Skin Cancer (Melanoma): Early Signs, Risk Factors, and Treatment Options

Melanoma often starts in the skin and may look like a changing mole or a new, unusual spot. Because it can sometimes grow and spread faster than other skin cancers, recognizing suspicious changes early and understanding how clinicians evaluate and treat it can make a meaningful difference in outcomes.

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.

What Is Melanoma?

Melanoma is a cancer that arises from melanocytes, the cells that produce melanin (the pigment that gives skin its color). It most often appears on sun-exposed areas, but it can also develop in places that receive little sun, such as the soles of the feet, under nails, or on mucosal surfaces. Melanoma may develop within an existing mole or appear as a new lesion. Clinicians typically evaluate a suspicious spot by examining its appearance and history (for example, whether it has changed), and they confirm the diagnosis with a skin biopsy.

Melanoma is also described by its “stage,” which reflects how deep or extensive it is and whether it has spread to lymph nodes or other organs. Details such as Breslow thickness (depth of the tumor in the skin) and ulceration help guide treatment planning.

Early Signs of Melanoma

Many clinicians teach the ABCDE checklist as a practical way to notice potentially concerning changes:

A: Asymmetry (one half doesn’t match the other) B: Border irregularity (edges may be ragged or blurred) C: Color variation (multiple shades such as brown, black, red, white, or blue) D: Diameter (often larger than 6 mm, though smaller lesions can still be melanoma) E: Evolving (any change in size, shape, color, or symptoms)

Another helpful concept is the “ugly duckling” sign: a spot that looks different from a person’s other moles. Symptoms such as itching, tenderness, bleeding, or crusting can also be warning signs—especially when paired with visible change. Because benign moles can change too, the key is a lesion that is new, unusual for you, or consistently evolving.

Risk Factors

Risk for melanoma is influenced by both genetics and environment. Ultraviolet (UV) exposure is a major contributor, including intense intermittent sun exposure and sunburns, as well as indoor tanning. People with fair skin, light eyes, or hair that burns easily may be more susceptible to UV damage, but melanoma can occur in any skin tone.

Other commonly cited risk factors include:

Having many moles or atypical (dysplastic) moles A personal history of melanoma or other skin cancers A family history of melanoma (especially in first-degree relatives) A weakened immune system (for example, due to certain medical conditions or immunosuppressive medications) Older age (risk increases over time), though melanoma also occurs in younger adults

It’s also important to know that melanoma may be harder to spot in darker skin tones because it can be less expected and may occur in less sun-exposed areas (such as palms, soles, and nail beds). Paying attention to new or changing lesions anywhere on the body is relevant for everyone.

Importance of Early Detection

Early detection matters because melanoma is often highly treatable when found before it has penetrated deeply or spread beyond the skin. Clinicians may recommend a combination of self-checks and professional skin examinations, especially for people with elevated risk.

A practical self-check involves looking over the entire skin surface monthly or periodically—front and back of the body, scalp (with help), between toes, and under nails. Taking periodic photos can help track change over time, which is often more informative than a single snapshot.

When a lesion is suspicious, the standard next step is typically biopsy. A biopsy provides the tissue diagnosis and additional details that help determine whether more surgery is needed and whether lymph nodes should be evaluated. Depending on the case, clinicians may also use tools like dermoscopy (a magnified skin exam) and, for higher-stage disease, imaging tests to look for spread.

Treatment Options

Treatment depends on the melanoma’s stage and features, overall health, and patient preferences. For many early melanomas, surgery is the main treatment. This usually involves wide local excision—removing the melanoma along with a margin of normal-appearing skin to reduce the risk of local recurrence.

For some melanomas (often based on thickness and other risk features), clinicians may recommend a sentinel lymph node biopsy to check whether cancer cells have reached nearby lymph nodes. If melanoma is found in lymph nodes or has spread elsewhere, management may include systemic therapy (treatments that reach cancer cells throughout the body).

Common systemic approaches include:

Immunotherapy: Drugs such as checkpoint inhibitors help the immune system recognize and attack melanoma cells. These may be used after surgery in higher-risk cases (adjuvant therapy) or for melanoma that cannot be removed surgically or has spread. Targeted therapy: If the melanoma has certain genetic changes (such as BRAF mutations), targeted drugs may be options. Testing the tumor can determine eligibility. Radiation therapy: Sometimes used for symptom control, for certain local/regional situations, or when melanoma involves the brain or other sites where radiation is helpful. Chemotherapy: Used less commonly than in the past for melanoma, but may still be considered in specific situations.

Follow-up is also a key part of care. After treatment, clinicians often recommend regular skin exams and, depending on stage, periodic imaging or lab tests. Ongoing sun protection and avoidance of tanning beds are typically advised to reduce UV damage and help lower the risk of additional skin cancers.

In summary, melanoma is a serious but often treatable skin cancer when identified early. Knowing what melanoma is, watching for early signs, understanding risk factors, and recognizing how treatment options are selected can help patients have clearer, more productive conversations with their healthcare team.