Melanoma: Signs and Symptoms

What to Look for in a Self-Exam

Melanoma is a type of skin cancer that can spread to other areas of the body. It is the deadliest skin cancer. A new spot on the skin or a spot that is changing in size, shape, or color is an important warning sign.

Melanoma is more than 20 times more common in White people than in Black people. The risk of melanoma increases with age. The average age of people diagnosed is 65. But melanoma is not uncommon among people younger than 30.

This article discusses the signs and symptoms of melanoma and will help you identify abnormal moles using the ABCDE method.

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The ABCDE Rule of Melanoma

A Normal Mole

normal mole photo

Skin Cancer Foundation 

A normal mole is usually an evenly colored brown, tan, or black spot on the skin. It can be flat or raised and round or oval. Some moles are present at birth, but most appear during childhood or young adulthood.

Moles are usually harmless, but recognizing changes in a mole early is critical for increasing the chances of a cure.

Features that set normal moles apart from melanomas include:

  • Symmetry: If you drew a line through the middle, both sides would match in color, thickness, and shape.
  • A consistent border: The borders are smooth and distinct.
  • A consistent color: The color is also consistent throughout. The mole pictured above has red specks, but they're present throughout. (This feature can be hard to judge.)
  • Small size: Moles are generally under 6 millimeters (mm) in diameter (about ¼ inch across). A larger size isn't a guarantee of melanoma but it bears watching.

The more of these features your mole has, the less concerning it is.

Melanoma

Melanoma is a type of skin cancer that can spread to other areas of the body. The most important warning sign of melanoma is a new spot on the skin or a spot that is changing in size, shape, or color.

Another important sign is a spot that looks different from all the other spots on your skin—known as the Ugly Duckling sign.

The ABCDE rule is a guide to help you identify signs of melanoma. 

A = Asymmetry

melanoma photo

 Skin Cancer Foundation 

Unlike healthy moles, melanomas are not symmetrical. One half does not match the other half in:

  • Size
  • Shape
  • Color
  • Thickness

In this picture, the left side is much thicker and darker than the right.

B = Border

melanoma photo

 Skin Cancer Foundation 

While a normal mole has a smooth, consistent border, the border of a melanoma can be:

  • Ragged
  • Scalloped
  • Blurred
  • Poorly defined

The pictured melanoma has a scalloped and notched border.

C = Color

melanoma photo

 Skin Cancer Foundation 

The color of melanoma isn't consistent. It can have shades of:

  • Tan
  • Brown
  • Black
  • Red
  • White
  • Blue

In this picture, the right side is dark black and the left side is tannish-red.

D = Diameter

melanoma photo

Skin Cancer Foundation  

Melanomas grow. Normal moles don't. So melanomas tend to be larger, with a diameter of more than 6 mm.

For perspective, 6 mm is just under 1/4 inch. A pencil eraser is about 5 mm. If your mole can't be fully covered by a new eraser, it's large enough to be concerned about.

E = Elevation

This photo contains content that some people may find graphic or disturbing.

Amelanotic nodular melanoma
Amelanotic nodular melanoma.

https://dermnetnz.org/topics/amelanotic-melanoma-images/?stage=Live

Melanomas can start flat but become raised as they grow. Although some moles can also be raised, if you can feel it, you should have it checked out.

Sometimes in melanoma assessment, the "E" in the ABCDE guide stands for "evolving." That's because melanomas change in size, shape, and color over time.

Normal Mole
  • Symmetrical

  • Border is well-defined, regular

  • Same color throughout

  • Less than 6 mm in diameter

  • Usually level with the skin

Melanoma
  • A=Asymmetrical

  • B=Border is irregular

  • C=Color is inconsistent

  • D=Diameter greater than 6 mm

  • E=Elevated above the skin

Ugly Duckling

Most normal moles on your body resemble one another. So along with checking for irregularities in spots on your skin, you should also check for any spots that look different than neighboring moles.

These "ugly duckling" spots can be larger, smaller, lighter, or darker than surrounding moles. It might also be a spot all by itself (isolated) with no moles around it.

Other Warning Signs

Not all melanomas are detectable by ABCDE. Other warning signs are:

  • Sores that don't heal
  • Pigment "bleeding" from a border
  • Redness or swelling beyond the border
  • Itchiness or pain
  • Changes in the surface (scales, oozing, bleeding)

What You Can Do

There are several steps you can take to identify any skin changes early.

Self-check: Check your skin head-to-toe once a month to identify potential skin cancers early. Have a family member check areas you can't see, such as your scalp and back. Take note of existing moles or lesions that grow or change.

Don't wait: Trust your instincts. Visit your healthcare provider if you see a spot that just doesn’t seem right.

Annual skin exam: Monthly self-exams are important, but not enough. See a dermatologist at least once a year for a professional skin exam.

When to See a Healthcare Provider

Any skin abnormality—whether mole, pimple, wart, or something else—should be evaluated by a healthcare provider or dermatologist if it:

  • Has any ABCDE characteristics
  • Gets bigger
  • Starts to itch
  • Bleeds
  • Doesn't heal

The appearance of a new, unusual mole should also be checked out. Such changes can be signs of melanoma and other forms of skin cancer, including basal cell and squamous cell carcinomas.

Summary

Normal moles are symmetrical, small, and usually flat. They have a smooth border and consistent coloration.

Melanomas are often asymmetrical, larger than 6mm, and elevated. They have irregular borders and inconsistent coloring.

Melanomas change over time. Normal moles don't.

You should keep an eye on your moles. But don't trust your health to a self-exam. If anything about a mole seems off or changes, get it checked. An early melanoma diagnosis means early treatment which gives you a better outlook.

Meanwhile, you can lower your risk of skin cancer by wearing sunscreen and avoiding excessive sunlight and tanning beds.

Frequently Asked Questions

  • What is the difference between a mole and melanoma?

    A mole is a benign growth composed of melanocytes (skin cells that produce melanin, also called pigment). Once formed, most moles remain the same.

    Melanoma originates in melanocytes. The cells grow out of control and can invade surrounding tissue. They can arise from moles, but this doesn't happen often.

  • Does a melanoma feel hard to the touch?

    It can, yes. The texture of melanoma can be firm or hard. Some feel lumpy, crusty, or scaly.

  • What is an atypical mole?

    Atypical moles seem to be a cross between a normal mole and melanoma. They tend to be larger than regular moles and have an irregular shape or color.

    Dermatologists generally keep a close eye on atypical moles. However, they rarely become cancerous.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Cancer Society. Key statistics for melanoma skin cancer.

  2. National Institutes of Health, National Cancer Institute. Moles to melanoma: Recognizing the ABCDE features.

  3. American Cancer Society. Signs and symptoms of melanoma skin cancer.

  4. American Academy of Dermatology Association. Skin cancer types: melanoma signs and symptoms.

  5. Skin Cancer Foundation. Melanoma warning signs.

  6. American Academy of Dermatology. Moles: Overview.

  7. American Cancer Society. Can melanoma skin cancer be prevented?

  8. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Are moles determined by genetics?

  9. National Institutes of Health, National Cancer Institute. Common moles, dysplastic nevi, and risk of melanoma.

  10. American Cancer Society. Risk factors for melanoma skin cancer.

Additional Reading

By Heather L. Brannon, MD
Heather L. Brannon, MD, is a family practice physician in Mauldin, South Carolina. She has been in practice for over 20 years.