Malignant Melanoma.

Everything you need to know.

Malignant Melanoma is a skin cancer that accounts for approximately 3% of skin cancer in the UK. It is a malignant tumour arising from the melanocytes – the cells that produce brown pigment and moles.

When melanocytes become malignant they form melanoma, but a pre-cancerous variant called lentigo maligna exists. In the early stages, melanoma can be slow-growing, in later stages it has the potential to spread (or metastasise) to other areas of the body.

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What causes Malignant Melanoma?

Many risk factors have been found but it is not always clear exactly how they may cause cancer. It’s not known why some moles become cancerous, while most don’t. The earlier your melanoma is diagnosed and treated, the less the cosmetic disfigurement and the less chance of recurrence or spread.


What are the symptoms/types of Melanoma?

There are several different types of skin cancer to be aware of:

Malignant melanoma

The appearance of a new mole, or any changes to an existing mole anywhere on the body, could be an indication of a melanoma. Pay particular attention to irregular sized or shaped moles, and those that itch or bleed. Melanoma is less common than other types of skin cancer, accounting for around 5% of all cases, but can spread quickly to other parts of the body, so if in doubt get it checked out by your doctor as soon as possible.


There are two more common types of non-melanoma skin cancer, both of which usually develop in the epidermis, which is the outermost layer of the skin:

  • Basal cell carcinomaThis starts in the basal layer of cells that line the epidermis, and accounts for around 75% of all skin cancer cases.
  • Squamous cell carcinoma:This starts in the cells which line the top layer of the epidermis, and accounts for around 20% of all skin cancer cases.

One of the first symptoms that could indicate the presence of non-melanoma cancerous cells is the appearance of a lump or patch on the skin which doesn’t heal within a few weeks. Cancerous lumps are typically red and firm, whilst patches are usually flat and scaly.

Any skin abnormality that has not healed after four weeks should be checked out by a specialist.

Malignant melanoma

What Melanoma treatments are available?

Most dermatologists use photodynamic therapy (PDT) to remove certain types of superficial precancerous lesions which affect the skin, including basal cell carcinomas, Bowen’s disease, and actinic keratoses. This modern treatment is safe and highly effective in removing precancerous lumps and patches, without causing any damage to the surrounding healthy cells. PDT manipulates the chemical interaction between light and a light-activated drug, leading to a series of chemical reactions that kill off any diseased cells, leaving healthy cells intact, and reducing the potential for scarring.

Melanomas can be treated by excision (removal). The tumour is then assessed under the microscope and the next step will depend on the results of the biopsy.

Melanoma treatments we offer include:

Please click on each treatment to find out more

  • Photodynamic therapy (PDT)

  • Surgical excision

Frequently asked questions

What does it look like?

Melanomas tend to resemble a mole that is undergoing changes in size, shape or colour. They may become lumpy or ‘nodular’ and even ulcerate with bleeding. Sometimes they occur in a pre-existing mole, but around half the time they arise in an area or normal skin.

Things to look out for

  • A: Asymmetry – the mole looks unusual, asymmetrical or irregular
  • B: Border – the border becomes blurred, ill-defined or irregular
  • C: Colour – more than 2 colours appear in the mole including brown, black or light areas giving a mottled appearance. A very dark or black appearance can occur
  • D: Diameter – if a mole is getting bigger it should be reviewed.
  • E: Evolving – if a mole changes it should be reviewed

Sign up to our free mole check reminder service by clicking here. Each month you will be sent a reminder email describing how to check your moles.

How might it affect me?

Pre-melanoma (lentigo maligna) and the earliest phase of melanoma (in-situ melanoma) are almost always cured with surgery. For melanoma beyond these early stages, it is the depth into the skin that the melanoma reaches that tells us how the disease might behave. This depth is termed the ’Breslow thickness’. The Breslow thickness will determine whether you require a simple excision or furthermore complex surgery including lymph gland biopsy.

The degree of spread a melanoma has undergone will be classified by stages:

  • Stage I: Localised to the original site only
  • Stage II: Localised to the skin only – the original site plus local skin spread
  • Stage III: Spread to the nearby lymph glands
  • Stage IV: Spread to the internal organs of the body

For more information on malignant melanoma, please see the British Association of Dermatologists website melanoma advice leaflets for stage 1stage 2stage 3, and stage 4 melanoma.

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