Accessibility Tools

Web Accessibility plugin by DJ-Extensions.com

Number 1 Skin Cancer & Pre-Cancer Care

B. Skin Cancer Types

Number 1 Skin Cancer & Pre-Cancer Care

A. Skin Cancer Diagnosis

B. Skin Cancer Types

C. Skin Cancer Treatment

D. Pre-Cancerous Lesions

Number 1 Medical Dermatology
(Chronic & Inflammatory Skin Diseases)
Number 3 Pigment & Lesion Disorders
Number 4 Non-Cancer Growth
Number 5 Surgical Dermatology (Non-Cancer Procedures)
Number 6 Cosmetic Dermatology
Melanoma PDF

• Melanoma

1. What is melanoma?

Melanoma is a type of skin cancer that starts in pigment-producing cells (melanocytes). It is less common than basal cell carcinoma (BCC) or squamous cell carcinoma (SCC), but it can be more serious because it has a higher chance of spreading if not treated early.

The good news: early detection and treatment are highly effective, which is why skin checks and prompt evaluation of changing moles are so important.

2. What does melanoma look like?

Melanoma can look like a changing mole or a new “different” spot. Dermatologists often teach the ABCDE rule:

A – Asymmetry: one half doesn’t match the other

B – Border: irregular, notched, or blurred edges

C – Color: multiple colors or uneven color (tan, brown, black, red, white, blue)

D – Diameter: often larger than 6 mm (but can be smaller)

E – Evolving: changing in size, shape, color, or symptoms (itching, bleeding)

Another helpful concept is the “ugly duckling” sign: a spot that looks noticeably different from your other moles.

3. Who is at higher risk?

Melanoma can occur in any skin type. Risk is higher if you:

  • Have a personal or family history of melanoma

  • Have many moles or atypical/dysplastic nevi

  • Have a history of intense sun exposure or blistering sunburns

  • Use (or used) tanning beds

  • Have a weakened immune system

  • Have breast cancer (personal or family history of breast cancer)
  • other familial cancer syndromes 

4. How is melanoma diagnosed?

Diagnosis typically includes:

  • Skin exam (often with dermoscopy to see patterns not visible to the naked eye)

  • Skin biopsy to confirm the diagnosis under the microscope

If melanoma is confirmed, your dermatologist will discuss next steps, which may include additional procedures or referrals depending on depth and risk features.

5. Treatment overview

Treatment depends on the melanoma’s depth and whether it has spread. Many melanomas are treated with:

  • Wide local excision (surgery to remove the melanoma with a safety margin of normal skin)

  • In some cases, Sentinel Lymph Node Biopsy(SLNB) may be recommended to check if melanoma has spread to nearby lymph nodes (based on risk factors and pathology)

 

👉 Important to Know About Where SLNB Is Done

  • SLNB is NOT performed in our dermatology office
  • It is done by an oncologic general surgeon
  • The procedure is performed in an operating room (OR) setting

  • It involves lymphatic mapping using specialized imaging (often nuclear medicine guidance)

We coordinate your care and refer you to the appropriate surgical team when SLNB is recommended.

If melanoma is more advanced, additional treatments may include systemic therapies (such as immunotherapy or targeted therapy) coordinated with oncology.

6. Pre-Op Instructions
(Before Melanoma Surgery)

These instructions are general and may be adjusted for your specific plan (excision, excision + sentinel node biopsy, etc.).

6. a) 1–7 days before

  • Tell us if you take blood thinners (including aspirin, warfarin, clopidogrel, apixaban, rivaroxaban) or have a bleeding disorder.
    Do not stop prescribed blood thinners unless your prescribing clinician instructs you.

6.a) continued: 

  • Tell us about:

    • Medication/adhesive/antiseptic allergies

    • History of keloids or poor wound healing

    • Prior reactions to local anesthetics

  • Arrange time off if your procedure site will limit activity.

6. b) Day of procedure

  • Follow your specific instructions about eating/drinking (especially if sedation or lymph node mapping is planned).

  • Wear comfortable clothing that allows access to the site.

  • Avoid lotions, oils, or makeup over the surgical area.

7. Post-Op Instructions (After Melanoma Excision)

Your team will provide specific wound care directions. Typical guidance includes:

7.a) Wound care

  • Keep the bandage on and dry for the first 24 hours (unless instructed otherwise).

  • Then daily:

    1. Gently wash with mild soap and water

    2. Pat dry

    3. Apply a thin layer of ointment if instructed

    4. Cover with a clean bandage

  • Avoid soaking (pools, hot tubs, baths) until cleared—especially if you have stitches.

7. b) Activity

  • Limit heavy lifting and strenuous exercise as advised (often several days to 2 weeks depending on location and closure).

  • If the surgery is on the back, shoulders, arms, legs, or near joints, you may need extra activity restrictions to prevent pulling on stitches.

7. c) Bleeding

If bleeding occurs:

  • Apply firm pressure for 15 minutes without checking

  • Repeat once if needed

  • If bleeding continues after 30 minutes of pressure, contact the office
7. d) Call the office urgently if you notice

  • Increasing redness, warmth, swelling, pus, fever

  • Worsening pain after the first day

  • Bleeding that won’t stop with pressure

  • Red streaking from the wound

Request An Appointment

Frequently Asked Questions

Is melanoma curable?

Many melanomas are highly treatable when found early. Treatment success depends on factors such as depth and whether it has spread.

Melanoma is confirmed by a skin biopsy, reviewed under the microscope.

No. Some melanomas can be lighter brown, pink, red, or even skin-colored. Any changing or different-looking lesion should be evaluated.

It’s a guide to warning signs in moles: Asymmetry, Border, Color, Diameter, Evolving.

Not everyone. A sentinel lymph node biopsy is considered in certain cases based on the biopsy report and risk factors. Your dermatologist will explain if it applies to you.

Any excision can leave a scar. Careful closure and good wound care help healing, and sun protection helps scars fade more evenly.

It can. That’s why follow-up skin exams and monitoring are important after treatment.

Contact us if you notice:

  • A new or changing mole

  • A spot that bleeds, crusts, or doesn’t heal

  • A lesion that looks different from your other moles (“ugly duckling”)

SLNB requires specialized imaging, surgical equipment, and an operating room setting. It is performed by an oncologic general surgeon with nuclear medicine support.

No. SLNB is a staging tool. Many patients have negative sentinel nodes, meaning no spread is found.

A negative result is reassuring. Treatment often continues with regular skin exams and follow-up based on melanoma stage.

A positive result means melanoma cells were found in the node. Your care team will discuss:

  • Additional staging

  • Possible oncology referral

  • Tailored surveillance or treatment options

SLNB is a diagnostic and staging procedure, not a treatment that removes all melanoma from the body.

Yes, a small scar is expected. Surgeons aim to minimize scarring while ensuring accurate staging.