Melanoma

If you notice any of these changes, consider booking a full body skin check.

How is melanoma diagnosed?

A possible melanoma is assessed through careful clinical examination, usually using a dermoscope. Certain colours, patterns, or structural features may raise suspicion.

If melanoma is suspected, the lesion is surgically removed (an excision biopsy) so that a skin pathologist can examine the tissue.

The diagnosis of melanoma is confirmed by microscopic examination of the tissue by a pathologist.

Sequential digital dermoscopy may also be used to monitor suspicious lesions and detect subtle changes over time.

Melanoma levels and stages

Melanoma stage describes how deeply the melanoma has grown and whether it has spread beyond the skin.

Early-stage melanomas are confined to the skin. More advanced stages involve spread to lymph nodes or distant organs.

Melanoma types

Melanomas are also categorised according to their appearance and growth pattern.

Superficial spreading melanoma

Usually appears as a dark flat patch with irregular borders. It tends to grow outwards, which enables early detection by the patient.

This is the most common form of melanoma, accounting for approximately 50% of cases.

Nodular melanoma

Nodular melanoma often appears as a firm, raised lump and tends to grow more rapidly than other types. It accounts for approximately 15% of melanomas.

Lentigo maligna melanoma

Lentigo maligna melanoma is a slow-growing type that typically occurs on chronically sun-exposed skin, particularly the face and scalp of older individuals. It accounts for around 10% of cases.

Treatment of melanoma

All melanomas require surgical removal with an appropriate margin of normal skin to ensure complete clearance.

The width of the margin depends on tumour thickness.

In most cases, the initial excision biopsy is followed by a wider excision once the diagnosis is confirmed.

We generally refer invasive melanoma (deeper than in situ) to a specialist melanoma unit for further assessment and follow-up. Depending on the findings, this may include lymph-node biopsy or imaging. Plastic-surgery referral may also be appropriate for a cosmetically or functionally sensitive site.

Further assessment

After diagnosis, additional assessment may be required to determine whether the melanoma has spread.

This may include:

• Examination of nearby lymph nodes
• A full skin examination
• Additional investigations in selected cases

Risk of spread depends on:

• Tumour thickness
• Ulceration
• Melanoma subtype
• Lymphatic or vascular involvement
• Patient factors

If the estimated risk of lymph node involvement is significant, a sentinel lymph node biopsy may be recommended.

This procedure is performed in a specialist melanoma unit.

Follow-up after melanoma

Regular follow-up is important to:

• Detect recurrence early
• Identify new primary melanomas
• Monitor lymph nodes where appropriate

For early-stage melanoma, follow-up commonly involves:

• Full-body skin examinations every 3–6 months initially
• Transition to annual review over time
• Higher-risk melanoma may require closer monitoring and specialist involvement.

Follow-up intervals are usually shorter during the first 2–5 years, when recurrence risk is highest.

Learn more about our full-body skin checks.

Risk of future melanoma

People who have had melanoma have an increased lifetime risk of developing a new primary melanoma.

This increased risk persists for life.

Some individuals are at particularly high risk, including:

• People with multiple prior melanomas

• People with a strong family history

In selected high-risk patients, mole mapping (total body photography) may be recommended.

Self-examination

Skin self-examination is an important part of ongoing care.

People with a history of melanoma should examine their skin every 1–2 months and report new or changing lesions.

Family screening

First-degree relatives (parents, siblings and children) of someone with melanoma have an increased risk and should consider regular skin checks. Learn more at the Melanoma Institute Australia website.

Does removing moles prevent melanoma?

Removing normal moles does not prevent melanoma.

Most melanomas arise as new lesions rather than from existing moles.

Sun protection reduces future melanoma risk. Skin checks and mole mapping help detect melanoma early; they do not prevent every melanoma. Ongoing care includes:

• Limiting ultraviolet exposure
• Regular full-body skin checks
• Mole mapping in selected high-risk patients

Related conditions

Some skin lesions can resemble melanoma or may be associated with increased melanoma risk.

• Melanoma in situ
• Dysplastic moles

References

Victorian Cancer Registry 2023. Melanoma statistics and trends.

Australian Institute of Health and Welfare 2023. Risk of melanoma of the skin by age and over time, in Cancer data in Australia.

Cancer Australia 2024. Melanoma of the skin.

Cancer Australia 2019. Relative survival by stage at diagnosis (melanoma), in National cancer control indicators.

Sladden M, Nieweg O, Howle J et al. Updated evidence-based clinical practice guidelines for the diagnosis and management of melanoma: definitive excision margins for primary cutaneous melanoma. Medical Journal of Australia volume208 issue3, February 2018, pages 137-142, 2018.

Melanoma Institute Australia 2024. Sentinel node metastasis risk.

Barbour A, Guminski A, Liu W et al. Follow up after initial definitive treatment for each stage of melanoma. Clinical practice guidelines for the diagnosis and management of melanoma, 2018.