Skin cancer is the most common form of cancer, responsible for one-third of all new cancer cases in Canada. Melanoma is rarer than other types, but it’s also the most serious. A small spot that appears to be just another mole you’ve had for years may change and invade surrounding tissue. Left untreated, melanoma can spread throughout the body and become life-threatening.
The good news is that when caught early, melanoma and other types of skin cancer are highly treatable. Knowing how to identify melanoma using the ABCDE method can help you protect your skin and long-term health. This guide will help you understand the signs of melanoma, how it compares to benign moles, and which changes you should never ignore. We also cover the importance of regular skin checks and how ICLS can help you take charge of your health, whether you have a new spot or a gradually changing lesion.
Understanding Melanoma Appearance
There’s no single definition of what melanoma looks like. It may appear as a flat freckle or a raised mole and can vary in colour, from brown or black to pink or even colourless. Its unpredictability is exactly what makes melanoma so dangerous. Regular self-checks and dermatology visits are critical for catching early melanoma and getting the proper treatment to prevent its spread.
Melanoma Vs. Normal Moles
So, what does melanoma look like compared to a harmless mole? Benign moles are symmetrical and evenly coloured, and they remain stable over time. Melanomas tend to evolve. When assessing melanoma vs. mole, remember: It’s the mole that looks different from the others that should raise a red flag. Asymmetry in moles, irregular borders, evolving moles, and other changes can all be signs of early melanoma or more advanced stages.
If you’re unsure whether a mole has changed or has always looked that way, consider professional mole mapping. At ICLS, this screening uses the advanced Fotofinder system to generate photo comparisons of moles over time. With this non-invasive procedure, your dermatologist can track the size, shape, and colour of moles across your body, catching subtle changes early.
With mole mapping, patients have greater peace of mind and a proactive way to monitor even difficult-to-see areas like the back and scalp. It’s especially useful for patients with multiple moles, suspicious spots, or risk factors like a family history of melanoma or other skin cancers.
Common Locations for Melanoma
Melanoma can appear anywhere on the body, including unexpected places. It’s more likely to develop in sun-exposed areas, but that’s not always the case. Regular monitoring and skin checks are essential to catch changes in the moles’ size and appearance.
Melanoma on the Face
Melanoma on the face is more common in older adults due to sun exposure over their lifetime. It can develop on the eyelids, nose, cheeks, scalp, and lips, where it may mimic a cold sore. These spots may resemble age spots or rough patches that don’t heal, often appearing reddish in light-skinned people and gray or brown in dark-skinned people.
Melanoma on Arms and Legs
Melanoma often appears on the back, shoulders, and arms. In women, it’s more common on the lower legs. If you’re monitoring your arms or legs, look for new, irregular spots in areas with frequent sun exposure.
Melanoma Under Nails
Nail melanoma, or subungual melanoma, looks like a dark stripe running vertically under a fingernail or toenail. It’s easy to mistake it for bruising or fungus, but unlike an injured nail, it doesn’t grow out or heal. If you notice discolouration on a single nail, mainly if it spreads to the surrounding skin, it’s time to see a dermatologist.
Key Signs: The ABCDE Rule
One of the simplest ways to detect melanoma is through the ABCDE rule. This acronym is easy to remember and gives you a checklist for spotting abnormalities early, when treatment outcomes are the most favourable.
A Is for Asymmetry
Asymmetry in moles — when one side is unlike the other — is a clear warning sign of melanoma or other skin cancers.
B Is for Border
Melanomas often have irregular borders, with edges that are blurred, jagged, or scalloped instead of smooth and defined.
C Is for Colour
Any variations in colour are red flags. There may be uneven pigmentation, with multiple shades of red, blue, white, brown, or black within a single spot.
D Is for Diameter
Melanomas are often larger than 6 mm (about the size of a pencil eraser). However, they can be smaller when diagnosed and still dangerous, especially if they’re evolving.
E Is for Evolving
A professional should continuously assess moles that grow, bleed, itch, or develop new colours.
Different Types of Melanoma and Their Appearance
Just as melanoma doesn’t always look the same, there are different types, each with unique characteristics. Recognizing the various types of melanoma is critical for early detection, especially for those with a family history, multiple moles, or other risk factors.
Superficial Spreading Melanoma
As the most common form, superficial spreading melanoma accounts for about 70% of cases. It typically grows outward and spreads across the skin’s surface before penetrating deeper into the vertical layers of the skin. Superficial spreading melanoma often appears on the trunk, legs, or arms as a flat or slightly raised lesion with uneven edges and colour variations.
Nodular Melanoma
This aggressive type is the second most common, making up 15% to 20% of melanomas. It grows down into the skin more quickly than other types, often on the face, chest, or back. Nodular melanoma typically appears as a dark, raised bump (sometimes mushroom-shaped) that may bleed or feel firm, but it can also be red, pink, or skin-coloured.
Lentigo Maligna Melanoma
This form is more common in older adults and develops in areas frequently exposed to the sun, such as the arms, ears, and face. It appears as a large, flat brown or tan lesion that gradually enlarges and darkens, often slowly spreading on the surface before growing down into the skin.
Acral Lentiginous Melanoma
This rare form of lentigo malignant melanoma, seen more often in people with darker skin, appears on the palms, soles, or under nails. Like lentigo malignant melanoma, it tends to spread slowly before growing down into the skin, making it difficult to detect without routine skin checks.
Early Signs: What Early Melanoma Looks Like
Early melanoma may look like just another spot. But those who diligently monitor their skin are more likely to catch abnormalities in time.
Identifying Early Stage Melanoma
Early-stage melanoma may appear as:
- A new mole or freckle that looks different than the others
- A flat patch that gradually changes in shape or colour
- A lesion that begins to itch, bleed, or crust over
- A spot that grows or changes noticeably in just a few weeks
Risk Factors for Melanoma
Knowing what to watch for can help you be proactive with your health. Common risk factors include:
- Fair skin that burns easily
- History of sunburns, especially in childhood
- Use of tanning beds
- Personal or family history of melanoma
- A large number of moles or atypical (dysplastic) moles
- Weakened immune system
- Age over 50
- Living at a high altitude or near the equator
- Previous radiation therapy
- Genetic conditions like xeroderma pigmentosum
When To See a Doctor
It’s always better to be safe than sorry. See a dermatologist if any of the following apply:
- A mole or spot changes in colour, size, or shape
- A lesion itches, bleeds, or becomes painful
- A spot shows up suddenly and grows quickly
- A spot appears under a nail with no known cause
- You have many moles and notice a new “outlier”
- You’ve never had a full-body skin check and are at higher risk
Regular dermatology visits enable early detection of any skin changes. If you’re searching “when to see a dermatologist,” it’s probably time to book an appointment.
FAQ on Melanoma
What does a melanoma look like when it first appears?
Melanoma may look like a flat or slightly raised dark spot with inconsistent colouring and uneven edges. It may appear suddenly or start as a mole that changes over time.
Is a melanoma usually raised or flat?
It can be either. Superficial types are often flat at first, while nodular melanoma is typically raised and firm.
How can you tell if a spot is melanoma?
The best way to identify melanoma is through the ABCDE checklist. Watch for asymmetry, uneven borders, multiple colours, growth, or changes over time.
What are the key signs and symptoms of melanoma?
Key melanoma symptoms include new or changing spots, moles that itch or bleed, and any lesion that doesn’t look like the others. Regular skin checks are the most thorough way to spot the signs, especially for hard-to-see areas like the back and scalp.
Do melanomas hurt or itch?
Yes, sometimes. Some spots may not be painful but could be itchy, tender, or oozing. Lack of symptoms doesn’t mean it’s harmless, so be sure to get any unusual spots checked out by a dermatologist.
Can melanoma appear in places not exposed to the sun?
Yes. Melanoma can appear anywhere, including between toes, under nails, on the scalp, and even in mucous membranes. Total-body skin checks are essential for finding irregularities and catching melanoma early.
Skin Cancer Signs: What To Remember
Knowing common skin cancer signs and checking your skin monthly is a smart preventive step. Use a mirror or ask a partner to examine areas you can’t see, and take photos to monitor changes over time. Best practice? When in doubt, get it checked out.
Book a Dermatology Consultation Today
Melanoma may seem elusive, but it’s not invisible. Empowering yourself with knowledge, staying vigilant, and seeking professional care can help you catch problems early and protect your skin for years to come.
At ICLS, our expert dermatology team offers comprehensive skin exams, mole mapping, and advanced treatment options. Whether you’re concerned about a single mole or want peace of mind with a full-body check, we’re here to help. In addition to monthly self-checks, we recommend a thorough exam with a dermatologist at least annually or more often for those at a higher risk.
Take the first step by booking a skin check today. Contact ICLS to schedule your consultation and get peace of mind, today and tomorrow.