Melanoma Symptoms & Signs

This page has been designed to answer common questions regarding early signs & symptoms and the diagnosis of Melanoma. Pictures below show what melanoma looks like.

If you would like to seek an online consultation/ advice or discuss the diagnosis of melanoma, please do post your question in the question box on the right.

The FAQ section and other links in the top menu bar, should give you all the information you need, regarding the consultation process.

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What is a mole?

Pigmentation is the skin is produced by specialised cells in the skin called melanocytes. These are present in everybody in equal numbers, including people of dark or lighter skin colours. This might come as a surprise as one would expect more melanocytes in someone of darker skin colour. However the only difference in someone with darker skin is that the melanocytes in people of darker skin types are hyperactive, enlarged and produce more pigmentation, compared to those in white skinned races.

The word ‘mole’ is commonly meant to imply an area of the skin (usually a few mm in diameter) which is darker than the surrounding skin. In medical terms moles are referred to as ‘naevi’ (naevus= singular). These lesions are usually caused by an excess number of melanocytes (pigment producing cells) in the area (as opposed to a freckle, which is caused by a normal amount of pigment producing cells which being activated by sunlight, produce excessive pigment i.e. the number of melanocytes in the area is within normal limits, unlike moles).

Read our Feature article in Everyday Health.

I have a raised/ bumpy mole, is that worrying?

Most moles are flat and one cannot feel them raised. However it is also quite common to have moles that are raised (because the melanocytes are significantly more in number and form a lump under the skin) or even have hairs growing through them. This is not a worrying sign by itself. In these instances it is also normal for the mole to be of normal skin colour and not be dark. This is because the lesion just has an excessive number of melanocytes but these cells are not mature enough to produce any pigment. Again, this is entirely normal. So basically moles can vary in colour from being skin coloured to dark black.

What is a congenital mole? Is it common for even older people to get new moles?

Most people are born with one or two moles (which we call birthmarks). But, it is not uncommon for these lesions to only become apparent as one grows older. These types of moles that appear at or just after birth are called congenital naevi. Most of the moles we see in adults however are acquired in later life, usually due to sun exposure (acquired naevi). In fact one can develop new moles in adult life until the age of 60, and this is completely normal. Most often the mole appears and grows in size gradually for a few months, before stabilizing. It is interesting that after the age of 60, one actually starts to gradually lose the moles acquired during adult life. This is again normal.

What is a melanoma?

Melanoma is a term used to describe cancerous change within moles. There are different types and grades of melanoma and this depends on a number of factors including the site and depth of the lesion.

So when should one worry about melanoma? What are the early signs & symptoms of melanoma?

The ABCDE rule for moles is well known anyway. For those who don’t:

A= Asymmetry- if you draw a line through the middle of the mole, the two halves are not approximate mirror images

B= irregular Border- if the mole has Ill-defined or blurred borders

C= varying Colours- if the mole has different colours within

D= Diameter more than 5mm

E= irregular Elevation- if the mole has flat and bumpy components

Apart from ABCDE, one should worry about moles if

There is a family history of melanoma

If one has more than 100 moles on the body

One has used sun beds extensively or has been an ardent sun worshipper (especially if you have had a lot of sunburns causing blistering)

A mole appears and keeps growing in size, without showing any sign of stabilising

A mole that is either itchy or bleeding

What does Melanoma look like?- Pictures of Melanoma and moles

Nodular melanoma- variation in colour is a sign of melanoma

Melanoma diagnosis- This is a benign mole

Who should I consult regarding advice on melanoma treatment and melanoma diagnosis?

Obviously if you have a worrying mole, it would be best to consult a dermatologist either online for an opinion, or in person. A dermatologist would be able to look at the lesion under a special magnifying lens called a Dermatoscope, and be able to decide whether there are any early signs of melanoma or if it can be left alone,

Other Online resources available:

The NHS self-assessment website: excellent tool for a quick self triage of worrying moles

The Dermnet NZ website has more detailed information and an extensive picture library of normal and abnormal moles

You can also consult a dermatologist online, if you have high quality digital images to hand.

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