Birthmarks and melanoma

A birthmark present from infancy can naturally grow as the body grows. The concerning feature is an unexplained evolution in colour, border, thickness, surface, or symptoms, particularly when it differs from the person's other marks.

Melanoma is a cancer of pigment-producing cells. It can present as a new dark lesion or as visible change within an existing mole or pigmented birthmark. Colour variation, an irregular outline, increasing thickness, ulceration, or spontaneous bleeding can prompt further investigation.

Appearance alone cannot confirm melanoma. A clinician examines the entire lesion and surrounding skin, often with a dermatoscope. If cancer is suspected, removal or biopsy allows a pathologist to examine the tissue and measure features that guide further care.

Become familiar with the birthmark's usual shape, shades, and texture. A clear photograph beside a ruler can help document evolution, but it does not replace an examination. Protect the area from ultraviolet exposure with clothing, shade, and broad-spectrum sunscreen.

Do not cut, burn, bleach, or treat a changing birthmark at home. Cosmetic laser treatment can alter visible pigment without providing tissue for diagnosis. A suspicious lesion needs assessment before any cosmetic procedure is considered.

Arrange a prompt dermatology visit for rapid enlargement, a new lump within the mark, spreading pigment beyond its edge, a sore that does not heal, repeated bleeding without injury, persistent pain or itch, or a marked change from previous photographs.

If melanoma is diagnosed, the next step depends on the pathology findings. Surgical excision is commonly used to remove affected skin with an appropriate margin. Selected cases may need lymph-node assessment, further imaging, immunotherapy, or structured follow-up rather than the same pathway for every patient.

Ask whether the birthmark needs dermoscopic photographs, biopsy, or complete removal; which specific feature prompted concern; how the scar will be managed; when pathology results will be discussed; and what skin or lymph-node checks may follow.