Causes Of Melanoma Skin Cancer

Overview

Melanoma is a type of skin cancer that starts in the cells that give your skin its color (melanocytes). It can appear as a new dark spot or as a change to an existing mole. When found early, it is highly treatable.

Melanoma is less common than other types of skin cancer, but its numbers have been rising over the past few decades. In the UK, it is the fifth most common cancer overall.

Anyone can develop melanoma, but it is more common in people with fair skin, light hair or eyes, a history of sunburns, many moles, or a family history of melanoma. It is more common in older adults, but it can also occur in younger people and rarely in children.

Symptoms

Common symptoms

• A new mole that appears after age 30
• A change in the size, shape, or color of an existing mole
• A mole with an irregular or ragged border
• A mole that has multiple colors, such as brown, black, pink, red, white, or blue
• A mole larger than 6 mm (about the size of a pencil eraser)
• A mole that itches, oozes, bleeds, or feels tender
• A sore that does not heal

Symptoms in children

• Melanoma is extremely rare in children, but any new mole that grows quickly, looks unusual, or stands out from other moles should be checked by a doctor.

Symptoms in older adults

• In older adults, melanoma often appears on the head, neck, ears, or back — areas with long-term sun exposure.
• A spot that changes shape, color, or size, even in areas that were not sun-exposed, should be examined.

Causes

Main causes

• Exposure to ultraviolet (UV) radiation from the sun or tanning beds damages the DNA in skin cells, which can lead to melanoma.
• Severe sunburns, especially during childhood, can increase the risk of melanoma later in life.
• Certain gene changes (mutations) in melanocytes can cause these cells to grow out of control.
• A weakened immune system may make it easier for melanoma cells to develop and spread.

Risk factors

• Fair skin that burns easily, light hair, or light eyes
• Having many moles, especially large or unusual ones
• A family or personal history of melanoma
• Frequent intense sun exposure or a history of sunburns
• Using tanning beds or sunlamps
• Living in sunny or high-altitude areas
• Taking medicines that suppress the immune system, such as after an organ transplant

When to see a doctor

See a doctor urgently if:

• Make an appointment within a few days if a mole changes in size, shape, or color, feels itchy, or bleeds.
• See a doctor if you notice a new mole after age 30.
• Have any spot checked immediately if it looks very different from your other moles — often called an 'ugly duckling' spot.

Book a routine appointment if:

• Have a yearly skin check with your doctor or a dermatologist, especially if you have risk factors.
• Ask for a whole-body skin exam if you have a family history of melanoma or many moles.

Diagnosis

A doctor will look at the suspicious spot, often with a special magnifying instrument called a dermatoscope. If it looks concerning, they will refer you to a skin specialist for a biopsy.

Tests that may be done

• Dermoscopy: a hand-held device that magnifies and illuminates the skin spot to help the doctor see details not visible to the naked eye.
• Skin biopsy: a small sample of the spot is removed, usually with local anaesthetic, and sent to a laboratory for examination.
• If melanoma is confirmed, further tests such as imaging scans or a sentinel lymph node biopsy may be arranged to check whether cancer has spread.

What to expect at your appointment

The biopsy is a quick procedure done in the clinic. The area is numbed, so you may feel a small pinch but no sharp pain. The sample is sent to a lab, and results usually come back within one to two weeks. If melanoma is found, you will be referred to a specialist skin cancer team to talk about next steps.

Treatment

Treatment for melanoma depends on the stage of the cancer, its thickness, and your general health. Surgery is the main treatment for early melanoma and often cures it.

Self-care at home

• Follow your doctor's wound-care instructions after a biopsy or surgery, and keep the area clean and dry.
• Check your skin monthly for any new or changing spots.
• Protect your skin from the sun by wearing hats, protective clothing, and broad-spectrum sunscreen.
• Avoid tanning beds and sunlamps completely.

Medical treatments

For thicker or advanced melanoma, treatment may include immunotherapy (which helps your immune system fight the cancer), targeted therapy (which attacks specific changes in cancer cells), or radiation therapy in certain situations. Your specialist team will explain the most appropriate options for your case.

When is surgery considered?

Surgery to remove the melanoma along with a small margin of healthy skin is the standard treatment for early-stage melanoma. If there is a risk the cancer has spread, your surgeon may also remove nearby lymph nodes to check for cancer cells.

Living with this condition

After treatment, you will have regular follow-up appointments to check for new melanomas or recurrence. In between, you can check your own skin monthly and protect it from the sun every day.

Lifestyle tips

• Wear a wide-brimmed hat and sunglasses when outdoors.
• Seek shade during peak sun hours, usually from 10 am to 4 pm.
• Avoid tanning beds and sunlamps at all times.
• Cover your skin with protective clothing, especially during long outdoor activities.

Diet and exercise

There is no special diet proven to prevent melanoma, but eating a balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins supports your overall health and recovery. Staying active and maintaining a healthy weight can also help your wellbeing.

Mental health and emotional wellbeing

A melanoma diagnosis can bring worry, sadness, and anxiety about the future. These feelings are normal. It may help to talk to your healthcare team about seeing a counsellor or joining a support group. If you ever feel overwhelmed or in crisis, please reach out to a mental health helpline in your country.

Prevention

Most cases of melanoma can be prevented by protecting your skin from UV radiation. This means avoiding sun exposure during peak hours, wearing protective clothing, using sunscreen, and never using tanning beds.

Vaccines

There is currently no vaccine to prevent melanoma.

Screening programmes

Regular skin self-examinations and periodic full-body skin checks by a doctor can help detect melanoma early. If you are at high risk, your doctor may recommend more frequent screening.

Complications

If left untreated

• Melanoma can grow deeper into the skin and spread to nearby lymph nodes.
• It can spread to distant organs such as the lungs, liver, brain, or bones, making treatment harder.
• Advanced melanoma can be life-threatening.

Long-term outlook

The outlook for melanoma is excellent when it is caught early. Most early melanomas are cured with surgery alone. Even when melanoma is advanced, newer treatments have greatly improved survival rates. Your specialist will give you an honest and personal outlook based on your exact situation.

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