Can melanoma be found early?

Melanoma can often be found early. Everyone can play an important role in finding skin cancer early, when it is most likely to be curable.

Self-exam

It's important to check your own skin, preferably once a month. You should know the pattern of moles, blemishes, freckles, and other marks on your skin so that you'll notice any new moles or changes in existing moles. Self-exam is best done in a well-lit room in front of a full-length mirror. A hand-held mirror should be used to help look at areas that are hard to see, such as the backs of your thighs.

All areas should be examined, including your palms and soles, scalp, ears, nails, and your back. (For a more thorough description of a skin self-exam, see our documents called Skin Cancer: Prevention and Early Detection and Why You Should Know About Melanoma) Friends and family members can also help you with these exams, especially for those hard-to-see areas, such as your back. Be sure to show your doctor any area that concerns you and ask your doctor to look at areas that may be hard for you to see. In men, about 1 of every 3 melanomas occurs on the back.

Spots on the skin that are new or changing in size, shape, or color should be seen by a doctor promptly. Any unusual sore, lump, blemish, marking, or change in the way an area of the skin looks or feels may be a sign of skin cancer or a warning that it might occur. The skin might become scaly or crusty or begin oozing or bleeding. It may feel itchy, tender, or painful. Redness and swelling may develop. Spots on the skin that look different from the surrounding moles (the "ugly duckling sign") should be evaluated.

It is sometimes hard to tell the difference between melanoma and an ordinary mole, even for doctors, so it is important to show your doctor any mole that you are unsure of.

What to look for

Normal moles

A normal mole is usually an evenly colored brown, tan, or black spot on the skin. It can be either flat or raised. It can be round or oval. Moles are generally less than 6 millimeters (about ¼ inch) across (about the width of a pencil eraser). A mole can be present at birth, or it can appear during childhood or young adulthood. New moles that appear later in life should be checked by a doctor.

Once a mole has developed, it will usually stay the same size, shape, and color for many years. Some moles may eventually fade away.

Most people have moles, and almost all moles are harmless. But it is important to recognize changes in a mole that can suggest a melanoma may be developing.

Possible signs and symptoms of melanoma

The most important warning sign for melanoma is a new spot on the skin or a spot that is changing in size, shape, or color. Another important sign is a spot that looks different from all of the other spots on your skin (known as the "ugly duckling sign"). If you have any of these warning signs, have your skin checked by a doctor.

The ABCD rule is another guide to the usual signs of melanoma. Be on the lookout and tell your doctor about spots that have any of the following features:

• A is for Asymmetry: One half of a mole or birthmark does not match the other.
• B is for Border: The edges are irregular, ragged, notched, or blurred.
• C is for Color: The color is not the same all over and may include shades of brown or black, or sometimes with patches of pink, red, white, or blue.
• D is for Diameter: The spot is larger than 6 millimeters across (about ¼ inch – the size of a pencil eraser), but melanomas can sometimes be smaller than this.

Some melanomas do not fit the rules described above, so it is important to tell your doctor about any changes in skin lesions, new skin lesions, or growths that look different from the rest of your moles.

Other warning signs are:

• A sore that does not heal
• Spread of pigment from the border of a spot to surrounding skin
• Redness or a new swelling beyond the border
• Change in sensation – itchiness, tenderness, or pain
• Change in the surface of a mole – scaliness, oozing, bleeding, or the appearance of a bump or nodule

Exam by a health care professional

Part of a routine cancer-related checkup should include a skin exam by a health care professional qualified to diagnose skin cancer. Your doctor should be willing to discuss any concerns you might have about this exam.

Any suspicious lesions or unusual moles should be seen by your primary doctor or by a dermatologist, a doctor who specializes in skin problems. Many dermatologists use a technique called dermatoscopy (also known as dermoscopy,epiluminescence microscopy [ELM], or surface microscopy) to look at spots on the skin more clearly. A digital or photographic image of the spot may be taken. (See the section called "How is melanoma diagnosed?" for more information.)