Pediatric melanoma: what parents should know

Melanoma is a cancer of pigment-producing cells. In a child, it may appear as a changing mole or a new dark, uneven, bleeding, crusted, or persistently itchy spot; some lesions are skin-coloured or red rather than dark. Change in size, shape, colour, or surface deserves attention, but an unusual mole is not proof of melanoma. A clinician examines the whole skin and nearby lymph nodes, then decides whether a biopsy is needed. Read more about [Melanoma](/conditions/melanoma/).

Make a timely appointment with a dermatologist and bring photographs showing when the lesion changed, if available. Do not pick, burn, or attempt to remove it at home. If melanoma is confirmed, [Surgical Excision](/treatments/surgical-dermatology/excisional-surgery/) is commonly discussed to remove the lesion with a margin of surrounding skin. Further surgery, a [Sentinel Lymph Node Biopsy](/treatments/diagnostics-and-staging/sentinel-lymph-node-biopsy/), imaging, or specialist treatments depend on examination and pathology findings. Advanced disease may lead to a discussion of [Immunotherapy](/treatments/systemic-therapy/immunotherapy/). The team should explain the plan in language appropriate for the child and include emotional support.

Arrange prompt review for a spot that changes noticeably, bleeds without clear injury, forms a persistent crust, becomes painful, or differs strongly from the child’s other moles. Seek urgent care for uncontrolled bleeding, rapidly increasing swelling, severe pain, or a child who is acutely unwell. New neurological symptoms in a child already diagnosed with melanoma, such as a seizure, weakness, confusion, or persistent severe headache, require emergency assessment.

Ask what features make the lesion concerning, whether removal will provide the diagnosis, and how the wound will be cared for. If melanoma is confirmed, ask what the pathology shows, whether staging tests are needed, which specialist will coordinate care, and how follow-up will be scheduled.