.




Between 1.01-2.0mm thick and ulcerated, or between 2.01-4.0mm and not ulcerated.




Between 2.01-4.0mm thick and ulcerated, or thicker than 4.0mm and not ulcerated.




Thicker than 4.0 mm and ulcerated.




Melanoma has spread through the lymphatic system to a nearby lymph node or to a skin site on the way to a lymph node.




Any thickness, not ulcerated, has spread to 1-3 nearby lymph nodes.




Any thickness, not ulcerated, has spread to 1-3 nearby lymph nodes. The nodes may or may not be enlarged, or has spread to small nearby areas but not to the nodes.




Any thickness, ulcerated, has spread to small nearby areas, or to 1-3 lymph nodes, or it may or may not be ulcerated but has spread to 4 or more nodes.




Melanoma has spread to distant parts of the body such as the lung, liver, brain, bone or GI tract via the bloodstream.




The sooner the condition is treated after noticing the early symptoms of melanoma are noticed, the better the prognosis and the simpler the treatment. For instance, a very thin melanoma may be completely removed during a biopsy and need no additional treatment. But if the melanoma spreads beyond the skin, more invasive treatments will be required, such as surgery, chemotherapy, radiation, and drugs, among others.