7 Warning Signs and Symptoms of Melanoma You Should Never Ignore

Melanoma is the most serious type of skin cancer that develops when melanocytes (pigment-producing cells) begin to grow uncontrollably. While melanoma accounts for only about 1% of skin cancers, it causes the majority of skin cancer deaths. Understanding the symptoms of melanoma is crucial for early detection, which significantly improves treatment outcomes and survival rates.

Early stage melanoma is highly treatable when caught quickly, making it essential to recognize the warning signs. This comprehensive guide will help you identify the key symptoms of melanoma, understand what causes this malignant condition, and learn how to protect yourself from this potentially deadly form of skin cancer.

1. Asymmetrical Moles (The “A” in ABCDE Rule)

One of the most significant symptoms of melanoma is asymmetry in moles or skin lesions. A normal, benign mole is typically symmetrical, meaning if you draw a line through the middle, both halves would match. However, a melanoma mole often exhibits asymmetry where one half looks different from the other half.

When examining your skin, pay close attention to any moles where:

• One half is noticeably different in shape, size, or texture from the other half
• The mole appears irregular or lopsided
• There’s an uneven distribution of color or pigmentation
• The edges on one side differ significantly from the other side

This asymmetry occurs because melanoma cancer cells grow in an uncontrolled, irregular pattern, unlike normal skin cells. If you notice any mole with pronounced asymmetry, especially if it has changed over time, you should have it examined by a dermatologist promptly.

2. Irregular or Poorly Defined Borders (The “B” in ABCDE Rule)

Border irregularity is another crucial warning sign of melanoma skin cancer. Normal moles typically have smooth, even borders that are clearly defined and easy to see. In contrast, a malignant melanoma often presents with borders that are uneven, ragged, notched, or blurred.

Characteristics of concerning borders include:

• Jagged or scalloped edges instead of smooth, round borders
• Borders that appear to fade into the surrounding skin
• Notches or indentations along the perimeter
• Poorly defined edges where it’s difficult to tell where the mole ends and normal skin begins
• Irregular outlines that look like the mole is spreading unevenly

These irregular borders develop because melanoma cancer cells invade surrounding tissue in an unpredictable manner. The edges may appear fuzzy or seem to blend into the adjacent skin. Any mole with borders that look significantly different from your other moles warrants medical attention.

3. Color Variations and Changes (The “C” in ABCDE Rule)

Uneven coloring or multiple colors within a single mole is a classic symptom of melanoma. While benign moles are usually a single shade of brown or tan, melanoma moles often display a variety of colors or unusual hues that can be quite striking.

Warning color changes include:

• Multiple shades of brown, tan, or black within the same lesion
• Patches of pink, red, white, or blue coloring
• Areas of darker black or very dark brown
• Loss of color in certain areas (hypopigmentation)
• A mottled appearance with irregular color distribution
• Any mole that becomes darker or changes color over time

The varied coloring occurs because different parts of the melanoma tumor may be at different stages of development or depth in the skin. Melanoma on face or other visible areas may be particularly noticeable when color changes occur. Some melanomas may even appear as pink or flesh-colored lesions, especially in individuals with fair skin, making them more difficult to identify.

4. Large Diameter (The “D” in ABCDE Rule)

Size is an important factor when evaluating potential symptoms of melanoma. The “D” in the ABCDE rule stands for diameter, and dermatologists use this as a key screening criterion. While not all large moles are cancerous, melanomas are typically larger than benign moles.

Size-related warning signs:

• Moles larger than 6 millimeters in diameter (about the size of a pencil eraser)
• Any spot that is growing larger over weeks or months
• New spots that start out larger than typical moles
• Lesions that continue to expand beyond normal mole size

However, it’s important to note that early stage melanoma can be smaller than 6 millimeters. Some melanomas are detected when they’re quite tiny, especially during regular skin examinations. The key is not just the absolute size, but whether a mole is growing or changing in diameter over time. Any mole that is expanding should be evaluated by a healthcare professional, regardless of whether it has reached the 6-millimeter threshold.

5. Evolving or Changing Characteristics (The “E” in ABCDE Rule)

Perhaps the most critical symptom of melanoma is evolution or change in an existing mole. The “E” in the ABCDE rule represents this evolving nature, and it’s often the warning sign that prompts people to seek medical attention. Any change in size, shape, color, elevation, or symptom (such as bleeding, itching, or crusting) should be taken seriously.

Types of concerning changes include:

• A mole that grows larger over weeks or months
• Changes in shape from round to irregular
• Color darkening or the appearance of new colors
• A flat mole that becomes raised or develops a bump
• Surface texture changes, such as becoming scaly, rough, or developing a crust
• Development of new symptoms like itching, tenderness, or pain
• Bleeding or oozing from a mole without injury
• The appearance of a new spot that looks different from all your other moles (known as the “ugly duckling” sign)

Most people have between 10 and 40 moles on their body, and these typically remain stable throughout adult life. When a mole begins to change or evolve, it signals that something abnormal is happening at the cellular level. This is particularly concerning in adults over age 30, as new or changing moles are less common after this age.

6. A New, Unusual Growth or Spot on the Skin

While many people focus on changes to existing moles, the appearance of a completely new spot on the skin can also be a symptom of melanoma. In fact, approximately 70-80% of melanomas arise in previously normal-looking skin rather than from existing moles. This makes monitoring your entire skin surface for new growths extremely important.

Characteristics of concerning new spots:

• A new dark spot that appears suddenly and grows relatively quickly
• A new mole that looks different from all your other moles (the “ugly duckling”)
• A new growth that has any of the ABCDE characteristics mentioned above
• A new spot that is black, very dark brown, or has multiple colors
• A new bump that is dome-shaped and dark in color
• A new flesh-colored or pink lesion that doesn’t heal
• A new spot in an area that gets significant sun exposure

It’s particularly important to monitor areas of your body that have received significant sun exposure throughout your life, as these are common sites for skin melanoma to develop. However, melanoma can appear anywhere on the body, including areas rarely exposed to the sun, such as the soles of the feet, palms of the hands, under the nails, or even in the mouth or eyes.

7. Additional Warning Signs and Symptoms

Beyond the ABCDE rule, there are several other symptoms of melanoma that should prompt immediate medical evaluation. These additional signs may indicate that a malignant melanoma is present or that a skin lesion requires professional assessment.

Other important symptoms include:

• Persistent itching or tenderness: A mole that consistently itches, burns, or feels tender may be a sign of melanoma cancer
• Bleeding or oozing: Any mole that bleeds spontaneously without trauma, or that oozes fluid, requires immediate evaluation
• Crusting or scabbing: The development of a crust or scab on a mole, especially one that doesn’t heal properly
• Surface changes: A previously smooth mole that becomes rough, scaly, or develops an unusual texture
• Swelling or redness: Inflammation beyond the border of a mole, or redness extending into surrounding skin
• A sore that doesn’t heal: Any persistent sore or ulceration on the skin that fails to heal within a few weeks
• Pigment spreading: Dark pigmentation spreading from a mole into the surrounding skin
• Satellite lesions: The appearance of new spots or bumps near an existing mole

In more advanced cases, symptoms of melanoma may extend beyond the skin. If melanoma has spread to lymph nodes, you might notice lumps or swelling in nearby lymph nodes. However, catching these symptoms early, when the cancer is still confined to the skin, offers the best prognosis.

What Causes Melanoma?

Understanding what causes melanoma can help you take steps to reduce your risk. While the exact mechanism isn’t fully understood, several factors contribute to the development of this malignant melanoma:

Ultraviolet (UV) Radiation Exposure: This is the most significant risk factor for melanoma skin cancer. Both UVA and UVB rays from the sun and artificial sources like tanning beds damage the DNA in skin cells, which can lead to cancerous mutations. A history of severe, blistering sunburns, especially during childhood and adolescence, significantly increases melanoma risk.

Genetic Factors: Approximately 10% of people with melanoma have a family history of the disease. Certain inherited genetic mutations, such as those in the CDKN2A gene, substantially increase melanoma risk. If multiple family members have had melanoma, your risk may be significantly elevated.

Fair Skin and Sun Sensitivity: People with fair skin, light-colored eyes (blue or green), blonde or red hair, and those who freckle or burn easily have a higher risk of developing melanoma. This is because lighter skin has less melanin, which provides some natural protection against UV radiation.

High Number of Moles: Having many moles (more than 50) or having atypical (dysplastic) moles increases your risk. People with these conditions should be particularly vigilant about monitoring their skin for changes.

Weakened Immune System: Individuals with compromised immune systems, whether from medical conditions like HIV/AIDS or from immunosuppressive medications taken after organ transplants, have an elevated risk of developing melanoma.

Age and Previous Skin Cancer: While melanoma can occur at any age, risk increases with age. Additionally, having a personal history of melanoma or other skin cancers increases the likelihood of developing another melanoma.

Geographic Location: Living in areas with intense year-round sun exposure, such as near the equator or at high altitudes, increases melanoma risk due to greater UV radiation exposure.

Prevention Strategies

While not all cases of melanoma can be prevented, there are several effective strategies to significantly reduce your risk of developing this serious form of skin cancer:

Sun Protection Practices:

• Apply broad-spectrum sunscreen with SPF 30 or higher daily, even on cloudy days
• Reapply sunscreen every two hours, or more frequently if swimming or sweating
• Seek shade during peak sun hours (10 AM to 4 PM)
• Wear protective clothing, including long sleeves, long pants, and wide-brimmed hats
• Wear UV-blocking sunglasses to protect the delicate skin around your eyes
• Be extra cautious near water, snow, and sand, which reflect UV rays and increase exposure

Avoid Tanning Beds and Sunlamps: Artificial UV radiation from tanning beds is a proven carcinogen and significantly increases melanoma risk. The World Health Organization has classified tanning devices as “carcinogenic to humans.” There is no such thing as a “safe” tan from a tanning bed.

Regular Self-Examinations: Perform monthly skin self-examinations to check for new or changing moles. Use a mirror or ask a partner to help examine hard-to-see areas like your back. Photograph suspicious moles to track changes over time. Early detection of melanoma dramatically improves treatment success rates.

Professional Skin Checks: Schedule annual full-body skin examinations with a dermatologist, especially if you’re at higher risk. People with many moles, a family history of melanoma, or previous skin cancer may need more frequent professional screenings.

Protect Children: Children’s skin is particularly vulnerable to sun damage. One severe sunburn during childhood can double the lifetime risk of melanoma. Ensure children wear sunscreen, protective clothing, and limit sun exposure during peak hours.

Vitamin D Considerations: While sun exposure helps your body produce vitamin D, you only need a small amount of sun exposure for this benefit. It’s safer to obtain vitamin D through diet and supplements rather than risking skin cancer through excessive sun exposure.

Be Aware of Medications: Some medications can increase sun sensitivity, making you more susceptible to sun damage. If you’re taking antibiotics, diuretics, or certain other medications, ask your doctor about photosensitivity and take extra sun protection measures.

Frequently Asked Questions

What is melanoma?

Melanoma is a type of skin cancer that develops in melanocytes, the cells that produce melanin (skin pigment). It is the most dangerous form of skin cancer because it can spread rapidly to other parts of the body if not caught early.

What is melanoma cancer and how is it different from other skin cancers?

Melanoma cancer is more aggressive than other common skin cancers like basal cell carcinoma or squamous cell carcinoma. It has a higher likelihood of spreading (metastasizing) to lymph nodes and other organs, making early detection critical for successful outcomes.

How can I tell the difference between a normal mole and a melanoma mole?

Use the ABCDE rule: check for Asymmetry, irregular Borders, multiple Colors, Diameter larger than 6mm, and Evolution (changes over time). Normal moles are typically symmetrical, have even borders, are one color, are smaller than 6mm, and remain stable. Any mole that exhibits ABCDE characteristics should be evaluated by a dermatologist.

Can melanoma appear on areas that don’t get sun exposure?

Yes, while sun exposure is a major risk factor, melanoma can develop anywhere on the body, including areas rarely exposed to the sun such as the soles of feet, palms of hands, under fingernails or toenails, and even in the eyes or mouth.

What does early stage melanoma look like?

Early stage melanoma may appear as a new spot on the skin or a change in an existing mole. It might be a small, dark spot with irregular borders and uneven coloring, or it could be a flat, brownish spot with darker speckles. Some early melanomas may be pink, red, or flesh-colored rather than brown or black.

Is melanoma always black or dark colored?

No, while many melanomas are dark brown or black, some can be pink, red, flesh-colored, or even white. These amelanotic melanomas can be particularly dangerous because they don’t look like typical melanomas and may be mistaken for benign skin conditions.

How fast does melanoma grow?

Growth rates vary, but melanoma can develop and progress relatively quickly, sometimes within weeks to months. This is why it’s important to monitor your skin regularly and seek immediate evaluation for any rapidly changing or new suspicious spots.

Can you have melanoma without any symptoms?

Yes, in its earliest stages, melanoma may not cause any pain, itching, or discomfort. This is why visual changes to moles or skin spots are so important to recognize. Many melanomas are discovered during routine skin examinations before any physical symptoms develop.

Are certain people more at risk for melanoma?

Yes, risk factors include fair skin, light-colored eyes, blonde or red hair, history of sunburns, family history of melanoma, having many or atypical moles, weakened immune system, older age, and significant UV exposure throughout life. However, melanoma can affect people of all skin tones and backgrounds.

When should I see a doctor about a mole?

See a doctor immediately if you notice any of the ABCDE warning signs, a new mole that looks different from your others, any mole that changes in size, shape, or color, or if you experience bleeding, itching, or pain in a mole. It’s better to have a benign mole checked than to delay diagnosis of a potential melanoma.

Can melanoma be cured if caught early?

When detected in its earliest stages, before it has spread deeper into the skin or to other parts of the body, melanoma has a very high cure rate. This makes early detection through regular skin monitoring and prompt medical attention for suspicious changes absolutely critical.

What should I do if I find a suspicious mole?

Don’t panic, but do take action promptly. Schedule an appointment with a dermatologist as soon as possible. Take clear photographs of the suspicious mole from multiple angles to document its appearance. Avoid sun exposure to the area, and don’t try to remove it yourself. Professional evaluation is essential for proper diagnosis.

References:

• American Cancer Society – Melanoma Skin Cancer
• Skin Cancer Foundation – Melanoma Information
• American Academy of Dermatology – Melanoma
• National Cancer Institute – Melanoma Treatment
• Mayo Clinic – Melanoma Symptoms and Causes
• NHS – Melanoma Skin Cancer