What are the first signs of melanoma?

Melanoma may begin in an existing mole or as a new pigmented mark. Watch for asymmetry, a border that becomes uneven, several shades within one lesion, growth, or a change in elevation. It can also appear as a dark streak under a nail or a mark on skin that receives little sun. Itch, tenderness, crusting, or bleeding can occur, but melanoma may have no sensation at all. Many changing moles are not melanoma; the significance lies in a new or evolving pattern that needs examination. An atypical mole is not the same as melanoma, but it may warrant closer monitoring.

Arrange a prompt skin examination rather than removing or picking at the lesion yourself. Note when you first saw the change, take a clear comparison photograph if safe to do so, and mention personal or family skin-cancer history. A clinician may inspect the mark with magnification and decide whether sampling or removal is needed. Do not wait for pain; early melanoma can be silent. If melanoma is diagnosed, treatment depends on its features and extent and may include surgery, immunotherapy, or targeted therapy.

Seek prompt medical review for a changing mole, a new unusual mark, repeated bleeding, persistent crusting, or a sore that does not heal. Request faster assessment if the lesion changes noticeably over a short period, becomes very dark or multicoloured, or sits under a nail. Emergency care is appropriate for heavy bleeding that will not stop with firm pressure.

Ask whether the mark needs dermoscopic examination, how it should be monitored, whether a biopsy is appropriate, and what follow-up schedule fits your findings.