We’ll help you understand melanoma skin cancer including its signs, symptoms, diagnosis & treatment options
What is melanoma skin cancer?
Melanoma skin cancer (also known as malignant melanoma or melanoma) is a type of skin cancer that starts in melanocytes. These are the cells in our body that make melanin, the pigment that gives skin its colour.
Melanoma can start in a mole, or in areas of the skin without a mole. In rarer cases, it can occur in the eyes or areas inside the body, such as the nose or throat.
Melanoma is different to types of non-melanoma skin cancer which start in the top layer of skin, including:
• Basal cell carcinoma (BCC) – the most common type of skin cancer that starts from an uncontrolled growth of basal cells
• Squamous cell carcinoma (SCC) – the second most common type of skin cancer that starts from an accelerated growth of squamous cells
Non-melanoma skin cancer is usually easier to treat than melanoma skin cancer which, although less common, can be more serious and spread to other parts of the body (advanced melanoma).
What are the signs & symptoms of melanoma?
Melanoma may be signalled by a change in your skin, a new mole or a change to the shape, colour or size of an existing mole. When it comes to checking moles for signs of changes, it can be helpful to follow the ABCDE rule to self-check.
Asymmetry – Ordinary moles are usually symmetrical (even and the same on both halves), whereas melanomas may be asymmetrical (uneven with an irregular shape)
Border – Ordinary moles usually have a border with a smooth edge, whereas melanomas may have a jagged or uneven edge
Colour – Ordinary moles are usually only one colour, most often a shade of brown, whereas melanomas may be a range of two or more different colours including red, pink, white, blue or brown mixed with black
Diameter – Ordinary moles are usually smaller than 6mm, whereas melanomas may be larger than this
Evolving – Ordinary moles don’t change over time. Moles that change in any way, such as in size, shape or colour, or moles that are bleeding, itchy, crusty, swollen or sore could be a sign of melanoma and should be checked by a medical professional, such as your GP
It’s important to regularly check for any changes to moles you have or a development of a new mole. If you need help checking moles on areas of your body you can’t see easily, such as your back or neck, ask a trusted family member, partner or friend for help.
On black and brown skin, the signs of melanoma may be harder to see and it’s more common for changes to develop in areas of the skin that aren’t exposed to the sun as much, including:
• The palms of the hands
• The soles of the feet
• Under the fingernails and toenails
It’s important to check for any signs of changes on skin that’s both exposed to the sun and not directly exposed to the sun.
If you’re worried about a mole or unusual mark (pigmented lesion) on your body, and you’re over the age of 18, you can have an assessment through the Mole Scanning Service*, provided by our partners ScreenCancer at selected Boots pharmacies. They cannot provide a diagnosis of skin cancer, but can analyse any moles or pigmented lesions and help identify anything that might be suspicious and need further investigation from your GP.
You should see a GP if:
• You have a mole that's changed size, shape or colour or that has any of the ABCDE signs above
• You have a mole that's painful or itchy
• You have a mole that's inflamed, bleeding or crusty
• You have a new or unusual mark on your skin that hasn’t gone away after a few weeks
• You have a dark area under a fingernail or toenail, not caused by an injury of any kind (this can sometimes look like a dark-coloured stripe)
We understand it can be worrying to find any signs or symptoms of skin cancer, but it’s important to speak to your GP as soon as possible, as early melanoma can be treated more easily.
If you need to talk to anyone about your worries, you can call Macmillan Cancer Support on 0808 808 00 00 or chat to them online.
How is melanoma identified & diagnosed?
Once you see a GP, they can advise on your signs and symptoms of melanoma. They may send photographs of any skin changes to a dermatologist or refer you in person to a dermatologist, where you’ll have further tests to check if you have melanoma. Tests can include:
• Using a dermatoscope (similar to a small magnifying glass) to look at your mole
• Checking your lymph nodes to see if they’re swollen
• Arranging for you to come back regularly to have moles checked or photographed
• Removing your mole in a procedure called an excision biopsy and sending it on for further tests
Having signs and symptoms of melanoma does not definitely mean you have skin cancer. However, if you do receive a diagnosis of melanoma, we understand this is difficult news to process and it can be helpful to have someone with you when you receive your results. Your medical team will be on hand to support you through the next steps and create a treatment plan that works best for your situation.
Macmillan Cancer Support have a range of resources to help you with getting a cancer diagnosis if you would like further support.
How is melanoma treated & managed?
The treatment that you receive will depend on what stage of melanoma you have been diagnosed with, which is determined by the size and position of your melanoma, and if it has spread.
Melanoma treatment options may include:
• Surgery – to remove the melanoma and surrounding cells. It could also be used in cases where the melanoma has spread to other areas of the body such as removing affected lymph glands
• Radiotherapy – this is sometimes used to help reduce the size of large melanomas and relieve your symptoms
• Targeted medicines – which aim to stop the cancer from growing
• Immunotherapy – which helps your immune system find and kill cancer cells
• Chemotherapy – a medicine used to kill cancer cells, sometimes used in advanced melanoma or in cases where you’re unable to have other treatments
What happens after melanoma treatment?
After your melanoma treatment, you may need follow-up appointments to help reduce the risk of melanoma coming back. These are dependent on what stage of melanoma you had, and could involve:
• Regular check-ups, scans and photographs
• Having measurements taken of your moles
• Checks for any changes to your skin
• Checks of your lymph nodes
• Checks of your scar (if you had surgery) and surrounding area
What are the causes & risk factors for melanoma?
The most common cause of melanoma is exposure to ultraviolet light (UV light) which comes from the sun and is also used in tanning lamps and beds. UV radiation can damage the DNA in melanocytes and cause these cells to grow more quickly than usual and develop into melanoma.
Melanoma can happen to anyone of any age. It’s more common in older people, but younger people can also get it.
Those with paler skin are more at risk of getting melanoma from sun damage, because they have less of the melanin type known as eumelanin, which helps protect from UV light. Whereas people with darker skin are at a lower risk of getting melanoma from sun damage because they have more of this protective type of melanin in their skin. Therefore, they’re more likely to get the type of melanoma that develops in areas of the body not regularly exposed to UV light, such as the soles of the feet and underneath toenails.
The main risk factors for getting melanoma include:
• Sunburn
• Sunbathing
• Using sun beds or tanning lamps
• Pale skin that burns easily
• Red or blonde hair
• Blue or green eyes
• A large amount of freckles or moles
• You’ve previously had melanoma
• A family history of melanoma
• A weakened immune system, such as HIV or AIDs, inflammatory bowel conditions like Crohn’s disease, or taking medicine that supresses your immune system (your GP should be able to advise further if this applies to any medicine you’re taking)
A risk factor does not definitely mean you will get cancer, but it’s important to be aware of them and look into practical steps you can take to help reduce your risk of getting melanoma, which we cover below.
Ways to help lower the risk of melanoma
The best ways to help lower your chances of getting melanoma are to speak to a GP if you notice any of the signs and symptoms listed above and to stay safe in the sun, no matter what skin type or tone you have.
When it comes to sun safety, you should always use a sunscreen of at least SPF30 or SPF50 for sensitive skin and children. This should have four or five-star UVA protection (some sunscreens may not use a star rating, but instead will be labelled with UVA in a circle, however sunscreens labelled five-star UVA protection is the highest available UVA protection). You should reapply sunscreen at least every two hours throughout the day, and after going in water.
You should also:
• Stay out of the sun during the hours of 11am and 3pm, which is the hottest part of the day in the UK
• Cover your arms and legs in the sun and wear a wide-brimmed hat and sunglasses with UV protection
• Protect babies’ and children’s skin from the sun, as it’s more vulnerable than adults
• See a doctor if you or your baby or child get sunburnt
• Avoid using sunbeds or tanning lamps
Looking for sun protection? Here are some options with both UVA and UVB protection to consider from Boots.
Watch our video below for more tips on how to choose and apply your sun protection.
Where can I get further support for melanoma?
You can find further information on melanoma and support with receiving a diagnosis or coping with treatment from:
• The NHS
If you think you may have signs or symptoms of melanoma skin cancer, but you’re not sure – if in doubt, get it checked out.
