Melanoma: Risk Factors and Symptoms
Melanoma is the most severe and aggressive type of skin cancer. In 2024, there will be an estimated 100,640 new cases of melanoma of the skin according to the National Cancer Institute (NCI). About 8,290 people will die of this disease.
Fortunately, if caught early, melanoma can be quite treatable. “More and more people are diagnosed with melanoma every year. But at the same time, more people are surviving a melanoma diagnosis,” says Shawn Demehri, MD, PhD, a dermatologist. He’s also a principal investigator at the Krantz Family Center for Cancer Research at Mass General Cancer Center and director of the Massachusetts General Hospital High Risk Skin Cancer Clinic.
Dr. Demehri reviews melanoma risk factors, symptoms, and steps you can take to help reduce your risk.
What is melanoma?
“Melanoma is the deadliest type of skin cancer. If it isn’t diagnosed early, it may quickly spread to other parts of the body,” says Dr. Demehri. Melanoma most often spreads to the lungs, liver, brain, and bones, according to the American Cancer Society.
Melanoma develops from melanocytes. These are the skin cells that produce melanin, the pigment that gives your skin its color. Melanoma can occur on any skin surface, but it’s more likely to appear on areas that have been exposed to the sun, like the face, neck, arms, or legs. It commonly develops from a preexisting mole or a new black- or brown-colored spot on the skin.
What are melanoma risk factors?
“People with fair skin and light hair are more likely to get any skin cancer, but it’s important to understand that anyone can get melanoma,” says Dr. Demehri.
Several factors can increase your risk of developing melanoma, including:
- Exposure to harmful UVA and UVB rays from the sun. UV rays are a type of radiation that can damage the DNA of skin cells. People with melanoma often have a history of sunburns as children or teenagers.
- Use of tanning beds.
- Fair skin, skin that burns, freckles, or skin that is painful under the sun
- The presence of dysplastic nevus (an atypical mole)
- The presence of multiple small or large moles
- Weak immune system
- Older age
- A family or personal history of prior melanoma
“Our team offers genetic counseling for people with a family history of melanoma, so you can know if you’re at risk and take steps to prevent it,” says Dr. Demehri.
Melanoma signs and symptoms
Melanomas are often brown or black, but can also be pink, tan, or white.
The first signs of melanoma are often:
- A mole or spot on the skin that has changed in size, shape, or color
- Unusual sores, lumps, or markings
- A new darkened spot on the skin
- A sore that doesn’t heal
- Redness or swelling around a mole
- The feeling of itchiness, tenderness, or pain on the skin
- A dark line in a fingernail or a dark spot in the eye
“You should get to know all the moles and marks on your body and check for any changes,” says Dr. Demehri. “We recommend checking your skin once a month.”
ABCDEs of melanoma
Though most moles are harmless, it’s important to recognize when they change. If you notice changes in your skin, you can use the ABCDEs of melanoma to evaluate moles:
- A is for asymmetrical: Does one side of the mole look different from the other?
- B is for border: Does the mole have a jagged border?
- C is for color: Does the mole have an uneven color? Is there more than one color present in the mole?
- D is for diameter: Is it bigger than a pea?
- E is for evolving: Has it changed recently?
Call your doctor if you notice any of these changes in your moles.
“Even if you don’t notice anything on your skin, you may want to have your primary care provider (PCP) or dermatologist check your skin once a year. We often notice things that you might miss,” says Dr. Demehri.
Melanoma screening
You can develop melanoma in more than one location at the same time. Your provider may perform the following exams and tests to diagnose melanoma:
- A physical exam: Your doctor looks closely at your skin and notes any moles that could be related to skin cancer.
- Dermoscopy: Your doctor examines the skin closely with a special microscope, which sees things the naked eye can’t detect.
- Reflectance confocal microscopy (RCM): Your doctor examines abnormal areas of the skin with this non-invasive imaging technique.
- Skin biopsy: Your doctor removes a tiny bit of your skin and sends it to a lab to look for cancer cells. Your doctor may remove the entire growth if there are significant melanoma concerns.
“If melanoma is diagnosed, we then check to see if it has spread to the lymph nodes or other areas of your body,” says Dr. Demehri.
How can you prevent melanoma?
