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How To Detect Melanoma Early

The Abcdes Of Melanoma

How to Use the ABCDEs to Detect Melanoma

The first five letters of the alphabet are a guide to help you recognize the warning signs of melanoma.

A is for Asymmetry. Most melanomas are asymmetrical. If you draw a line through the middle of the lesion, the two halves dont match, so it looks different from a round to oval and symmetrical common mole.

B is for Border. Melanoma borders tend to be uneven and may have scalloped or notched edges, while common moles tend to have smoother, more even borders.

C is for Color. Multiple colors are a;warning sign. While benign moles are usually a single shade of brown, a melanoma may have different shades of brown, tan or black. As it grows, the colors red, white or blue;may also appear.

D is for Diameter or Dark.;While its ideal to detect a melanoma when it is small, its a warning sign if a lesion is the size of a pencil eraser or larger. Some experts say it is also important to look for any lesion, no matter what size, that is darker than others. Rare, amelanotic melanomas are colorless.

E is for Evolving. Any change in size, shape, color or elevation of a spot on your skin, or any new symptom in it, such as bleeding, itching or crusting, may be a warning sign of melanoma.

If you notice these warning signs, or anything NEW, CHANGING or UNUSUAL on your skin see a dermatologist promptly.

A is for Asymmetry

D is for Diameter or Dark

E is for Evolving

E is for Evolving

When Should I Call My Doctor

You should have a skin examination by a doctor if you have any of the following:

  • A personal history of skin cancer or atypical moles .
  • A family history of skin cancer.
  • A history of intense sun exposure as a young person and painful or blistering sunburns.
  • New or numerous large moles.
  • A mole that changes in size, color or shape.
  • Any mole that itches, bleeds or is tender.

A note from Cleveland Clinic

Receiving a diagnosis of melanoma can be scary. Watch your skin and moles for any changes and seeing your doctor regularly for skin examinations, especially if youre fair-skinned, will give you the best chances for catching melanoma early when its most treatable.

Last reviewed by a Cleveland Clinic medical professional on 06/21/2021.


How To Perform A Self

1. Examine your face

Especially your nose, lips, mouth and ears front and back. Use one or both mirrors to get a clear view.

2. Inspect your scalp

Thoroughly inspect your scalp, using a blow-dryer and mirror to expose each section to view. Get a friend or family member to help, if you can.

3. Check your hands

Palms and backs, between the fingers and under the fingernails. Continue up the wrists to examine both the front and back of your forearms.

4. Scan your arms

Standing in front of the full-length mirror, begin at the elbows and scan all sides of your upper arms. Dont forget the underarms.

5. Inspect your torso

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How Your Phone Can Help You Spot Skin Cancer

Telemedicine is a growing field, and skin care is not to be left out: Over the last several years, a handful of skin cancer detection apps popped up allowing you to analyze your skin with your smartphone and artificial intelligence algorithms.;

Some send photos to a dermatologist, some provide instant feedback and others offer helpful reminders about self-checking your skin and scheduling a doctor’s appointment.;

Here are a few you can download on iOS and Android.;

Miiskin uses hi-res digital photography to capture magnified photos of moles on your skin.;

How Is Melanoma Diagnosed


If you have a mole or other spot that looks suspicious, your doctor may remove it and look at it under the microscope to see if it contains cancer cells. This is called a biopsy.

After your doctor receives the skin biopsy results showing evidence of melanoma cells, the next step is to determine if the melanoma has spread. This is called staging. Once diagnosed, melanoma will be categorized based on several factors, such as how deeply it has spread and its appearance under the microscope. Tumor thickness is the most important characteristic in predicting outcomes.

Melanomas are grouped into the following stages:

  • Stage 0 : The melanoma is only in the top layer of skin .
  • Stage I: Low-risk primary melanoma with no evidence of spread. This stage is generally curable with surgery.
  • Stage II: Features are present that indicate higher risk of recurrence, but there is no evidence of spread.
  • Stage III: The melanoma has spread to nearby lymph nodes or nearby skin.
  • Stage IV: The melanoma has spread to more distant lymph nodes or skin or has spread to internal organs.

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I’ve Been Diagnosed With Melanomawhat Happens Next

Doctors use the TNM system developed by the American Joint Committee on Cancer to begin the staging process. Its a classification based on three key factors:

T stands for the extent of the original;tumor, its thickness or how deep it has grown and whether it has ulcerated.

What Is Breslow depth?

Breslow depth is a measurement from the surface of the skin to the deepest component of the melanoma.

Tumor thickness: Known as Breslow thickness or Breslow depth, this is a significant factor in predicting how far a melanoma has advanced. In general, a thinner Breslow depth indicates a smaller chance that the tumor has spread and a better outlook for treatment success. The thicker the melanoma measures, the greater its chance of spreading.

Tumor ulceration: Ulceration is a breakdown of the skin on top of the melanoma. Melanomas with ulceration are more serious because they have a greater risk of spreading, so they are staged higher than tumors without ulceration.

N indicates whether or not the cancer has already spread to nearby lymph nodes. The N category also includes in-transit tumors that have spread beyond the primary tumor toward the local lymph nodes but have not yet reached the lymph nodes.

M represents spread or metastasis to distant lymph nodes or skin sites and organs such as the lungs or brain.

After TNM categories are identified, the overall stage number is assigned. A lower stage number means less progression of the disease.

Amelanotic Melanoma: It Doesnt Look Like Other Melanomas

Odds are, if you have spent time on, you know the classic ABCDE warning signs of melanoma:;Asymmetry,;Border irregularity,;Color variations,;Diameter over ¼ inch or Dark in color, and;Evolution or change. But did you know that some melanomas have very different features?

For example, certain melanomas may have no color at all. Physicians refer to these as amelanotic melanomas, because they are conspicuously missing melanin, the dark pigment that gives most moles and melanomas their color. These unpigmented melanomas may be pinkish-looking, reddish, purple, normal skin color or essentially clear and colorless.

  • An example of a flat, amelanotic, superficial spreading melanoma on the leg.
  • A nodular melanoma developing within an amelanotic melanoma in situ on the scalp.

While these melanomas lack pigment, they may have other melanoma warning signs to stay on the lookout for, such as asymmetry and an irregular border. In addition, more and more physicians today stress the importance of the E in the ABCDEs evolution or change. The Skin Cancer Foundation recommends that you;examine your skin head to toe every month, especially looking for any new mole;or any sign of change in an existing mole. If you spot any change that you consider suspicious, see a skin specialist without delay.

To help you spot unusual melanomas, you can also use early recognition strategies;beyond the ABCDEs, such as the Ugly Duckling sign.

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How Dangerous Is Melanoma Its All A Matter Of Timing

Skin cancer holds the unfortunate distinction of being the worlds most common cancer. Though its prevalence around the globe is disturbing, there is some good news: When caught early, skin cancers are almost always curable.

You might already know that catching a cancer early means a more favorable prognosis. But it can be difficult to comprehend just how big a difference early detection makes with melanoma, the most dangerous form of skin cancer. Melanoma should never be underestimated, but treating a tumor early rather than after it is allowed to progress could be lifesaving.

Leland Fay, 46, understands better than most the seriousness of this distinction. When the Monument, Colorado native was diagnosed with melanoma in 2012, he was given a bleak prognosis due to the advanced stage of the tumor it had already reached stage IV.

Leland hadnt thought much of the little black mole on his head a few months earlier, when a dermatologist froze it off during a routine exam. But the mole resurfaced, bigger than it had been originally. After a biopsy and imaging tests, doctors told Leland it was melanoma, and that it had already spread. He could have as few as six weeks to live.

To fully comprehend the significance of timing, it can be helpful to understand exactly what happens to a melanoma when it advances to a later stage, and what it means when a melanoma spreads beyond the original tumor site.

Screening For Skin Cancer

How To: Prevent and Detect Melanoma with Waters Edge Dermatology

While early detection and treatment of skin cancer can improve patient outcomes,4 convincing data regarding the benefit of mass screening programs are lacking.5 In addition, the ability to identify potentially malignant lesions varies with physician training.6; Thus, except for very high-risk persons with a history of skin cancer or atypical mole syndrome, for whom periodic screening is universally recommended, there is considerable debate about who should be screened, who should perform the screening and how often screening should be performed .7; Part of the screening process should include an assessment of patient risk .1,812

Skin Cancer Screening Recommendations from Various Organizations

American Academy of Dermatology; Skin Cancer Foundation; and American Cancer Society

*Available at

Information from Public Health Service. Office of Disease Prevention and Health Promotion. Clinician’s handbook of preventive services. Washington, D.C.: U.S. Department of Health and Human Services, 1994:155.

Skin Cancer Screening Recommendations from Various Organizations

American Academy of Dermatology; Skin Cancer Foundation; and American Cancer Society

*Available at

Information from Public Health Service. Office of Disease Prevention and Health Promotion. Clinician’s handbook of preventive services. Washington, D.C.: U.S. Department of Health and Human Services, 1994:155.

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The Risks The Causes What You Can Do

Skin cancers like melanoma have damaged DNA in skin cells that lead to uncontrolled growth of these cells. Ultraviolet rays;from the sun or tanning beds damage DNA in your skin cells. Your immune system repairs some of this damage but not all. Over time, the remaining DNA damage can lead to mutations that cause skin cancer. Many other factors also play a role in increasing the risk for melanoma, including genetics , skin type or color, hair color, freckling and number of moles on the body.

Understanding what causes melanoma and whether youre at high risk of developing the disease can help you prevent it or detect it early when it is easiest to treat and cure.

These factors increase your melanoma risk:

  • Many moles: The more moles you have on your body, the higher your risk for melanoma. Also, having large moles , or any atypical moles, increases the risk for melanoma.
  • Fair skin:;Melanoma occurs more frequently in people with fair skin, light eyes and light or red hair.
  • Skin cancer history: People who have already had melanoma or nonmelanoma skin cancers run a greater risk of developing melanoma in the future.
  • Genetics:;Melanoma can run in families one in every 10 patients has a family member who also has had the disease.

Melanoma Early Detection And Treatment Are Critical

Although it accounts for less than 5% of all skin cancer cases, melanoma is responsible for the vast majority of skin cancer deaths. This form of cancer starts in the melanocytes, cells deep in the epidermis, or in moles on the surface of the skin that produce pigment.

Early detection and treatment are critical to prevent this cancer from spreading throughout the body.

Melanoma has several distinguishing characteristics that experts call the ABCDEs. A mole or growth is considered suspicious if

  • it is Asymmetrical, meaning that each half of the growth looks different from the other;
  • its orders are irregular, ragged, or blurry;
  • its Color is unusual;
  • its Diameter exceeds 6 millimeters, about that of a pencil eraser;
  • it has Evolved, enlarged, or changed in any way.

If you have a mole with any of these characteristics, see your doctor for a thorough skin exam.

Rates of melanoma have been rising for at least three decades. Your risk of developing melanoma is higher if you have

  • red or blond hair
  • a history of being in the sun a lot, especially as a child
  • a mother, father, sister, or brother with melanoma.

Features of freckles or moles that raise your risk of melanoma include

For more on melanoma and important information on keeping your skin healthy, buy Skin Care and Repair, a Special Health Report from Harvard Medical School.

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When To See A Dermatologist

The general rule of skin cancers is that they do not improve with time; they continue to grow. You shouldnt try to treat a suspicious mole, bump, or possible skin cancer on your own. If a growth on the skin looks concerning to your dermatologist, it will be biopsied to determine a diagnosis under the microscope.

Fortunately, not every spot on the skin that is worrisome turns out to be skin cancer.

Dont let nerves keep you from getting a concerning spot-checked by a dermatologist. Consider that your nerves will be calmed if it is determined not to be skin cancer, and if it is indeed skin cancer, catching it early typically means that treatment will be easier for you.

Findings Indicate That Prompt Treatment Is Especially Important For Stage I Melanoma

Oral Cancer Awareness  Early Detection is Key
Cleveland Clinic
A new study underscores the importance of early detection and treatment of melanoma, the deadliest form of skin cancer. The research indicates that the sooner patients were treated, the better their survival, particularly for stage I melanoma.

A new Cleveland Clinic study underscores the importance of early detection and treatment of melanoma, the deadliest form of skin cancer. The research, published online in the Journal of the American Academy of Dermatology, indicates that the sooner patients were treated, the better their survival, particularly for stage I melanoma.

Using the National Cancer Database, researchers from Cleveland Clinic’s Dermatology & Plastic Surgery Institute studied 153,218 adult patients diagnosed with stage I-III melanoma from 2004 to 2012 and found that overall survival decreased in patients waiting longer than 90 days for surgical treatment, regardless of stage. In addition, the delay of surgery beyond the first 29 days negatively impacted overall survival for stage I melanoma, though not for stage II or III.

Melanoma rates are on the rise, and it’s estimated that 161,790 new cases of the disease will be diagnosed in the U.S. this year. On average, one American dies of melanoma every hour.

Anyone who notices any new, changing or suspicious spots on their skin, or any spots that are changing, itching or bleeding, should see a board-certified dermatologist for diagnosis.

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Skin Biopsies Sample Tissue For Cancer

Skin cancer screening starts with a physical evaluation of symptoms. Tests can be done to determine the presence of cancer and which type of skin cancer it could be.

Skin biopsies, or samples, remove tissue from the lesion. The sample is looked at under a microscope and determined to be cancerous or non-cancerous.

How Common Is Melanoma

Melanoma accounts for only about 1% of all skin cancers, but causes the great majority of skin cancer-related deaths. Its one of the most common cancers in young people under 30, especially in young women.

Melanoma incidence has dramatically increased over the past 30 years. Its widely accepted that increasing levels of ultraviolet exposure are one of the main reasons for this rapid rise in the number of melanoma cases.

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Can Melanoma Be Found Early

Melanoma is one of the most common cancers diagnosed in the United States and the deadliest form of skincancer. Melanoma can spread quickly to other organs, and it causes the vast majority of skin cancer deaths in the United States. Luckily, melanoma can often be detected in its early and most treatable stages.

The five-year survival rate for people whose melanoma is thindefined as less than one millimeter in thicknessand has not spread to lymph nodes or other distant sites is 99 percent. Once melanoma has spread, the survival rate drops significantly, especially if the melanoma has reached distant parts of the body. Thats why taking steps to prevent melanoma and identify it early are critical.


What Causes Melanoma

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Most experts agree that a major risk factor for melanoma is overexposure to sunlight, especially sunburns when you are young. Statistics tell us that 86% of melanomas are caused by solar ultraviolet rays. How does the sun cause skin cancer? UV exposure can cause damage to a cells DNA, making changes to particular genes that affect how cells grow and divide. The potential for problems comes when your skin’s DNA is damaged and those cells start reproducing.

UV radiation from tanning beds also increases the risk of melanoma and has been designated as a carcinogen by the World Health Organization. Tanning bed use may be related to over over 6,000 cases of melanoma per year in the United States.

Although anyone can develop melanoma, an increased risk for developing the disease is seen in people with:

  • A personal history of melanoma.
  • A family history of melanoma.
  • Fair skin, freckles, blond or red hair and blue eyes.
  • Excess sun exposure, including blistering sunburns.
  • An address near the equator or in high elevations living in these locations may increase your UV exposure.
  • A history of tanning bed use.
  • Many moles, especially atypical moles.
  • A weakened immune system.

Melanoma is more common in white people, but it can occur in people of all skin types. People with darker skin most often get melanoma on their palms, soles and nails.

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