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Melanoma

Melanoma is the most serious type of skin cancer because it can spread beyond the skin if left undiagnosed and untreated. It can develop anywhere on the body, but certain areas are more commonly affected. In people with fair skin, it often appears on the trunk in men and on the lower legs in women. In people with darker skin, melanoma is more likely to develop on the palms of the hands, soles of the feet, or beneath the fingernails or toenails. When detected and treated early, melanoma is highly curable. At Avant Dermatology, regular skin examinations, prompt evaluation of suspicious moles, and early treatment play an important role in protecting your health.

What is melanoma?

Melanoma develops in melanocytes, the cells that produce melanin, the pigment that gives skin, hair, and eyes their color. These cells are found throughout the skin, so melanoma can develop almost anywhere on the body.

Many melanomas begin as a new dark spot, while others develop from an existing mole that changes over time. Although they commonly occur on areas exposed to the sun, such as the face, back, arms, and legs, melanoma can also develop on the palms, soles of the feet, beneath the fingernails or toenails, and even inside the mouth.

Unlike many other skin cancers, melanoma has the potential to grow deeper into the skin and spread through the lymphatic system or bloodstream. This makes early diagnosis especially important.

What are the signs and symptoms?

The earliest signs of melanoma often involve changes in a mole or the appearance of a new pigmented lesion. Knowing what to watch for can help detect melanoma before it becomes more advanced.

Dermatologists commonly use the ABCDE rule to evaluate suspicious moles.

  • A – Asymmetry: One half of the mole does not match the other.
  • B – Border: The edges are irregular, uneven, blurred, or poorly defined.
  • C – Color: Multiple colors or varying shades of brown, black, tan, red, white, or blue are present.
  • D – Diameter: The spot is larger than about 6 millimeters – the size of a single pea or width of an eraser tip on a standard wooden pencil, although melanomas may be smaller.
  • E – Evolving: The mole changes in size, shape, color, thickness, or develops symptoms such as itching, bleeding, crusting, or tenderness.

Another warning sign is the “ugly duckling” mole. This is a mole that looks noticeably different from your other moles. Because most moles on an individual tend to have a similar appearance, one that stands out deserves evaluation. Any new or changing skin lesion should be examined by a dermatologist.

What are the risks and causes?

Melanoma develops when genetic damage causes melanocytes to grow uncontrollably. While the exact cause varies, excessive exposure to ultraviolet (UV) radiation remains the leading preventable risk factor.

Repeated sunburns, especially during childhood and adolescence, increase the risk of melanoma later in life. Indoor tanning beds also expose the skin to concentrated UV radiation and significantly increase melanoma risk.

How is Melanoma diagnosed?

Diagnosing melanoma begins with a comprehensive skin examination. During your visit to Avant Dermatology, your provider reviews your health history and carefully evaluates suspicious moles and examines your skin for other abnormal lesions.

If melanoma is suspected, a skin biopsy is performed. During the procedure, using local anesthesia, a small part of the suspicious lesion is removed and sent to a pathology laboratory for microscopic evaluation. The biopsy confirms whether melanoma is present. If positive for melanoma, additional studies and lymph node evaluation may be recommended to determine whether the cancer has spread.

What is the treatment?

Treatment depends on the stage of melanoma and whether it has spread beyond the skin.

Most early-stage melanomas are treated with surgical excision. Mohs micrographic surgery is a specialized outpatient surgical procedure to remove skin cancers in functionally and aesthetically sensitive areas. Mohs is the gold standard treatment for skin cancers including basal and squamous cell skin cancer lesions on the face, scalp, ears, hands, shins, feet and genitals.  Mohs surgery offers the highest cure rates and best cosmetic results for skin cancers in cosmetically sensitive areas, where standard excision could be disfiguring. Dr. Shiela Farhang is a fellowship-trained Mohs surgeon. For many patients, Mohs surgery alone provides a cure.

If the melanoma is thicker or has higher-risk features, Dr. Farhang will refer you to cancer specialist, who may perform a sentinel lymph node biopsy to determine whether cancer cells have spread to nearby lymph nodes.

Advanced melanoma may require additional therapies. Immunotherapy has become one of the most important treatments because it helps the immune system recognize and attack melanoma cells. Some patients may benefit from targeted therapy, which attacks specific genetic mutations within melanoma cells. Radiation therapy or chemotherapy may also be appropriate in selected cases.

Your dermatologist works closely with other specialists to develop an individualized treatment plan based on the stage of the melanoma and your overall health.

Early detection saves lives

Although not every case of melanoma can be prevented, protecting your skin and that of your children, from excessive UV exposure can significantly reduce the risk. Wearing broad-spectrum sunscreen or mineral sunscreen SPF 30 or highter, seeking shade during peak sunlight hours, wearing protective clothing, and avoiding tanning beds all help limit sun damage.

Equally important is becoming familiar with your own skin. Performing monthly skin self-examinations and scheduling regular skin cancer screenings can help identify melanoma before it becomes advanced.

If you notice a changing mole, a new spot, or a skin lesion that concerns you, don’t wait to have it evaluated. At Avant Dermatology & Aesthetics, Dr. Sheila Farhang, Dr. Roshni Rawlani, and Jennifer Briner, PA-C provide comprehensive skin cancer screenings, thorough evaluations, and personalized treatment plans. Our experienced dermatology team is dedicated to identifying suspicious lesions and detecting melanoma and other skin cancers as early as possible, helping protect your long-term skin health.