What should you know about congenital melanoma?

A congenital mole is not the same thing as melanoma. Most changes in a birthmark are not enough to establish a diagnosis, and melanoma can be difficult to judge from appearance alone. Warning changes include a new or enlarging area, uneven colour, altered border, bleeding, crusting, ulceration, or a firm nodule within the lesion.

A dermatologist may examine the skin with magnification, photograph the lesion, and recommend a biopsy or excisional surgery. A pathologist examines the tissue. If melanoma is confirmed, staging may include assessment of nearby lymph nodes and scans selected for the individual situation.

Arrange specialist care promptly if a congenital mole is changing or has developed a new lump, sore, or bleeding area. Bring earlier photographs and information about when the change began. Do not pick at a crust or repeatedly injure the lesion, and protect it from avoidable friction and sun exposure.

Treatment depends on the pathology and stage. It may involve skin cancer surgery or tumour removal surgery, with further treatment such as immunotherapy considered for some diagnoses. Follow-up after cancer treatment helps clinicians check the treated area, nearby nodes, and any new skin changes.

Seek prompt medical review for rapid growth, a new firm section, persistent bleeding, ulceration, marked colour change, or a sore that does not heal. Urgent assessment is needed for severe headache, weakness, confusion, seizures, or new vision problems in someone with a known melanoma, because these symptoms can have serious causes and should not be watched at home.

Ask whether the lesion needs biopsy or complete removal, what the pathology shows, whether nearby lymph nodes need assessment, which specialist will coordinate care, what treatment options fit the stage, and how follow-up will be organised.