Melanoma is a malignant tumor that originates in melanocytes, the cells which produce the pigment melanin that colors our skin, hair, and eyes. The majority of melanomas are black or brown. However, some melanomas are skin-colored, pink, red, purple, blue or white. The risk of metastasis or spread to distant sites or internal organs is directly correlated to the thickness of the melanoma.  A thin melanoma, less than 1 mm in thickness, is the least likely to spread.  A thick melanoma over 4 mm in thickness is the most likely to metastasize.  The amount of skin removed around the melanoma is determined by the thickness. "In Situ" melanoma, confined to the epidermis, and other thin melanomas less than 1 mm in thickness are typically removed with a 10 mm radius of normal skin.  Thicker melanomas are usually removed with a 20 mm radius of normal skin.  The Skin Cancer Foundation has more information on staging and treatment options for melanoma. The American Academy of Dermatology has more information on how to diagnose melanoma.

ABCDEs of Melanoma Detection

Look for Danger Signs in Pigmented Lesions of the Skin

Consult your dermatologist immediately if any of your moles or pigmented spots exhibit:

One half is unlike the other half.

An irregular, scalloped, or poorly defined border.

Is varied from one area to another; has shades of tan, brown, or black; is sometimes white, red, or blue.

Melanomas usually are greater than 6mm (the size of a pencil eraser) when diagnosed, but they can be smaller.

A mole or skin lesion that looks different from the rest or is changing in size, shape, or color.

Am I at Risk?

Everyone is at some risk for melanoma, but increased risk depends on several factors: sun exposure, number of moles on the skin, skin type and family history (genetics).

Sun exposure

Both UVA and UVB rays are dangerous to the skin, and can induce skin cancer, including melanoma. Blistering sunburns in early childhood increase risk, but cumulative exposure also is a factor. People who live in locations that get more sunlight — like Texas, Florida, Hawaii, and Australia — get more skin cancer. Avoid using a tanning booth or tanning bed, since it increases your exposure to UV rays, increasing your risk of developing melanoma and other skin cancers.

Moles

There are two kinds of moles: normal moles — the small brown, tan or pink growths or "beauty marks" that appear in the first few decades of life in almost everyone — and atypical moles that are flat, irregular brown, pink or tan growths also known as dysplastic nevi. Regardless of type, the more moles you have, especially over 40 moles, the greater your risk for melanoma.

Skin Type

As with all skin cancers, people with fairer skin and light colored eyes are at increased risk of melanoma.

Family History

About one in every ten patients diagnosed with the disease has a family member with a history of melanoma. If your mother, father, siblings or children have had a melanoma, you are in a melanoma-prone family. Each person with a first-degree relative diagnosed with melanoma has a 50 percent greater chance of developing the disease than people who do not have a family history. If the cancer occurred in a grandmother, grandfather, aunt, uncle, niece or nephew, there is still an increase in risk, although it is not as great.

Personal History

Once you have had melanoma, you run an increased chance of recurrence. Also, people who have or had basal cell carcinoma and squamous cell carcinoma are at increased risk for developing melanoma. If you have had intense sunburns as a child or used indoor tanning beds you will have an increased risk of melanoma.

Weakened Immune System

Compromised immune systems as the result of chemotherapy, an organ transplant, certain other medications, excessive sun exposure, and diseases such as HIV/AIDS or lymphoma can increase your risk of melanoma.

If you are in any of these risk groups, you can protect yourself and your children by practicing safe sun habits, that is using a sunscreen every day and donning protective clothing and a hat when in the sun, remembering to self-examine your skin monthly, watching for the warning signs of melanoma and getting yearly exams by a dermatologist or other physician experienced in skin care.

Moles in an Active Stage

Moles in people belonging to melanoma-prone families are subject to change at certain times of life. They may get larger or show alterations in color or elevation, so for those periods, they are described as being active. While the reasons for these changes are not fully known, there could be a hormonal component: Moles are more active at puberty and during pregnancy. Some — but not all — physicians advise high-risk individuals not to take hormonal medications, such as oral contraceptives or hormone replacement therapy. Discuss this with your dermatologist.

Examination Scheduling

Individuals with the many moles or lots of atypical moles can improve their chances of early detection by increasing the frequency of skin self-examination and by visiting a physician more often. The clinician may take photographs or measure the moles to document whether there are new moles or changes in older ones. The patient and family members even the hair dresser or barber can assist by looking out for changes.