Melanoma after treatment in teenagers

Overview

Melanoma is a type of skin cancer. If you have had treatment for melanoma, this article explains what happens next: regular check-ups, protecting your skin, watching for warning signs, and keeping your health and wellbeing on track. It is not individual medical advice, but it can help you understand what to expect.

Melanoma is rare in teenagers, but it is the most common type of skin cancer in this age group. Because it is unusual, treatment and follow-up are often carried out by a specialist skin cancer team.

It can affect teenagers of all skin types. It is more common in people with fair skin, a history of sunburn, many moles, or a family member who has had melanoma. It is also more likely in people who have used tanning beds.

Symptoms

Common symptoms

• A new pigmented spot or mole that looks different from all the other spots on your skin
• A change in an existing mole's size, shape, colour, or symmetry
• A sore or bump that does not heal, or that bleeds easily
• An itchy, crusty, or tender mole
• A dark streak under a fingernail or toenail

Symptoms in children

• Melanoma in children and teenagers can look less typical: it may be pink or red rather than dark brown.
• A warning sign may be a spot that grows quickly, bleeds easily, or appears unlike any of the person's other spots.
• Moles with uneven edges, multiple colours, or that keep changing should be checked by a doctor.

Symptoms in older adults

• The same warning signs apply at any age, but older adults often develop melanoma on the back or legs.
• The spot can be flat, slow growing, and less colourful.
• Some melanomas in older skin have very little dark pigment, so any new, changing, or non-healing spot should be checked.

Causes

Main causes

• The main cause is damage to skin cells from ultraviolet (UV) light in sunlight or tanning beds.
• Some melanomas start in an existing mole, but many start as a new spot on normal-looking skin.
• In a small number of families, inherited gene changes increase the risk of melanoma.

Risk factors

• Fair or light skin that burns easily
• A history of sunburn, especially in childhood or as a teenager
• Having many moles, or unusual-looking moles
• Use of tanning beds or sunlamps
• A personal or family history of melanoma
• A weakened immune system

When to see a doctor

See a doctor urgently if:

• Contact your doctor or skin specialist as soon as possible if you notice a new or changing spot, a mole that bleeds or itches, or a sore that does not heal.
• Also contact them right away if you feel a new hard lump under your skin, especially near your armpit, neck, or groin.

Book a routine appointment if:

• Follow the follow-up schedule your specialist gives you, even if your skin feels fine.
• If you have a mole that worries you but is not changing quickly, mention it at your next appointment.

Diagnosis

For a possible new or returning melanoma, a doctor or specialist nurse examines the skin, often using a dermatoscope, which is a small magnifying tool with a light. If anything looks suspicious, they will take a biopsy to check the tissue under a microscope.

Tests that may be done

• Skin biopsy – removing all or part of the suspicious spot so it can be examined in the laboratory
• Sentinel lymph node biopsy – testing the first lymph node that drains the area if melanoma is found
• Imaging scans – such as ultrasound, CT, or MRI, if the doctor needs to check inside the body
• Blood tests – to help assess your overall health

What to expect at your appointment

The doctor will ask about your history and examine the skin. If you need a biopsy, the area is numbed first, so it should not hurt. It may feel like a small pinch. Results usually take one to two weeks. Your team will explain what the results mean and what happens next.

Treatment

After a teenager has completed melanoma treatment, the main focus is follow-up. This means regular skin checks, appointments, and sun protection. If melanoma returns, treatment depends on where it is, how deep it is, and whether it has spread. Your specialist team will create a plan that is right for you.

Self-care at home

• Attend every follow-up appointment and track any new or changing spots.
• Use a broad-spectrum sunscreen and reapply it when outdoors, even on cloudy days.
• Wear a wide-brimmed hat, sunglasses, and long sleeves or trousers when the sun is strong.
• Never use tanning beds or sunlamps.
• Take photos of any worrying spot with your phone and show your team.

Medical treatments

If melanoma returns and surgery cannot remove it completely, your team may talk about treatments that work across the body. These include immunotherapy, which helps your own immune system fight melanoma, targeted therapy, which attacks cells with certain gene changes, and sometimes radiotherapy. Chemotherapy is used less often now. Your specialist will explain each option, its likely benefits, and possible side effects.

When is surgery considered?

Surgery is usually the first treatment for melanoma that comes back in the skin. The surgeon removes the melanoma and a small border of healthy skin around it to make sure no cancer cells are left. This is often done with local anaesthetic, so you are awake but the area is numb.

Living with this condition

Life after treatment can feel like a mix of relief and worry. You may have regular hospital visits, and then longer gaps between them. A good routine includes checking your skin, using sun protection, keeping up with school or work, and doing things you enjoy. It is okay to talk about what you are feeling.

Lifestyle tips

• Get some gentle physical activity most days, if your care team agrees.
• Keep a simple monthly skin self-check routine.
• Reduce stress with activities you like, such as music, sport, art, or time with friends.
• Try to get enough sleep and keep a steady daily rhythm.

Diet and exercise

There is no special diet that treats melanoma. Eating a balanced diet with plenty of fruit and vegetables, whole grains, and protein can support healing and energy. Regular exercise can improve your mood, strength, and sleep. If you feel tired or unwell, check with your team before starting a new activity.

Mental health and emotional wellbeing

Having cancer as a teenager can bring up many feelings: anxiety, sadness, anger, or numbness. Fear that the cancer may return is common, especially around check-ups or skin scans. It can also change how you see your body. These feelings are normal, and you do not have to manage alone. Talk to your care team, a counsellor, or a trusted adult. If you are thinking of harming yourself or feel in crisis, contact your local emergency number or a crisis helpline right away.

Prevention

You cannot change the past, but you can lower the risk of another melanoma by protecting your skin from UV light, never using tanning beds, and being alert to new or changing spots. Follow-up care is the best form of prevention.

Vaccines

There is currently no vaccine to prevent melanoma.

Screening programmes

After treatment, your specialist team will screen your skin regularly. This is a planned check for new melanomas or signs of recurrence. Between appointments, you should continue to look at your own skin and report anything new.

Complications

If left untreated

• If a returning melanoma is not treated, it can grow deeper into the skin.
• It can spread to lymph nodes, lungs, liver, brain, or other organs.
• If it spreads, it becomes harder to treat, but treatment can still help.

Long-term outlook

The outlook for teenagers with melanoma is good, especially when it is found early. Most teenagers recover and go on to live active, full lives. Even if melanoma comes back, regular follow-up means it can be caught sooner. Treatments have improved a great deal in recent years, and there is real hope for the future.

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