Melanoma Screening

Melanoma is a cancer that develops from melanocytes, cells that produce a natural level of pigment, called melanin, in the skin. The skin also creates melanin in an effort to protect itself from sun damage and is the reason skin darkens when exposed to sunlight. Melanin is found in darkened areas such as moles, freckles, and other spots. Melanocytes can become cancerous when damaged, sometimes by ultraviolet (UV) light from the sun.

Melanoma often resembles a mole and appears as a new spot or a change in a previously existing mole. This form of skin cancer can appear anywhere on the body, and it has a higher chance of spreading than other forms of skin cancer.

Because UV damage is sometimes the cause, melanoma can appear on areas of the body that receive intermittent sun exposure, including the trunk, legs, and arms, and higher amounts of sun exposure, such as the face and head. More rarely, a melanoma grows on the soles of the feet, the palms of the hands, or even in the mucous membranes of the mouth, vagina, or anus.

Signs and Symptoms

Melanoma is a different type of skin cancer from the more common basal and squamous cell skin cancers—and it can be more serious. It can be aggressive and spread quickly if not treated early.

NYU Langone researchers and physicians established the ABCDE system, which helps you identify the signs and symptoms of melanoma. In general, you should look for any changes in the size, shape, or color of a mole, freckle, or other dark spot on the skin.

A for Asymmetry

One half of the mole or pigmented area of skin does not look like the other half. Most healthy moles look the same on both sides.

B for Border Irregularity

The edges of the mole or pigmentation appear uneven, notched, or blurred.

C for Color

The color of the mole or pigmented area of skin is uneven. For example, it may contain multiple shades of black, brown, tan, red, or blue.

D for Diameter

The mole or area of skin pigmentation is wider than a quarter inch—the size of a pencil eraser. Some early melanomas can be smaller, however.

E for Evolution

The size, shape, or color of the mole or pigmented area of skin changes, or new symptoms, such as itching, bleeding, crusting, or tenderness, develop.

Screening

NYU Langone offers a melanoma screening program, which helps detect the cancer early, when doctors can most effectively treat it. Our physicians are experts at monitoring people at high risk for developing melanoma. They use advanced imaging techniques to detect early melanomas and to reduce unnecessary biopsy—the removal of tissue for examination under a microscope.

Those at high risk for melanoma include people with more than 50 moles; atypical, or unusual, moles; a history of any type of skin cancer; a family history of skin cancer; exposure to excessive amounts of sunlight, as occurs in jobs involving a lot of time outdoors; or a history of one or more blistering sunburns as a child.

People with fair skin, freckles, red or blond hair and green, blue, or gray eyes are also at an increased risk of developing melanoma, although you can develop the condition if you have darker skin.

NYU Langone doctors can help you create a screening plan tailored to your risk level. For example, people at average risk for melanoma should be examined only once a year as part of a routine physical exam. But those at high risk may need to be screened more often.

To screen for melanoma, a doctor conducts a full-body skin exam, visually inspecting the skin for suspicious moles. NYU Langone doctors may also use dermoscopy, in which a specialized handheld lens is used to examine the skin, and photography of all of the skin or of specific moles.

Dermoscopy

A dermatologist examines your skin with a dermatoscope, a handheld device that uses a lens to light and magnify the skin. This device allows the doctor to see more deeply into the skin, identify subtle features of melanoma, and determine if a biopsy is needed.

Photography

Total body photography is sometimes used in people who have more than 50 moles or who have unusual moles. High-resolution digital photos are taken of a person’s skin as a baseline. The photos can be used as a reference when your doctor looks for new or changing lesions during future skin exams. Photographs of specific moles may be taken, sometimes through the lens of a dermatoscope.

Skin Self-Exam

NYU Langone dermatologists recommend that you conduct a monthly skin self-exam while fully naked to look for unusual-looking moles or skin cancers. The ABCDE system can help you find melanoma. A family member or close friend can help you check places on your body that are hard to see, such as your scalp or back.

More Melanoma Resources

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