A freckle that changes shape. A mole that feels itchy. A spot that looks just a little… off. These subtle changes may be easy to dismiss but they could be the earliest signs of melanoma, the most dangerous type of skin cancer.

While melanoma is less common than other skin cancers, it is significantly more aggressive and can spread rapidly to other organs if left untreated. The good news? Early detection can save lives, often making the difference between a small, treatable skin lesion and a life-threatening illness.

What Is Melanoma?

Melanoma is a type of skin cancer that begins in melanocytes, the cells that produce melanin, the pigment responsible for skin color. Unlike basal cell or squamous cell carcinoma, melanoma has a high risk of metastasis (spreading to lymph nodes or internal organs), making early detection especially critical.

Melanoma can appear anywhere on the body, not just sun-exposed areas. While it most often develops on the back, legs, arms, and face, it can also occur under the nails, on the soles of the feet, or even in the eyes or mucous membranes.

Who’s at Risk?

Anyone can develop melanoma, but certain factors increase the risk:

• Fair skin, freckles, or light hair 
• History of sunburns, especially in childhood 
• Use of tanning beds 
• Family or personal history of skin cancer 
• High number of moles or atypical (dysplastic) moles 
• Weakened immune system 
• Older age, although melanoma also affects young adults 

Even people with darker skin can get melanoma often diagnosed later and in less typical locations, like the palms or soles.

The ABCDE Rule

One of the most effective tools for identifying potential melanoma is the ABCDE rule. It helps distinguish ordinary moles from those that may need medical attention:

• A – Asymmetry: One half of the mole doesn’t match the other 
• B – Border: Irregular, blurred, or jagged edges 
• C – Color: Uneven shades of brown, black, pink, red, white, or blue 
• D – Diameter: Larger than 6 mm (about the size of a pencil eraser) 
• E – Evolving: Changing in size, shape, color, or sensation (itching or bleeding) 

A mole that looks different from others nearby sometimes called the “ugly duckling” is also a red flag.

Other Symptoms to Watch For

In addition to changes in existing moles, melanoma may present as:

• A new pigmented or unusual lesion on the skin 
• A mole that bleeds, crusts, or becomes painful 
• A dark streak under a fingernail or toenail (subungual melanoma) 
• A dark spot in the eye (ocular melanoma), sometimes affecting vision 
• Unexplained swollen lymph nodes 

If melanoma spreads, symptoms may include fatigue, weight loss, or pain, depending on where it has metastasized.

Diagnosing Melanoma

If a suspicious lesion is found, your doctor may:

• Perform a dermatoscopic examination using a magnifying tool 
• Take photographs for monitoring changes over time 
• Recommend a skin biopsy removing part or all of the lesion for lab analysis 

If melanoma is confirmed, additional tests such as lymph node biopsy, PET/CT scans, or MRI may be needed to determine the stage and spread.

Staging and Prognosis

Melanoma is staged based on tumor thickness (Breslow depth), ulceration, and lymph node involvement:

• Stage 0–1: Early-stage melanoma, confined to the top layers of skin 
• Stage 2: Thicker tumors but still localized 
• Stage 3: Cancer has spread to nearby lymph nodes 
• Stage 4: Distant metastasis to organs like the lungs, liver, or brain 

The earlier the diagnosis, the better the outcome. Stage 1 melanomas have a 5-year survival rate of over 90%, while advanced melanoma requires aggressive treatment.

Treatment Options

Treatment depends on the stage and location but may include:

• Surgical excision: Removing the tumor and surrounding skin 
• Sentinel lymph node biopsy: To assess spread 
• Immunotherapy: Boosting the immune system to fight cancer cells 
• Targeted therapy: For melanomas with specific gene mutations (e.g., BRAF) 
• Radiation therapy or chemotherapy: In advanced cases 

Regular follow-up and skin checks are crucial even after successful treatment, as melanoma can recur.

Can Melanoma Be Prevented?

While not all melanomas are preventable, UV protection is the best defense:

• Avoid tanning beds entirely 
• Wear broad-spectrum sunscreen (SPF 30 or higher), even on cloudy days 
• Reapply every two hours and after swimming or sweating 
• Wear protective clothing, hats, and sunglasses 
• Seek shade between 10 a.m. and 4 p.m., when UV rays are strongest 
• Perform monthly skin self-exams and see a dermatologist annually 

Early awareness saves lives literally.

Protect Your Skin, Protect Your Life

Melanoma often begins with something as simple as a spot on the skin but ignoring it can have devastating consequences. The good news is that early detection and proactive care can stop melanoma in its tracks.

If you’ve noticed suspicious skin changes, are at high risk for melanoma, or want expert guidance on skin cancer prevention, the dermatology and oncology teams at Erdem Hospital offer comprehensive skin screenings, diagnostic services, and advanced treatments so you never have to face the unknown alone.