Information from the American Academy of Dermatology
Q. What is melanoma?
A. Melanoma, the most serious form of skin cancer, is characterized by the uncontrolled growth of pigment-producing cells. Melanomas may appear on the skin suddenly without warning but also can develop within an existing mole. The overall incidence of melanoma continues to rise. In fact, melanoma rates in the United States doubled from 1988 to 2017.1
Q. Is melanoma a serious disease?
A. Melanoma is highly treatable when detected early, but advanced melanoma can spread to the lymph nodes and internal organs, which can result in death. It is estimated that 7,180 people will die from melanoma in 2021.2-3
Q. What causes melanoma?
A. Exposure to natural and artificial ultraviolet light is a risk factor for all types of skin cancer, including melanoma.2 Research indicates that both UV light from the sun and tanning beds can cause melanoma and increase the risk of a benign mole progressing to melanoma.4
- Experiencing five or more blistering sunburns between ages 15 and 20 increases one’s melanoma risk by 80 percent.5
- Exposure to tanning beds increases the risk of melanoma, especially in women 45 or younger.6-7
The majority of melanoma cases are attributable to UV exposure.8-10 Other possible factors include genetics and immune system deficiencies.
Q. Who gets melanoma?
A. Melanoma can strike anyone. In fact, more than 1 million Americans are living with melanoma.11
Before age 50, rates are higher in women compared to men. After age 50, and in general, men have higher rates. White populations have higher rates compared other races.2,29 Your risk is also increased if you:
- Have more than 50 moles, large moles or atypical (unusual) moles.2,12,30
- Have had a previous melanoma or non-melanoma skin cancer, which is more common than melanoma.12-16,30
- Have a family history of melanoma.2
- Have sun-sensitive skin (i.e., you sunburn easily; have red or blonde hair; or have blue or green eyes).2
- Have a history of excessive sun exposure or indoor tanning.2
- Have had other previous cancers, such as breast or thyroid cancer.17-20
Skin cancer can affect anyone, regardless of skin color. In patients with skin of color, the disease is often diagnosed in its later stages, when it’s more difficult to treat.21
Research has shown that patients with skin of color are less likely than white patients to survive melanoma.22
Q. What are atypical moles?
A. Most people have moles (also known as nevi). Atypical moles are unusual moles that are generally larger than normal moles and variable in color. They often have irregular borders and may occur in far greater numbers than regular moles. It is important to recognize that atypical moles are not limited to any specific body area — they may occur anywhere. The presence of atypical moles is an important risk factor for melanoma developing in a mole or on apparently normal skin.
Q. What does melanoma look like?
A. Recognition of changes in the skin is the best way to detect early melanoma. They most frequently appear on the upper back, torso, lower legs, head and neck, though these may vary by age, gender, and race.23-27
- Rates of melanoma on the trunk/torso are higher in females 15-39 years old compared to males in this age range.23
- People with skin of color are prone to skin cancer in areas that aren’t commonly exposed to the sun, like the palms of the hands, the soles of the feet, the groin and the inside of the mouth. They also may develop melanoma under their nails.21
The American Academy of Dermatology urges everyone to examine their skin regularly. This means looking over your entire body, including your back, your scalp, your palms, your soles, and between your toes.
If you notice a mole on your skin, you should follow the ABCDE rule, which outlines the warning signs of melanoma:
- Asymmetry: One half does not match the other half.
- Border irregularity: The edges are ragged, notched or blurred.
- Color: The pigmentation is not uniform. Different shades of tan, brown or black are often present. Dashes of red, white, and blue can add to the mottled appearance.
- Diameter: While melanomas are usually greater than 6mm in diameter when diagnosed, they can be smaller.
- Evolving: The mole or skin lesion looks different from the rest or is changing in size, shape or color.
If you notice a new mole, a mole different from others on your skin, or one that changes, itches or bleeds, even if it is smaller than 6mm, you should make an appointment to see a board-certified dermatologist as soon as possible.
Q. Can melanoma be cured?
A. When detected in its earliest stages, melanoma is highly treatable. The average five-year survival rate for individuals whose melanoma is detected and treated before it spreads to the lymph nodes is 99%. The five-year survival rates for melanoma with regional and distant spread are 66% and 27%, respectively.2-3
Early detection is essential. Dermatologists recommend a regular self-examination of the skin to detect changes in its appearance. Changing, suspicious or unusual moles or blemishes should be examined as soon as possible. A board-certified dermatologist can make individual recommendations as to how often a person needs a skin exam from a doctor based on individual risk factors, including skin type, history of sun exposure, and family history.
Q. Can melanoma be prevented?
A. UV exposure is the most preventable risk factor for all skin cancers, including melanoma. Here’s how to protect your skin from the sun’s harmful UV rays:
- Seek shade. Remember that the sun’s rays are strongest between 10 a.m. and 2 p.m. If your shadow is shorter than you are, seek shade.
- Wear protective clothing, including a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses with UV protection, when possible. For more effective sun protection, select clothing with an ultraviolet protection factor (UPF) number on the label.
- Apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. Broad-spectrum sunscreen provides protection from both UVA and UVB rays.
- Use sunscreen whenever you are going to be outside, even on cloudy days.
- Apply enough sunscreen to cover all skin not covered by clothing. Most adults need about 1 ounce — or enough to fill a shot glass — to fully cover their body.
- Don’t forget to apply to the tops of your feet, your neck, your ears, and the top of your head.
- When outdoors, reapply sunscreen every two hours when outdoors, or after swimming or sweating.
- Take care around water, snow, and sand. These reflect and intensify the sun’s damaging rays.
- Avoid tanning beds. UV light from tanning beds can cause skin cancer and early skin aging.
- Consider using a self-tanning product if you want to look tan, but continue to use sunscreen with it.
Related AAD resources
1SEER*Explorer: An interactive website for SEER cancer statistics; Melanoma of the Skin Long-Term Trends in SEER Age-Adjusted Incidence Rates, 1975-2017. Surveillance Research Program, National Cancer Institute. Accessed February 16, 2021. Available from https://seer.cancer.gov/explorer/.
2American Cancer Society. Cancer Facts & Figures 2021. Atlanta: American Cancer Society; 2021.
3Siegel RL, Miller KD, Jemal A. Cancer statistics, 2021. CA Cancer J Clin. 2021; doi: 10.3322/caac.21654.
4Shain, AH et al. The genetic evolution of melanoma from precursor lesions. N Engl J Med 2015; 373: 1926-1936.
5Wu S, Han J, Laden F, Qureshi AA. Long-term ultraviolet flux, other potential risk factors, and skin cancer risk: a cohort study. Cancer Epidemiol Biomar Prev; 2014. 23(6); 1080-1089.
6Ting W, Schultz K, Cac NN, Peterson M, Walling HW. Tanning bed exposure increases the risk of malignant melanoma. Int J Dermatol. 2007 Dec;46(12):1253-7.
7Colantonio S, Bracken MB, Beecker J. The association of indoor tanning and melanoma in adults: systematic review and meta-analysis. J Am Acad Dermatol 2014;70:847–57.
8Arnold M, Kvaskoff M, Thuret A, Guenel P, Bray F and Soerjomatarm I. Cutaneous melanoma in France in 2015 attributable to solar ultraviolet radiation and the use of sunbeds. J Eur Acad Dermatol Venereol. Published online April 16, 2018. https://doi.org/10.1111/jdv.15022
9Arnold M et al. Global burden of cutaneous melanoma attributable to ultraviolet radiation in 2012. Int J Cancer. 2018 April. https://doi.org/10.1002/ijc.31527.
10Parkin DM, Mesher D and Sasieni P. Cancers attributable to solar (ultraviolet) radiation exposure in the UK in 2010. British Journal of Cancer. 2011. 105 (S66–S69) doi: 10.1038/bjc.2011.486.
11SEER Cancer Stat Facts: Melanoma of the Skin. National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/statfacts/html/melan.html
12Beroukhim K, Pourang A, Eisen DB. Risk of second primary cutaneous and noncutaneous melanoma after cutaneous melanoma diagnosis: A population-based study. J Am Acad Dermatol. 2020 Mar;82(3):683-689. doi: 10.1016/j.jaad.2019.10.024. Epub 2019 Oct 15. PMID: 31626886.
13Bower CP, Lear JT, Bygrave S, Etherington D, Harvey I, Archer CB. Basal cell carcinoma and risk of subsequent malignancies: a cancer registry-based study in southwest England. J Am Acad Dermatol 2000;42:988-91.
14World Health Organization, Solar ultraviolet radiation: Global burden of disease from solar ultraviolet radiation. Environmental Burden of Disease Series, N.13. 2006.
15Hemminki K, Dong C. Subsequent cancers after in situ and invasive squamous cell carcinoma of the skin. Arch Dermatol 2000;136:647-51.
16Rosenberg CA, Greenland P, Khandekar J, Loar A, Ascensao J, Lopez AM. Association of nonmelanoma skin cancer with second malignancy. Cancer 2004;49:81-5.
17Grenader T, Goldberg A, Shavit L. Second cancers in patients with male breast cancer: a literature review. J Cancer Surviv. 2008;2(2):73-78.
18Satram-Hoang S, Ziogas A, Anton-Culver H. Risk of second primary cancer in men with breast cancer. Breast Cancer Res. 2007;9(1):R10.
19Auvinen A, Curtis R, Ron E. Risk of subsequent cancer following breast cancer in men. J Natl Cancer Inst. 2002;94(17):1330-1332.
20Canchola A, Horn-Ross P, Purdie D. Risk of secondary primary malignancies in women with papillary thyroid cancer. Am J Epidemiol. 2006;163(6):521-527.
21Agbai ON, Buster K, Sanchez M, Hernandez C, Kundu RV, Chiu M, Roberts WE, Draelos ZD, Bhushan R, Taylor SC, Lim HW. Skin cancer and photoprotection in people of color: a review and recommendations for physicians and the public. J Am Acad Dermatol. 2014;70(4):748-62.
22Dawes SM et al. Racial disparities in melanoma survival. J Am Acad Dermatol. 2016 Nov; 75(5):983-991.
23Yuan TA, Lu Y, Edwards K, Jakowatz J, Meyskens FL, Liu-Smith F. Race-, Age-, and Anatomic Site-Specific Gender Differences in Cutaneous Melanoma Suggest Differential Mechanisms of Early- and Late-Onset Melanoma. Int J Environ Res Public Health. 2019 Mar 13;16(6):908. doi: 10.3390/ijerph16060908.
24Culp MB, Lunsford NB. Melanoma Among Non-Hispanic Black Americans. Prev Chronic Dis. 2019;16:E79. Published 2019 Jun 20. doi:10.5888/pcd16.180640
25Matthews NH, Li WQ, Qureshi AA, Weinstock MA, Cho E. Epidemiology of melanoma. Exon Publications. 2017 Nov 30:3-22.
26Mahendraraj K, Sidhu K, Lau CSM, McRoy GJ, Chamberlain RS, Smith FO. Malignant Melanoma in African-Americans: A Population-Based Clinical Outcomes Study Involving 1106 African-American Patients from the Surveillance, Epidemiology, and End Result (SEER) Database (1988-2011). Medicine (Baltimore). 2017;96(15):e6258. doi:10.1097/MD.0000000000006258
27Enninga EA, Moser JC, Weaver AL, Markovic SN, Brewer JD, Leontovich AA, Hieken TJ, Shuster L, Kottschade LA, Olariu A, Mansfield AS. Survival of cutaneous melanoma based on sex, age, and stage in the United States, 1992–2011. Cancer medicine. 2017 Oct;6(10):2203-12.
28Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: randomized trial follow-up J Clin Oncol Jan 20, 2011:257-263; published online on December 6, 2010.
29Howlader N, Noone AM, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2017, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2017/, based on November 2019 SEER data submission, posted to the SEER web site, April 2020.
30Müller C, Wendt J, Rauscher S, et al. Risk Factors of Subsequent Primary Melanomas in Austria. JAMA Dermatol. 2019;155(2):188-195. doi:10.1001/jamadermatol.2018.4645