Melanoma: What It Is, Causes, Types, Symptoms & Treatments

As you prepare to head out into the sun this summer, it’s important to protect yourself. Of all the skin cancers, melanoma is the one that scares doctors and patients the most and unfortunately, many Black Americans are unaware that they are at risk of developing it.

“The patients have to understand they are at risk so they can come to the doctor,” Meena Moossavi, MD, a dermatologist practicing in Detroit, Michigan says. “The providers need to know what to look for so they can diagnose as soon as possible.”

Luckily, there are now several options for treatment should you be diagnosed with this aggressive, sometimes deadly, cancer.

“If you get diagnosed right away, it’s a better prognosis than when the diagnosis is made after months or years,” Moossavi adds. “I’ve been talking about this with the [medical] students and residents and we always come to the same conclusion: Education is the most important thing.”

Melanoma affects over 1 million Americans, and its rates have risen significantly in the past 30 years, according to the American Academy of Dermatology (AAD). Although Black people less likely to develop melanoma than non-Hispanic White people, Blacks who do develop the cancer have a much lower five-year survival rate.

Here, experts explore what melanoma is, along with its causes, risk factors and key symptoms. Plus, you’ll learn about melanoma’s stages, types and treatments.

What is melanoma?

The American Cancer Society (ACS) explains that cancer occurs when cells begin to grow out of control. Melanoma is a type of cancer that starts in the pigment-making cells, known as “melanocytes.” While not as common as other forms of skin cancer, it is more serious.

“Melanoma is more aggressive and more likely to spread to the lymph nodes,” according to Dr. Hugh Greenway, a dermatologic surgeon with Scripps MD Anderson Cancer Center and Scripps Clinic in California. “It’ll spread to the liver, to the brain and throughout the body if not checked.”

According to the AAD, ultraviolet light from the sun or tanning beds is the cause of melanoma.

Risk factors include:

Blistering sunburns
Tanning bed use
Light skin, light-colored eyes, or red or blond hair
Moles that are asymmetrical or large
Time in the sun without protection
Numerous moles (50 or more)
Being age 50 or older
A family history of melanoma
Lowered immunity
A thyroid, breast or previous skin cancer diagnosis

To reduce these risks, Greenway recommends wearing sunglasses, a wide-brimmed hat and using a water-resistant sunscreen that protects against both UVB and UVA light when out in the sun.

“I tell my patients here at Scripps between a 30 to 50 [SPF sunscreen] is fine,” he advises.

Melanoma types

The Skin Cancer Foundation lists four main types of melanoma:

Superficial spreading melanoma is the most common type and tends to occur on the upper back, the legs for women and the torso for men
Lentigo maligna melanoma tends to occur in older adults and often shows up on the arms, upper torso, face and ears
Acral lentiginous melanoma is the most common type for people of color and mostly occurs on the soles of the feet, palms and under the nails
Nodular melanoma is considered the most aggressive type and typically occurs on the arms, legs, torso and scalp in older men

Melanoma Skin Cancer Symptoms

So, what does melanoma look like?

Scripps MD Anderson Cancer Center says to be on the lookout for irregular-looking spots on your skin, new spots or ones that change size, shape, or color.

Other melanoma symptoms may include:

Fluid (like blood or pus) on a spot’s surface
Itching, redness, or pain
New inflammation outside the spot’s original borders
Color (pigmentation) that spreads tothe surrounding areas
A spot that won’t heal

To help you identify a melanoma, Greenway suggests the A-B-C-D-E rule.

“‘A’ stands for asymmetry,” he explains. If you draw a line down the middle of a melanoma spot or mole, one half won’t typically match the other.

The “B” is borders that aren’t regular. “That one [mole] that’s got a lot of outcropping and things, we say that’s a little irregular,” he notes.

“C” stands for color. “All of a sudden if you’ve got a mole that’s got a lot of blacks in it, reds, different colors, that could be a sign that mole’s a problem.

‘D’ is just for being different, and ‘E’ is for a mole that’s sort of starting to evolve and change a little bit.”

He advises that itchy moles or ones you’re suddenly aware of could be early signs of melanoma, while bleeding moles may indicate more advanced stages of the disease.

Stages of melanoma

According to the ACS, the stages of melanoma are:

Stage 0: The cancer is only on the skin’s outer layer
Stage I: The tumor is less than 2 mm thick and hasn’t spread beyond the skin
Stage II: The tumor is at least 1 to 4 mm thick and hasn’t spread beyond the skin
Stage III: The primary tumor can vary in size or not be visible, and the cancer has spread to nearby lymph nodes or areas of the skin
Stage IV: The tumor has spread to distant lymph nodes or organs

Melanoma treatments

Scripps states that melanoma treatments include:

Surgery to remove the cancer
Chemotherapy and radiation
Immunotherapy drugs
Targeted gene and protein therapy

One study published recently in the journal Cancer Discovery found that certain mRNA vaccines combined with immunotherapy helped reduce the risk of melanoma tumors returning, although more research is needed before this treatment is broadly available.

Early detection is also key to better melanoma outcomes, according to Greenway.

“You probably ought to have your skin checked once a year,” he recommends. “We know that if we can make the diagnosis [early], we can cure it with greater than 99% [cure rate] in most people.”

Frequently Asked Questions About Melanoma Symptoms

1. What are the common symptoms of malignant melanoma?

Malignant melanoma often begins as a new mole or a change in an existing mole. Common symptoms of malignant melanoma include:

Asymmetry (one half doesn’t match the other)
Irregular borders
Multiple or unusual colors
Diameter larger than 6mm
Evolving shape, size, or color

Early detection is crucial, so monitoring any changes in your skin is important.

2. Where can I find melanoma symptoms pictures to help with identification?

You can find melanoma symptoms pictures on reputable medical websites like the American Academy of Dermatology, the Mayo Clinic, or the Skin Cancer Foundation. These images help distinguish benign moles from potentially cancerous ones and show variations of melanoma across skin tones.