What should you know about familial melanoma?

A family pattern may be suspected when several close relatives have had melanoma, when melanoma occurs at a younger age than expected, or when one person develops more than one primary melanoma. A family history does not determine that every relative will develop the condition. A dermatologist can review the pattern, examine changing moles, and decide whether referral for genetic counselling is appropriate.

Warning signs include a new or changing mole, uneven colour, an irregular outline, growth, bleeding, or a sore that does not settle. Melanoma can occur on skin that receives little sun, so checks should include the scalp, between the toes, nails, and other less visible areas.

Write down which relatives were affected, the type of skin cancer if known, and the age at diagnosis. Arrange a baseline skin examination and ask how often follow-up is suitable. Check your skin in a consistent way and use photographs to compare changes, while protecting exposed skin from ultraviolet light. Do not remove or biopsy a suspicious mole at home.

If melanoma is diagnosed, care may include surgical excision and, depending on the findings, sentinel lymph node biopsy or other skin cancer surgery. Treatment decisions depend on the tumour and the individual rather than family history alone.

Book a prompt dermatology appointment for a mole that changes in size, shape, colour, or sensation, or for a new pigmented mark that looks different from your other moles. Seek urgent medical care for rapidly worsening bleeding, severe pain, spreading redness, or symptoms such as new weakness, confusion, or persistent severe headache. These symptoms need assessment and should not be explained away by family history.

Ask whether your family pattern suggests genetic counselling, which relatives should be told, what skin-check schedule fits your risk, and whether dermoscopy or photographs would help monitor moles. If melanoma is found, ask how its stage affects surgery, follow-up after cancer treatment, and whether immunotherapy is relevant.