Malignant Melanoma

Malignant Melanoma



Melanoma is a type of skin cancer that develops from the pigment-producing cells (melanocytes) in the skin. Unlike non-melanoma skin cancers (basal and squamous cell carcinomas), melanoma can grow quickly and spread to other parts of the body. However, when detected early and treated, the cure rate can be very high.

Melanoma most often develops as a new growth, not in an existing mole. However, it is hard to memorize all existing moles, so regular skin checks looking for the following is important. The earlier the detection of the melanoma, the easier it is to treat.

  • A mole that is growing, changing shape, or changing color
  • A mole that looks scaly, oozes, or bleeds
  • New, dark spot on the skin that looks like a mole, but grows quickly
  • Pain, itch, or bleeding in a new spot on the skin
  • A streak (usually brown or black) underneath a fingernail or toenail
  • A bruise on the foot that does not heal

It is important to know that melanoma can also develop in the eyes, mouth, and genitals. Regular examination of these sites by a health care professional is recommended to screen for melanoma in these areas.

Risk Factors

Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. Ultraviolet light (UV) from the sun and indoor tanning beds can cause skin cancer. Not all melanomas are caused entirely by UV rays. Heredity also plays a role. Research shows that if a first-degree relative (parent, brother, sister, or child ) had melanoma, a person has a greater risk of getting melanoma.

In addition to a family history and UV exposure, some people have a higher risk of developing melanoma including those with:

  • Light skin, hair, and eyes
  • Fair skin that tans poorly or burns easily
  • Red or blond hair
  • Blue or green eyes
  • 50 or more small moles
  • Moles called "atypical nevi" or "dysplastic nevi"
  • Past blistering sunburns or a history of indoor tanning
  • A previous melanoma or other skin cancer
  • Weak immune system (due to disease, organ transplant, or medicine)

Men over 50 are at a higher risk of developing melanoma compared to the rest of the general public. Melanoma can also affect younger people. In fact, melanoma is the second most common form of cancer in females age 15-29 years old.


A dermatologist will look carefully at all skin and examine growths, moles, and dry patches. To get a better look, a dermatologist may use a device called a dermatoscope or magnifying lens that helps to see pigment and structures in the lesion.

Concerning lesions will be biopsied. This involves biopsying the lesion or a sample of it for microscopic evaluation by a pathologist. A biopsy is quick, safe, and easy for a dermatologist to perform, usually in the same visit as your skin exam. A biopsy should not cause anxiety. The discomfort and risks are minimal.


American Academy of Dermatology



Your treatment depends on how deeply the melanoma has grown into your skin, whether the melanoma has spread to other parts of the body, and your overall health. Treatment often starts with surgery. In its earliest stage, melanoma grows in the epidermis (outer layer of skin). Your dermatologist may refer to this as melanoma in situ or stage 0. In this stage, the cure rate is nearly 100%.

Your dermatologist will want to treat all of the cancer. Your dermatologist can perform surgery in their office. You may remain awake during the surgical procedure. There are two common procedures for surgically treating melanoma:

  • Excision: Your dermatologist will numb your skin and surgically reduce the melanoma. Some of the normal looking skin around the melanoma will also be reduced. This procedure is appropriate for most in situ and invasive melanomas.
  • Mohs surgery: A dermatologist who has completed additional training in Mohs surgery performs this procedure. This procedure involves reducing the visible skin cancer. The tissue that is treated is examined under a microscope by the Mohs surgeon to determine if there are any cancer cells remaining at any outer edges of the reduced tissue. During this time, you remain at the surgical suite of office. If cancer cells are still present at any edge of the reduced tissue, the Mohs surgeon will continue to treat additional layers of skin or underlying affected tissue until cancer cells are no longer seen. This technique allows for complete treatment of the skin cancer, yet minimizes the damage of healthy skin. In most cases, Mohs surgery can be completed within a day or less.

When melanoma is caught early, excision or Mohs surgery may be the only treatment you need.

When melanoma grows deeper into the skin or spreads, treatment becomes more complex. It may begin with a surgery, followed by additional treatment or more surgery. Treatment may also involve radiation therapy or chemotherapy to treat cancer cells. Some patients receive immunotherapy to boost their body’s immune system, which increases the body’s abilities to fight the cancer. If the melanoma is advanced, the patient often receives a combination of these treatments by a team of physicians that may include a dermatologist, and surgical and medical oncologists.

It is important to note that numerous promising clinical trials are ongoing for the treatment of advanced melanoma.


Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. You can have fun in the sun and decrease your risk of skin cancer. Here’s how:

  • Seek shade when appropriate. Remember that the sun’s rays are strongest between 10 a.m. and 2 p.m. If your shadow appears to be shorter than you are, seek shade.
  • Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, where possible.
  • Generously apply a broad-spectrum, water-resistant sunscreen with a Sun Protection Factor (SPF) of 30 or more to all exposed skin. “Broad-spectrum” provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Reapply approximately every two hours, even on cloudy days, and after swimming or sweating.
  • Research has found that daily sunscreen use cuts the incidence of melanoma in half.
  • Use extra caution near water, snow, and sand because they reflect and intensify the damaging rays of the sun, which can increase your chances of sunburn.
  • Avoid tanning beds. If you want to look tan, consider using a self-tanning product, but continue to use sunscreen with it.

What we do

  • Full Body Skin Examinations
  • Biopsies to confirm the diagnosis
  • Excisions

Download these treatment information documents:

Wound Care Instructions after Biopsy and ED&C
Post-Excision Wound Care Instructions


What is melanoma?

Melanoma is the most deadly type of skin cancer. It can take many shapes and appearances. Melanoma is usually a dark color like brown, blue, or black. Other signs to look for include: irregular borders, asymmetry (one half looks different than the other half), and size – melanomas are usually large (bigger than a pencil eraser)


American Academy of Dermatology

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