What Does Melanoma Look Like? Visual Guide to Skin Cancer Detection

Melanoma is the most dangerous type of skin cancer, but early detection can make all the difference in successful treatment outcomes. Knowing what melanoma looks like and how to identify suspicious skin changes is crucial for protecting your health. This comprehensive guide will help you understand the warning signs and visual characteristics of melanoma so you can perform effective self-examinations and know when to seek medical attention.

Understanding Melanoma and Why Visual Recognition Matters

Melanoma develops when melanocytes, the cells that produce pigment in your skin, begin to grow abnormally. Unlike other forms of skin cancer, melanoma can spread quickly to other parts of the body if not caught early. However, when detected in its earliest stages, melanoma has a cure rate of approximately 99%.

Regular self-examination of your skin is one of the most effective ways to catch melanoma early. By familiarizing yourself with what melanoma looks like, you can identify concerning changes and consult with a healthcare professional promptly.

The ABCDE Rule: Your Primary Guide for Melanoma Detection

Dermatologists and cancer specialists recommend using the ABCDE rule when examining your skin. This simple acronym helps you remember the key warning signs that distinguish potentially dangerous moles from benign ones.

A: Asymmetry

Normal moles are typically symmetrical, meaning if you draw an imaginary line through the middle, both halves would match. Melanomas often appear asymmetrical, with one half looking noticeably different from the other in shape, color, or thickness.

When examining a spot on your skin, check if one side mirrors the other. If one portion is raised while the other is flat, or if one side is darker than the other, this asymmetry warrants medical evaluation. Asymmetrical growths are one of the earliest and most reliable indicators of potential melanoma.

B: Border Irregularity

Benign moles generally have smooth, even borders that create a clear distinction between the mole and surrounding skin. Melanomas, in contrast, typically have irregular, uneven, or poorly defined edges.

Look for borders that are:

• Ragged or notched
• Blurred or fuzzy
• Scalloped in appearance
• Difficult to determine where the mole ends and normal skin begins

These irregular borders occur because melanoma cells grow at different rates and in unpredictable patterns, creating an uneven edge.

C: Color Variation

While normal moles are usually a single shade of brown, melanomas often display multiple colors within the same lesion. This color variation is a significant warning sign that should prompt immediate medical attention.

Melanomas may contain various shades including:

• Different tones of brown or tan
• Black areas
• White or gray patches
• Red or pink sections
• Blue or bluish-black regions

The presence of multiple colors, especially unusual colors like red, white, or blue, indicates that different types of abnormal cells may be present at varying depths in the skin. Any mole with uneven coloring or multiple distinct colors should be evaluated by a healthcare professional.

D: Diameter

Melanomas are typically larger than benign moles when detected, often measuring more than 6 millimeters (about 1/4 inch) in diameter. This is approximately the size of a pencil eraser.

However, it’s important to note that melanomas can be smaller when first developing. Don’t dismiss a suspicious spot simply because it’s small. Any new growth or existing mole that’s growing larger deserves attention, regardless of its current size.

E: Evolving

Perhaps the most important warning sign is change over time. Any mole or skin spot that evolves in size, shape, color, elevation, or symptoms should be examined by a healthcare provider.

Watch for these evolving characteristics:

• Growing larger
• Changing shape or becoming more irregular
• Changing color or developing new colors
• Becoming raised when previously flat
• Developing new symptoms such as itching, tenderness, or pain
• Beginning to bleed or crust over
• Developing a different texture or becoming scaly

Any change in a mole’s appearance or behavior is reason to schedule a dermatology appointment. Trust your instincts—if something looks or feels different, get it checked.

What Does Melanoma Look Like on Different Skin Tones?

Melanoma can appear differently depending on a person’s skin tone, and it’s crucial to understand these variations for accurate detection across all populations.

Melanoma on Light Skin

On lighter skin tones, melanomas typically appear as dark brown or black spots with irregular features. They may also show pink, red, or white areas within the lesion. The contrast between the melanoma and surrounding skin is usually quite noticeable, making detection somewhat easier.

Melanoma on Dark Skin

On darker skin tones, melanoma often appears in areas not typically exposed to the sun, such as:

• Palms of hands
• Soles of feet
• Under fingernails or toenails
• Inside the mouth
• Genital areas

Melanomas on darker skin may appear as dark brown or black spots, but they can also be lighter in color or even have a reddish tone. The pigmentation may be less uniform, and these melanomas are sometimes mistaken for bruises, calluses, or other benign conditions, leading to delayed diagnosis.

Less Common Types of Melanoma and Their Appearance

Amelanotic Melanoma

Not all melanomas are dark. Amelanotic melanoma lacks pigment and appears as pink, red, or flesh-colored growths. These can be particularly dangerous because they don’t fit the typical profile of a dark, pigmented lesion. Amelanotic melanomas may resemble:

• A pink or red bump
• A flesh-colored raised area
• A persistent sore that doesn’t heal
• A growth that bleeds easily

Nodular Melanoma

Nodular melanoma is an aggressive form that grows quickly and appears as a raised bump rather than a flat spot. These melanomas are often uniform in color—typically black, blue-black, or dark brown—but can also be red or pink. They grow vertically into the skin rather than spreading across the surface, making them particularly dangerous.

Acral Lentiginous Melanoma

This type of melanoma appears on the palms, soles, or under the nails. It may look like a dark streak under a nail or a dark patch on the palm or sole. This is the most common type of melanoma in people with darker skin tones.

Where Does Melanoma Most Commonly Appear?

While melanoma can develop anywhere on the body, certain areas are more prone to this type of skin cancer:

In men: Melanoma most frequently appears on the back, chest, head, and neck.

In women: Melanoma commonly develops on the legs, back, and arms.

In people with darker skin: Melanoma is more likely to occur on areas with less pigmentation, including the palms, soles, and beneath nails.

However, melanoma can develop in areas not typically exposed to the sun, including the eyes, mouth, genital regions, and even internal organs in rare cases.

How to Perform a Skin Self-Examination

Regular self-examinations are essential for early melanoma detection. Follow these steps for a thorough skin check:

1. Examine your face, ears, neck, chest, and abdomen: Use a mirror to check your front and sides, then raise your arms to check your underarms.
2. Check your arms and hands: Examine the tops and undersides of your arms, between your fingers, and under your nails.
3. Inspect your legs: Look at the front and back of your legs, your feet (including the soles and between toes), and under toenails.
4. Use a hand mirror for hard-to-see areas: Check your back, buttocks, genital area, and the back of your neck and ears.
5. Check your scalp: Part your hair in sections or ask someone to help you examine your entire scalp.

Perform these self-examinations monthly, and take photos of any suspicious spots to track changes over time. Keep a record of where moles are located and note any that appear new or changing.

The “Ugly Duckling” Sign

Beyond the ABCDE rule, dermatologists also use the “ugly duckling” sign to identify melanoma. This principle suggests that normal moles on a person’s body tend to resemble one another, like siblings. A melanoma, however, often stands out as different from other moles—the “ugly duckling” of the group.

When examining your skin, look for any mole or spot that looks noticeably different from the others in terms of size, shape, color, or behavior. This outlier deserves medical evaluation even if it doesn’t clearly meet the ABCDE criteria.

When to See a Doctor

You should consult a healthcare professional or dermatologist immediately if you notice:

• Any new mole or skin growth, especially after age 30
• A mole that meets one or more of the ABCDE criteria
• A spot that looks significantly different from your other moles
• A mole that bleeds, oozes, or doesn’t heal
• A growth that itches, is tender, or feels painful
• A dark streak under a fingernail or toenail
• A sore that doesn’t heal within a few weeks
• Any skin change that concerns you

Don’t wait or hope that a suspicious spot will go away on its own. Early detection is critical for successful treatment, and dermatologists are trained to identify melanoma in its earliest stages.

Risk Factors for Melanoma

Understanding your risk factors can help you determine how vigilant you need to be about skin examinations:

• Fair skin: People with light skin that burns easily have higher risk
• History of sunburns: Especially blistering sunburns in childhood or adolescence
• Excessive UV exposure: From sun or tanning beds
• Many moles: Having more than 50 moles increases risk
• Atypical moles: Large or unusually shaped moles
• Family history: Having blood relatives with melanoma
• Personal history: Previous melanoma or other skin cancers
• Weakened immune system: Due to medical conditions or medications
• Age: Risk increases with age, though melanoma affects people of all ages

However, melanoma can affect anyone regardless of risk factors. People with darker skin tones, while at lower overall risk, often face later-stage diagnosis due to lower awareness and different presentation patterns.

Prevention and Protection Strategies

While knowing what melanoma looks like is essential for early detection, prevention is equally important:

• Apply broad-spectrum sunscreen with SPF 30 or higher daily
• Seek shade during peak sun hours (10 a.m. to 4 p.m.)
• Wear protective clothing, including wide-brimmed hats and UV-blocking sunglasses
• Avoid tanning beds completely
• Perform monthly skin self-examinations
• Get annual professional skin examinations, especially if you have risk factors
• Be extra cautious if you have a history of sunburns or family history of melanoma

The Importance of Professional Skin Examinations

While self-examinations are valuable, they cannot replace professional skin checks by a qualified dermatologist. Dermatologists have specialized training and tools to identify melanoma that may not be obvious to the untrained eye.

Schedule annual full-body skin examinations, or more frequently if recommended based on your risk factors. During these appointments, your dermatologist will examine your entire body, including areas difficult to see on your own, and may use dermoscopy—a special magnifying tool that allows detailed examination of skin lesions.

What Happens If Melanoma Is Suspected?

If your doctor identifies a suspicious spot, they will typically perform a biopsy—removing all or part of the growth for laboratory analysis. This is the only way to definitively diagnose melanoma.

If melanoma is confirmed, additional tests may be needed to determine if it has spread. Treatment options depend on the stage and location of the melanoma but may include surgical removal, immunotherapy, targeted therapy, radiation, or chemotherapy. Your healthcare team will discuss the most appropriate treatment plan for your specific situation. Always consult with your doctor before starting any treatment regimen.

Key Takeaways for Melanoma Recognition

Recognizing what melanoma looks like can save your life. Remember these essential points:

• Use the ABCDE rule (Asymmetry, Border irregularity, Color variation, Diameter, Evolving) to evaluate moles
• Melanoma can appear different on different skin tones
• Not all melanomas are dark—some are pink, red, or flesh-colored
• Any changing mole deserves medical attention
• The “ugly duckling” that looks different from your other moles may be melanoma
• Perform monthly self-examinations and annual professional skin checks
• When in doubt, get it checked out—early detection is critical

Your skin is your body’s largest organ, and changes in its appearance can provide important health information. By staying vigilant and knowing what to look for, you can catch melanoma early when it’s most treatable. Trust your instincts, examine your skin regularly, and don’t hesitate to consult a healthcare professional about any concerns. Your proactive approach to skin health could make all the difference.

Sources:

• American Cancer Society – Melanoma Skin Cancer Signs and Symptoms
• American Academy of Dermatology – Melanoma Symptoms
• The Skin Cancer Foundation – Melanoma Information
• National Cancer Institute – Melanoma Treatment
• CDC – Skin Cancer Symptoms