Melanoma is the most dangerous form of skin cancer. Originating in the basal layer of the epidermis, melanoma forms from melanocytes, cells which produce the pigment melanin to protect the skin from harmful ultraviolet rays. Both tanning beds and natural sunlight contribute to the production of melanin, and too much exposure to either one puts you at risk of developing melanoma. As the cancer continues to develop, cells rise to the surface of the skin and the lesion becomes visible to the naked eye.
Many people believe the development of a melanoma will be immediately apparent, but the signs and symptoms of this aggressive cancer are often less obvious than you’d think. Malignant spots may look like other harmless skin conditions, causing patients to delay seeing their doctor for far too long. Over 10,000 patients every year die from this disease, so early detection is essential to preventing a fatal outcome. The American Cancer Society states that a self-check for suspicious growths should be done at least once a month. By understanding the common signs and symptoms of melanoma, you can raise your chances of identifying an at-risk spot and be sure to schedule a timely, and possibly life-saving, visit to your dermatologist.
1. New Growths/Moles
While some melanomas develop from existing spots, the majority are new growths. A study published in the Journal of the American Academy of Dermatology states that over 70 percent of melanomas are new spots, with less than 30 percent occurring as a malignant change from a previously existing mole. This information supports the current recommendation of frequent self-checks, but it’s also reason to expand your search for unusual marks on your body. Focusing solely on known moles can distract from a lesion that may be just starting to form. Considering a third of melanomas appear on the back, it’s a good idea to have your partner look at the areas you can’t see.
Some people have large amounts of moles and other spots. This makes keeping track of new growths quite the challenge. If you’re someone with tens or even hundreds of moles, using a body chart can be helpful. Simply draw a basic outline of a human body on a sheet of paper, then put a check mark where you currently have spots. Any time you notice a mark that could be new, refer to the body chart to see if it was already around. If you do notice any new growths/moles, the first thing to check for is asymmetry.
2. Asymmetrical Moles or Marks
Symmetry refers to a shape that is consistent on all sides. Asymmetrical moles or marks exhibit differences between two sides of the mole. You can determine whether a spot is symmetrical or asymmetrical by simply drawing a line through the middle of it. If both sides are identical, your spot is symmetrical. If the line reveals a variation on one side of the growth, this is a warning sign. Most benign spots only have minor differences across the entire mark. Cancerous growths, however, often have a significant size difference on one side. Once you’ve divided the spot in half by drawing a line, you may notice oddities in the borders of the lesion. This is another common warning sign.
3. Irregular Edges
The borders of a melanoma are often noticeably different from that of a benign mole. A normal spot should have distinct, clearly defined edges that don’t differ from one side of the spot to the other. Abnormal growths like melanomas often feature irregular edges with nodules or scalloping and commonly have blurred, unclear borders that make distinguishing the perimeter of the mole difficult. Ragged or scalloped edges may be a sign of nodular melanoma, a particularly aggressive cancer that requires quick intervention. Fading and discoloration on the edges of a mole can be a sign of malignancy as well.
4. Discoloration
Healthy moles are often a monotone shade of brown or tan. Melanomas, however, come in many shades and colors. While black is perhaps the most striking, any discoloration through a spot is concerning. Moles that have a dark brown shade in one area with the color fading to a light tan in another are worrisome, along with moles that exhibit bright red or pink spots. Blue is a particular sign of malignancy, so any blue discoloration merits a trip to the doctor. Amelanotic melanomas are a more subtle-looking type of malignancy that have no dark pigment, thus appearing skin-colored. Because some spots present with relatively normal coloring, it’s important to take into account other factors, like diameter.
5. Diameter
Lesions greater than six millimeters are over five times as likely to be melanomas than spots which are less than six millimeters. Bigger melanomas are particularly prevalent in older patients, and larger size is often correlated with greater thickness. Six millimeters is about the size of a pencil eraser, so any mole that matches up to the end of a pencil is a red flag and should be examined by a dermatologist promptly. Though a substantial diameter is a big warning sign, the most common type of melanoma, superficial spreading melanoma, can take months or even years to grow. That’s why it’s important to carefully monitor any changes in your existing spots.
6. Changing Spots
Any change to an existing spot is cause for concern, which is why monthly self-checks are so important. However, certain changes are more worrisome than others. Pigment spreading into the surrounding skin, redness or swelling, oozing or pus and a change in sensation are all possible signs of malignancy. Changing spots that were previously smooth but now appear bumpy or crusty are a sign to get yourself checked out quickly. Raised moles and other benign skin spots can get irritated occasionally, but they shouldn’t cause persistent discomfort, so take note if a spot presents with symptoms such as itchiness.
7. Itchiness
While wearing tight clothing or engaging in excessive activity can cause a mole to itch, itchiness with no notable source is a sign of melanoma. This can be a particularly difficult symptom to notice, since itchiness can come and go throughout the day. You may not even notice you’ve been scratching at a mole until weeks have passed. This is why using a mirror or asking a partner to check your back is so important. If you notice a spot is itchy, pay attention to how long the irritation lasts. When it persists for more than a few days, it’s a warning sign, especially when accompanied by pain.
8. Pain
Healthy moles are painless. Melanomas, on the other hand, can cause a variety of unpleasant sensations. Pain, numbness, tingling, stinging, prickling and even burning are all signs of a current malignancy. The spot may ooze and bleed, causing tenderness and discomfort. Regular moles don’t cause swelling, while melanomas can appear inflamed in both the spot itself and the surrounding tissue. Pay special attention if a previously painless mole begins to feel sore. Not all unhealthy moles cause pain, but if you experience a growth that’s bothersome for more than a few days, a trip to the dermatologist is in store.
