Mole or Melanoma? Here's How to Spot the Difference

Skin cancer is the most common type of cancer in the United States. And melanoma is the most serious type of skin cancer. It happens when pigment-producing cells (aka melanocytes) mutate and grow out of control.

Melanoma can affect any area of your skin, but it tends to appear on your face, chest, back, and legs. In rare cases it can pop up in your digestive system or eyes 👀 . If it isn’t treated, the cancer can spread to other parts of your body like your lymph nodes or internal organs.

While it most often affects older folks, melanoma isn’t uncommon in people under 30.

Skin cancer is broken down into five stages, from 0 (least serious) to 4 (most serious).

Here’s a rundown of the stages of melanoma:

• Stage 0. The cancer affects only the outermost layer of skin. Some doctors refer to this stage as precancer. It’s sometimes also called melanoma in situ.
• Stage 1. The cancer is up to 2 millimeters (mm) in depth and hasn’t spread to other areas.
• Stage 2. The cancer is deeper than 2 mm but hasn’t spread to lymph nodes or distant parts of your body.
• Stage 3. The cancer has spread from your skin to at least one lymph node. The tumor may or may not be ulcerated (meaning the skin surrounding the tumor has broken down), and the cancer hasn’t spread to distant parts of your body.
• Stage 4. The cancer has spread to distant areas of your body like your liver, lungs, brain, or gastrointestinal tract.

The symptoms of melanoma can vary from person to person.

These are some of the most common:

• scaly, dry, or rough skin spots
• moles that ooze, bleed, or crust
• moles that have an uneven color
• smooth, shiny, waxy, or pale lumps
• painful, tender, or itchy spots or sores
• ulcers on or near a mole or discolored spots of skin

Remember your ABCDEs

Most moles or beauty marks are totally harmless. But some skin spots, such as atypical moles, can be a sign of something serious.

According to the Skin Cancer Foundation, folks with 10 or more atypical moles are 12 times more likely to have melanoma.

The ABCDE test can help you spot an atypical mole:

• Asymmetric. It may have an uneven shape.
• Border. The mole’s rim may appear notched, blurred, or ragged.
• Color. It can be uneven shades of black, tan, brown, white, or blue.
• Diameter. These moles tend to be larger than a pencil eraser (but can be smaller).
• Evolving. It may change in shape, size, color, and height. You might also notice sudden crusting, itching, or ulceration.

Reminder: When it doubt, check it out. Hit up a dermatologist, even if it might be “just a mole.” Better safe than sorry, fam!

There are four main types of melanoma. Here are the deets on each.

1. Superficial spreading melanoma

This is the most common type of melanoma. It accounts for 70 percent of all cases. The cancer usually starts slow on the surface of the skin and gradually grows deeper.

2. Nodular melanoma

Nodular melanoma makes up 10 to 15 percent of all cases. It grows faster than other types of melanoma and is considered aggressive.

3. Acral lentiginous melanoma

This is the rarest form of melanoma overall, but it’s the most common type to affect folks with darker skin. It usually appears on your feet or hands or under your nails.

4. Lentigo maligna melanoma

This typically slow-growing form of melanoma starts off as lentigo maligna. That’s when the disease has affected only the outermost layer of skin. Then, as it gets deeper, it’s considered lentigo maligna melanoma.

It’s more common in older adults or folks who have had a lot of ultraviolet (UV) radiation exposure.

These photos show examples of melanoma, but it can look different on different folks. Remember that it’s important to get any suspicious spots checked out by your doc.

We still don’t know the exact cause of melanoma. But several factors could increase your risk of developing skin cancer.

You might be at a higher risk if you have:

• light eyes
• pale or fair skin
• blonde or red hair
• 10 or more atypical moles
• prolonged exposure to UV rays
• skin that easily gets sunburned
• a type of birthmark called a giant congenital melanocytic nevi

BTW, melanoma can run in families. About 10 percent of people who get melanoma have a family member who has also had it.

Melanoma isn’t a one-size-treats-all sort of disease. Treatment can depend on:

• your age
• your overall health
• the stage of the cancer
• the type of melanoma you have

Depending on your situation, your doctor may recommend several common treatment options.

Surgery

A variety of surgical procedures are used to treat and cure melanoma:

• Wide excision. The tumor is removed and the wound is stitched back together. You may need a skin graft if a large area of skin is removed.
• Mohs micrographic surgery (MMS). Your doc will remove very thin layers of the affected skin and analyze each layer with a microscope. They’ll stop removing layers once the results come back cancer-free.
• Lymph node dissection. Your surgeon will remove the lymph nodes near the primary melanoma tumor. This can help them determine whether the cancer has spread and decide how aggressive your treatment should be.
• Amputation. If the cancer has gotten really deep and is on a spot like your finger, amputation might be the best way to beat the cancer.

Immunotherapy (aka immuno-oncology)

This is a type of medication that stimulates your immune system. It helps your body destroy cancer cells more efficiently.

Types of immunotherapy for melanoma include:

• CTLA-4 inhibitors like ipilimumab (Yervoy)
• PD-L1 inhibitors like tezolizumab (Tecentriq)
• oncolytic virus therapies like talimogene laherparepvec (Imlygic)
• PD-1 inhibitors like pembrolizumab (Keytruda) and nivolumab (Opdivo)

Chemotherapy

Chemo is a type of drug that can kill cancer cells. It can come with pretty gnarly side effects, though, because it also damages some healthy cells. While other treatments would be a better fit for melanoma that’s caught earlier, chemotherapy could be used in more advanced cases.

Radiation therapy

Radiation therapy uses high energy rays to kill cancer cells. It can help treat melanoma that has metastasized (spread) to other parts of your body.

Like chemotherapy, this is generally used only in more severe cases of melanoma.

The only way to 10/10 know you have melanoma is to go to a doctor. A dermatologist will run a series of tests to determine a diagnosis. Here’s what will prob go down:

• Health history. Your dermatologist will ask you if you have a history of skin disease or if skin cancer runs in your family. They’ll also go over the rest of your relevant medical history.
• Physical exam. Your derm will do a visual exam to look for any irregular marks or moles on your skin. They may also use a special camera or a microscope to take a deeper look.
• Biopsy. Your derm may take a small tissue sample to test for cancerous cells.

Melanoma recovery can depend on:

• your age and general health
• how advanced your cancer is
• the type of melanoma you have
• the type of treatment(s) you get

PSA: Looking at survival rates online can be scary AF. Try to remember that these numbers are just rough estimates. Your doc can give you a more precise assessment based on your unique situation.

Melanoma is the most serious form of skin cancer. An estimated 106,110 people in the United States will be diagnosed with the disease in 2021. While melanoma can be life-threatening, there are tons of treatments that can provide long-term remission.

Early detection is super-duper important. It’s best to see a dermatologist for a checkup at least once a year and to avoid long-term sun or UV exposure to reduce your risk.

If you notice any unusual marks or moles anywhere on your skin, get them checked out by a derm.