Early signs of melanoma

Melanoma symptoms

Because many melanomas develop on the skin where they can be seen, they have a good chance of being detected early. Regular examination of the skin for any new or unusual growths, or changes in existing moles, is critical. If you find anything suspicious, you should discuss it with your primary care physician, a dermatologist (skin doctor) or a health care professional qualified to diagnose melanoma.

Most moles are harmless. A normal mole is generally colored evenly (brown, black or tan), and are less than 6 mm in diameter (about the size of a pencil eraser). They can be flat or raised, and generally do not change over time.

Early warning signs of melanoma

The first sign of melanoma is typically a new spot on the skin, or a change in the size, shape or color of an existing mole. The ABCDE method may help you determine whether an abnormal skin growth may be melanoma:

  • Asymmetry: The mole has an irregular shape.
  • Border: The edge is not smooth, but irregular or notched.
  • Color: The mole has uneven shading or dark spots.
  • Diameter: The spot is larger than the size of a pencil eraser.
  • Evolving or Elevation: The spot is changing in size, shape or texture.

The only way to be sure if a mole is melanoma is to have it examined by a doctor.

Other melanoma symptoms may include:

  • Sores that do not heal
  • Pigment, redness or swelling that spreads outside the border of a spot to the surrounding skin
  • Itchiness, tenderness or pain
  • Changes in texture, or scales, oozing or bleeding from an existing mole
  • Blurry vision or partial loss of sight, or dark spots in the iris

Because cancer symptoms vary—and not all melanomas develop from moles—it is important to discuss new or unusual skin growths with your doctor.

Although many melanomas develop in areas exposed to the sun, they may also develop in areas that are usually hidden from the sun. In addition to examining the legs, trunk, arms, face and neck, it is important to look at the areas between the toes, underneath fingernails and toenails, on the palms of the hands, the soles of the feet, the genitals and even the eyes.

Next topic: What are the types of melanoma?

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

ABCDE rule

Changes in the size, shape, color, or feel of a mole are often the first warning signs of melanoma. These changes can occur in an existing mole, or melanoma may appear as a new or unusual-looking mole. The “ABCDE” rule is helpful in remembering the warning signs of melanoma:

  • Asymmetry. The shape of one-half of the mole does not match the other.

  • Border. The edges are ragged, notched, uneven, or blurred.

  • Color. Shades of black, brown, and tan may be present. Areas of white, gray, red, or blue may also be seen.

  • Diameter. The diameter is usually larger than 6 millimeters (mm) or had grown in size; this is 1/4 inch, about the size of a pencil eraser. Melanoma may be smaller when first detected.

  • Evolving. The mole has been changing in size, shape, color, or appearance, or it is growing in an area of previously normal skin. Also, when melanoma develops in an existing mole, the texture of the mole may change and become hard or lumpy. Although the skin lesion may feel different and may itch, ooze, or bleed, a melanoma skin lesion usually does not cause pain.

When to see a doctor

Many melanomas are dark brown or black and are often described as changing, different, unusual, or “ugly looking.” However, any skin abnormality that is growing or changing quickly and does not go away, whether colored or not, should be examined by a doctor. Bleeding may be a sign of more advanced melanoma. In addition, the appearance of a new and unusual mole is more likely to be melanoma.

If you are concerned about a new or existing mole, please talk with your family doctor or a dermatologist. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

What Does Melanoma Look Like? 5 Skin Cancer Signs to Watch For

Melanoma is the deadliest form of skin cancer, but it’s often treatable if caught at an early stage. That’s why it’s important to know the early signs of melanoma, which usually starts as a mole or other suspicious skin spot.

You can perform a skin cancer self-exam in just 10 minutes, if you know what to look for. All you need to do is memorize five warning signs, called the ABCDEs of melanoma, which can help you distinguish between normal skin markings and what could be signs of a cancerous mole.

In these photos, courtesy of the Skin Cancer Foundation, the first example for each set is what doctors would probably consider normal skin. The second is an example of a something that could be a warning sign of melanoma.

RELATED: 5 Signs of Skin Cancer Other Than an Abnormal Mole

Asymmetry

If you drew a line down the middle of a spot that could be melanoma, the two sides wouldn’t match.

Image zoom Image zoom

RELATED: Are You Getting a Good Skin Cancer Check?

Borders

Uneven, squiggly edges can be a sign of early melanoma.

Image zoom Image zoom

RELATED: 5 Best Ways to Protect Against Skin Cancer

Color

Check for subtle shading differences within the mole, or colors other than brown or black, like red or blue. Benign moles are usually all one shade of brown.

Image zoom Image zoom

RELATED: 3 Tips for Applying Sunscreen

Diameter

A mole 1/4-inch across (about the size of a pencil eraser) or larger should set off red flags. It could be a sign of a cancerous mole.

Image zoom Image zoom

RELATED: 10 Things You Don’t Know About Melanoma

Evolution

Any changes—in size, shape, color, or more—can be signs of melanoma. Benign moles usually look the same over time.

Image zoom Image zoom

Get more on melanoma here.

This post was originally published on April 13, 2015 and has been updated.

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

  • By Julie Mazziotta

Symptoms


Skin cancer (melanoma)

The first sign of a melanoma is often a new mole or a change in the appearance of an existing mole.

Normal moles are generally round or oval, with a smooth edge, and usually no bigger than 6mm (1/4 inch) in diameter.

But size isn’t a sure sign of melanoma. A healthy mole can be larger than 6mm in diameter, and a cancerous mole can be smaller than this.

Picture of a normal mole Credit:

Anagramm / Thinkstock

See your GP as soon as possible if you notice changes in a mole, freckle or patch of skin, particularly if the changes happen over a few weeks or months.

Picture of a melanoma Credit:

Scott Camazine / Alamy Stock Photo

Signs to look out for include a mole that’s:

  • getting bigger
  • changing shape
  • changing colour
  • bleeding or becoming crusty
  • itchy or sore

The ABCDE checklist should help you tell the difference between a normal mole and a melanoma:

  • Asymmetrical – melanomas have 2 very different halves and are an irregular shape
  • Border – melanomas have a notched or ragged border
  • Colours – melanomas will be a mix of 2 or more colours
  • Diameter – most melanomas are larger than 6mm (1/4 inch) in diameter
  • Enlargement or elevation – a mole that changes size over time is more likely to be a melanoma

Melanomas can appear anywhere on your body, but they most commonly appear on the back in men and on the legs in women.

They can also develop underneath a nail, on the sole of the foot, in the mouth or in the genital areas, but these types of melanoma are rare.

Melanoma Signs and Symptoms: Early Detection Is Key

Dermatologists use the ABCDE system to examine suspicious moles. Thinkstock

Recognizing the early signs of melanoma — and getting yourself to a doctor as soon as possible if you see anything suspicious — is vital.

That’s because the earlier the diagnosis, the better the prognosis. For melanoma treated early, before it has time to spread, the five-year survival rate is over 98 percent.

Once the cancer has spread, treatment is more complicated and recovery a lot less certain.

Dermatologists recommend examining your skin once a month, looking for any abnormal spots or growths that might signal melanoma or another type of skin cancer.

Scrutinize your entire body, from your scalp to your soles and the tips of your toes — and between the toes, too. Use a full-length mirror and a hand mirror or enlist a partner to inspect hard-to-see areas like the back of your neck. (1)

The ABCDEs of Melanoma

Dermatologists use an acronym, ABCDE, to describe the differences between a benign (harmless) mole and a malignant one.

  • A is for asymmetry. Most benign moles are symmetrical: If you draw a line through the middle, the halves match. Asymmetry, on the other hand, is a warning sign for melanoma.
  • B is for border. A benign mole has smooth, even borders; a malignant mole may have scalloped, notched, or otherwise irregular edges.
  • C is for color. Most benign moles are a single color, usually some shade of brown. Malignant moles might contain several different shades of brown, tan, or black, or they might be red, white, or blue.
  • D is for diameter. Malignant moles are usually bigger in diameter than benign ones. They tend to be larger than the eraser on a pencil (about ¼ inch) but may be smaller if caught early.
  • E is for evolving. Benign moles usually stay the same. Malignant ones can morph in size, color, shape, elevation, or other characteristics. (2)

Some melanomas don’t neatly fit into the ABCDE categories. See a doctor if you have any of the following warning signs:

  • A sore that does not heal.
  • Spread of pigment from the border of a spot into the skin around it.
  • Redness or a new swelling beyond the border of the spot.
  • Change in sensation, such as itchiness, tenderness, or pain.
  • Change in the mole’s surface: oozing, bleeding, scaliness, or the appearance of a bump or lump. (3)

Searching for Ugly Ducklings

If the ABCDE approach seems complicated, dermatologists have come up with a simpler way to identify a suspicious mole: Ask yourself whether it’s an “ugly duckling” that looks different from all the other moles around it.

It might be larger and darker, for instance, or it might be a small red mole surrounded by bigger brown moles. For a person who has few other moles, any change in a spot or growth makes it an ugly duckling.

Researchers at the Mayo Clinic in Arizona who evaluated this method found patients were able to use it more effectively than the ABCDE approach. (4)

Skin Self-Exams: A How-to Guide

Once you know what to look for, you need to start looking.

Together with yearly skin checks by a doctor, regular self-examination is critical for catching melanoma and other types of skin cancer early.

According to the Skin Cancer Foundation, monthly self-exams should be sufficient for most people, but they recommend checking with your doctor to make sure you don’t need to look more frequently.

Once you’ve done a few self-exams, they get easier and faster. You should be able to complete it in 10 minutes. (5)

You’ll need a bright light, a full-length mirror, a hand mirror, two chairs or stools, a blow-dryer, and a pencil.

You’ll also want a body map (downloadable from the Skin Cancer Foundation) to record the location, size, and color of each mole, freckle, birthmark, and any other spot or growth. This will help you monitor these lesions for changes.

Here’s how to do the exam:

  • Look closely at your face, paying extra attention to your nose, lips, mouth, and ears — front to back. Use the hand mirrors (one or both) if necessary.
  • Examine your scalp, using a mirror and a blow-dryer to move hair out of the way. Get a friend or family member to help if possible.
  • Scrutinize your hands: the palms and backs, between the fingers, and underneath the fingernails. Move up your wrists to your forearms, examining the skin front and back.
  • Facing the full-length mirror, examine your upper arms (including your underarms) starting at the elbows.
  • Check the neck, chest, and torso. Women should lift their breasts to see the undersides.
  • Facing directly away from the full-length mirror, use the hand mirror to examine the back of your neck, shoulders, upper back, and any part of the back of your upper arms you weren’t able to see before.
  • Using both mirrors, examine your lower back, buttocks, and backs of both legs.
  • Sit down and take turns propping each leg on the other chair or stool. Use the hand mirror to examine the genitals. Scan the front and sides of both legs, thigh to shin, as well as the ankles, tops of feet, between the toes, and under the toenails. Scrutinize the soles of the feet and heels. (6)

RELATED: What Are Some of the Signs and Symptoms of Cancer?

Why Having a Skin-Check Partner Is a Smart Move

Researchers are finding that when it comes to spotting melanoma, two sets of eyes are better than one.

In a study at the Northwestern University Feinberg School of Medicine, researchers recruited patients who’d previously been treated for melanoma, and who were thus at increased risk for developing a second melanoma.

Each patient brought in a partner — a spouse, family member, or friend. Half the partners were trained to identify suspicious lesions.

The researchers discovered that the patient-and-trained-partner duos spotted more early-stage melanomas than pairs who were simply reminded to do regular self-exams. Being trained with a partner to do skin exams appeared to promote more frequent performance of self-exams and helped people pick up melanomas accurately. (7)

How do I check myself for melanoma?

The first symptom of a melanoma is usually the appearance of a new spot, or a change in an existing freckle or mole. The change may be in size, shape or colour and is normally noticed over several weeks or months.

The ABCDE guidelines provide a useful way to monitor your skin and detect the early signs of melanoma. Please note that this is just a guide and melanoma may present with different characteristics. This is why regular skin checks from a professional are so important.

Please seek expert advice if you notice any of the following:

A is for ASYMMETRY:

One-half of a mole or birthmark does not match the other.

B is for BORDER irregularity:

The edges are irregular, ragged, notched, or blurred.

C is for COLOUR variation:

The colour is not the same all over, but may have differing shades of brown or black, sometimes with patches of red, white, or blue.

D is for DIAMETER:

The area is larger than 6 mm (about the size of a pencil eraser) or is growing larger.

E is for EVOLVING:

Changes in size, shape, colour, elevation, or another trait (such as itching, bleeding or crusting).(This last point is likely the strongest of all of the warning signs)

How do I make sure I don’t miss anything?

  • Stand in front of a full length mirror in a well lit room.
  • Start at the top and work your way down your body.
  • Begin by using a brush or hairdryer to part your hair into sections so that you can check your scalp.
  • Move to your face and neck, not forgetting your ears, nostrils and lips.
  • Be sure to check both the top and underneath of your arms. Don’t forget your fingernails.
  • As you move down your body don’t forget to check places where the sun doesn’t shine! Melanoma can be found in places that do not have exposed skin.
  • Ask a partner or family member to check your scalp and back.
  • The best way to monitor changes on your skin is by taking photographs every few months and comparing them to identify any changes. React quickly if you see something growing and/or changing.

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *