NICE melanoma guidance: what to know

Melanoma is a skin cancer that can begin in pigment-producing cells. A changing mole or new pigmented lesion may show change in size, shape, colour, border, or symptoms such as bleeding or persistent itching, but appearance alone cannot confirm the diagnosis. Examination by a trained clinician and laboratory assessment of removed tissue provide the diagnosis.

Staging considers features of the melanoma and whether it has reached nearby lymph nodes or other parts of the body. A sentinel lymph node biopsy may be discussed in selected situations. Brain metastases are a separate advanced disease context, not an assumption made from a changing mole.

Arrange assessment for a lesion that is changing, looks unlike your other moles, bleeds without a clear injury, or does not heal. Do not pick or repeatedly irritate it; take a clear photograph and note changes while waiting. If melanoma is diagnosed, the team may discuss surgical excision or other skin-cancer surgery, with treatment chosen according to the lesion and stage. Advanced disease may involve systemic treatments such as immunotherapy.

Seek prompt dermatology or primary-care review for a new or changing pigmented lesion, especially when it has an irregular border, several colours, rapid growth, bleeding, crusting, or persistent symptoms. Seek urgent help for uncontrolled bleeding, rapidly worsening swelling, severe pain, or new neurological symptoms such as weakness, confusion, or a seizure.

Ask what the examination shows, whether the lesion should be removed, what the pathology report means, whether staging tests or sentinel lymph node biopsy are relevant, and how follow-up will be organised after treatment.