Symptoms and Signs of Melanoma

What are the ABCD signs of melanoma?

looking at sign of melanoma on the shoulder
What are the signs and symptoms of melanoma?. Peter Dazeley Collection/Getty Images

What are the signs and symptoms of melanoma, and how can you remember these with the ABCDE mnemonic?

Melanoma Skin Cancer

Melanoma is the most aggressive type of skin cancer that affects approximately 5% of people diagnosed with skin cancer.  Even though it is only responsible for 5% of skin cancer, it is also the cause of most skin cancer deaths.

Risk factors for melanoma include excess sun exposure, having fair skin, and having a family history of melanoma.

  Despite these risk factors, many people who develop the disease do not have any risk factors, and even those without risk factors should be alert to the signs and symptoms and contact their doctor if they note anything abnormal on their skin.  Some people have a genetic predisposition to melanoma, and it's thought that 55% of melanomas have a genetic component.

Melanoma is most treatable when detected early. Moles or other spots on the skin should be self-examined each month. Look for any changes in the existing areas and look for new moles.

Signs and Symptoms of Melanoma

A melanoma may begin as a new "spot" on the skin, or as a change in an existing mole.  Note that even if you have had a mole as long as you can remember, any change should be carefully examined and evaluated. As you read through these possible signs, note the mnemonic.  This will also be reviewed again under self-exams below.

When you finish reviewing these signs and symptoms, take a look at these pictures of melanoma to make this easier to understand.  Possible signs and symptoms of a melanoma include:

A - Asymmetry - Asymmetry of a mole may be a sign of melanoma.

B - Border - Unlike regular (non-cancerous) moles, melanomas often have an irregular border or edge.

C - Color - Melanomas tend to be "more colorful" than regular moles, with colors varying from flesh colored to the typical dark brown or black of a mole, to red.  Different colors occurring in the same mole are also of concern, and some melanomas have a classic "red white and blue" appearance.

D - Diameter - Melanomas tend to be larger than normal moles (but certainly not always.)  Any mole that has a diameter which is the same or larger than the diameter of a pencil eraser should be evaluated.

E - Elevation - E stands for elevation.  Instead of being flat, a mole may be elevated off the skin, or different parts of the mole may have different elevations.

E - Evolving - Some people instead use the letter E instead to signal them to look for moles that are evolving. Evolving can refer to any component of the mole, for example, it could be changing in size, in color, in shape, or in degree of elevation.  The mole may also change in texture, for example, become scaly.

F - Funny looking - Some physicians add an extra letter to the pneumonic and include F, for "funny looking."  Many melanomas simply don't look like normal moles.

Itching/Other sensations - Often overlooked is the presence of symptoms in a mole.

  Melanomas may sometimes cause itching (and they can break down and scab if you scratch them, making them more difficult to evaluate) or some kind of sensation, rather than being devoid of specific sensation as most moles.

Sores on the skin that do not heal - If a sore on your skin does not heal after a period of 2 weeks, you should have your doctor examine you for the possibility of melanoma.

Bleeding or oozing from a mole - If bleeding or oozing comes from a mole or spot, it is imperative that it be examined by a physician. This is often indicative of advanced melanoma and needs to be evaluated.

Late symptoms - If a melanoma grows large and spreads to other regions of the body, it may cause symptoms related to that spread.  For example, a melanoma which has spread to the liver may cause jaundice, a yellowish discoloration of the skin.  Cancers which have spread may also cause "systemic symptoms" such as fatigue, unintentional weight loss, and weakness.

Diagnosing Melanoma

Sometimes it is difficult to discern between an ordinary mole and a melanoma, and even skin cancer specialists sometimes find the distinction difficult.  If you have any doubt, it is important to have it checked out by a physician, and have a biopsy if indicated. Skin should be examined for any suspicious areas by a physician on a yearly basis at a minimum if skin cancer has never been diagnosed.  Some people with atypical moles see their dermatologists yearly or more often and have pictures taken to watch for any progression of moles.

Self-Exams for Melanoma and the ABCD Mneumonic

When doing a self-examination, you need to look at all areas of your body. It helps to have a mirror to view difficult-to-see areas.  Look for any changes to color, shape, and size to any freckle, mole, blemish or reddened areas.

A quick review of the ABC's of melanoma include to watch for include:

  • A - Asymmetry
  • B - Border
  • C - Color
  • D - Diameter
  • E - Elevation

When doing your exam, keep in mind that melanoma can occur anywhere on the skin, including areas which are never exposed to the sun.  It may also occur under nailbeds or even in the eye (ocular melanoma.)  People with dark skin can get melanoma, and due to similarities in color between skin and the mole, these can be more difficult to diagnose.  And people without any risk factors, or who have had very little sun exposure can get melanoma.  On this note, even if you have been very careful about using sunscreen, you could still get melanoma - and in fact, researchers are uncertain whether sunscreen actually prevents melanoma (though it can clearly reduce the risk of other skin cancers.)

Preventing Melanoma

While it's impossible to prevent melanoma, you may be able to reduce your risk.  Since exposure to UV rays is a risk factor, avoid tanning beds and sunlamps, and practice caution in the sun.  Sunscreen is recommended, though we are uncertain whether the use of sunscreen decreases the risk of melanoma.  Being smart in the sun is the ideal way to lower risk, and includes avoiding the sun during midday (especially from 10 am to 2 pm) using protective clothing to cover your skin, and wearing a hat or using an umbrella and seeking shade to reduce exposure. 

It's important to state again: don't rely on sunscreen but practice other sun safety practices.

At the same time, a deficiency in vitamin D  from the sun may be a risk factor for melanoma.  Ask your doctor to check your vitamin D level, and ask for recommendations if your level is low.  It's been found that many people are deficient in this vitamin (which acts like a hormone) and a deficiency may raise the risk of other cancers as well.  Finally, eating a healthy diet and getting exercise is important, as it is for cancer prevention in general.


National Cancer Institute. Melanoma Treatment – for Health Professionals (PDQ). Updated 02/02/16. 

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