Melanoma Symptoms: What to Look For on Your Skin
Written by North Editorial Staff | Clinically reviewed by Laura Morrissey, RN, BSN | Last reviewed: March 2026
Key Takeaways
Melanoma can appear anywhere on the body, not just sun-exposed skin, including the scalp, under nails, between the toes, and inside the eye.
The ABCDE rule: Asymmetry, Border, Color, Diameter, Evolving, is the most widely used framework for recognizing suspicious spots.
Melanoma can look very different depending on your skin tone and the subtype involved; some forms are pink or skin-colored rather than dark.
Early detection dramatically improves outcomes, the 5-year survival rate for localized melanoma is approximately 99%.
If a spot changes, bleeds, itches persistently, or simply looks different from your other moles, see a dermatologist promptly.
What Are the Early Signs of Melanoma?
The earliest signs of melanoma are usually changes to an existing mole or the appearance of a new, unusual spot on the skin. Look for a lesion that is asymmetrical, has an irregular or ragged border, contains more than one color, is larger than a pencil eraser, or is changing over time. These features are captured in the ABCDE rule, the standard framework dermatologists use to assess suspicious lesions. Any spot that looks different from your other moles, the “ugly duckling” sign, also warrants attention.
The ABCDE Rule: How to Identify a Suspicious Spot
The ABCDE rule gives you a practical checklist for evaluating spots on your skin. No single feature confirms melanoma, but the more boxes a lesion checks, the more urgently it needs professional evaluation.
Asymmetry
Draw an imaginary line through the center of the spot. In a benign mole, both halves should look roughly the same. In a melanoma, the two halves typically do not match, one side may be larger, more irregular, or differently shaped than the other. Asymmetry alone is not definitive, but it is a meaningful warning sign.
Border
Benign moles tend to have smooth, well-defined edges. Melanoma borders are often irregular, notched, scalloped, or poorly defined, the edge may appear to bleed or fade into the surrounding skin rather than ending cleanly. Borders that appear to be spreading outward unevenly are particularly concerning.
Color
A healthy mole is typically a uniform shade of brown or tan. Melanoma often contains multiple colors within a single lesion, shades of brown, black, red, white, or blue can appear together. Areas of white or light color within a previously darker spot can indicate regression, a process where the immune system attacks the lesion and creates pale patches. Multiple colors within one spot are a strong signal to have the lesion evaluated.
Diameter
Melanomas are often larger than 6 millimeters in diameter, roughly the size of a pencil eraser, when first noticed. However, this is a guideline rather than a rule. Early melanomas can be smaller than 6 mm, and some benign lesions are larger. If a spot is small but has other concerning features, those features take priority. Do not wait for a spot to grow before seeking evaluation.
Evolving
This may be the most important feature. Any mole or skin lesion that is changing, in size, shape, color, texture, or sensation, deserves prompt attention. Changes that develop over weeks or months are more alarming than long-stable spots. New symptoms like itching, bleeding, crusting, or soreness in a previously unremarkable lesion should be evaluated right away.
Where Melanoma Can Appear
Many people picture melanoma as a dark spot on the back or shoulders, areas with significant sun exposure. While that is a common location, melanoma can develop anywhere on the body, including places that rarely or never see sunlight.
Scalp and hairline. Melanoma on the scalp is often missed during self-exam because hair conceals the skin. Use a comb or hair dryer on a low setting to part the hair and examine the scalp systematically, or ask a partner or hairdresser to help.
Under the nails (subungual). Melanoma can develop in the nail bed and initially appears as a dark streak running the length of the nail. This is particularly easy to mistake for a bruise or a fungal infection. A streak that does not grow out with the nail, or that is widening, should be evaluated.
Between the toes and on the soles. The soles of the feet and the spaces between toes are common sites for acral lentiginous melanoma, particularly in people with darker skin tones. These areas are rarely checked and often go unexamined for years.
Palms of the hands. Like the soles, the palms can harbor acral lentiginous melanoma. Any new or changing dark spot on the palm warrants attention.
Eyes. Ocular melanoma develops in the cells of the uvea (the pigmented layer inside the eye) or, less commonly, on the surface of the eye. It often causes no visible change to the outside of the eye and may only be detected during a routine dilated eye exam. Symptoms, when they occur, can include blurred vision, floaters, or a change in the appearance of the iris.
Genitals and mucosal surfaces. Melanoma can develop on the mucous membranes of the mouth, nose, throat, vagina, anus, and urethra. Mucosal melanoma is rare but tends to be diagnosed at a later stage because these areas are not routinely examined.
Because melanoma can occur anywhere, a full-body skin exam, including these less obvious areas, is an important part of your self-monitoring routine.
Melanoma in Different Skin Tones
A harmful misconception persists: that melanoma only affects people with fair skin. While it is true that people with lighter skin, lighter eyes, and a history of sun exposure face a higher statistical risk, melanoma can and does occur in people of all skin tones.
In people with darker skin, melanoma most often presents as acral lentiginous melanoma: a subtype that arises on the palms, soles, and under the nails, areas where UV exposure is not the primary driver. This subtype is diagnosed more frequently in Black, Asian, and Hispanic populations than in white populations. Tragically, people with darker skin tones are often diagnosed at a later stage, which is associated with worse outcomes. This disparity is partly due to the misconception that darker skin confers complete protection, and partly because acral sites are not always included in standard skin self-exam guidance.
If you have darker skin, the ABCDE rule still applies, but pay particular attention to your palms, soles, fingernails, and toenails. Any new dark streak under a nail, especially if it is widening or does not grow out, should be evaluated promptly by a dermatologist. Dark patches on the soles or palms that are irregular in shape or color also warrant attention.
For people with very dark skin, melanoma on the body surface may be more difficult to see because the color contrast is less pronounced. Any lesion that is changing, irregularly shaped, or simply “looks wrong” compared to other spots on your skin is worth having examined, regardless of how dark or light it appears.
Symptoms of Advanced Melanoma
When melanoma is caught early and confined to the skin, it rarely causes symptoms beyond the visible lesion itself. As it progresses and spreads to nearby lymph nodes or distant organs, additional signs may appear.
Enlarged lymph nodes. Swollen, firm, or tender lymph nodes, particularly in the groin, armpit, or neck near a primary melanoma, may indicate that the cancer has spread regionally. A sentinel lymph node biopsy is one way doctors assess this spread.
Fatigue. Unexplained, persistent tiredness that does not improve with rest can be a sign of systemic disease.
Unintended weight loss. Losing weight without trying, especially in combination with other symptoms, should always be evaluated by a physician.
New skin nodules. Hard bumps under the skin near the original melanoma, or in areas distant from it, can represent in-transit metastases or satellite lesions, cancer that has spread through the lymphatic vessels.
Neurological symptoms. If melanoma spreads to the brain, symptoms may include headaches, seizures, vision changes, or personality changes.
Respiratory symptoms. Cough, shortness of breath, or chest pain can occur if melanoma has spread to the lungs.
It is important to note that these symptoms are not specific to melanoma, many other conditions can cause them. However, if you have a history of melanoma and develop any of these signs, contact your oncologist promptly.
Melanoma vs. Normal Moles: Key Differences
Most moles are completely benign and never become melanoma. Understanding what a typical mole looks like helps you recognize when something looks out of place.
A normal mole is:
Round or oval with a smooth, well-defined border
Uniformly one shade of tan or brown
Smaller than 6 mm in most cases
Stable in size, shape, and color over time
Flat or only slightly raised
Consistent in appearance with your other moles
A suspicious lesion may be:
Asymmetrical (one half does not match the other)
Irregular, notched, or poorly defined at the border
Multiple colors within a single lesion
Larger than 6 mm or actively growing
Changing in any way over weeks or months
Itching, bleeding, crusting, or painful without trauma
Distinctly different from all your other moles, the “ugly duckling”
Dermoscopy: a technique in which a dermatologist uses a handheld magnifying instrument with a light source, allows close examination of skin structures not visible to the naked eye. Studies consistently show that dermoscopy significantly improves the accuracy of melanoma detection compared to the naked eye alone.
If you undergo biopsy: the only definitive way to diagnose melanoma, a small sample of the suspicious lesion is removed and examined under a microscope by a pathologist. A biopsy is a straightforward outpatient procedure and the only way to know for certain whether a lesion is melanoma.
When to See a Doctor
See a dermatologist if you notice any of the following:
A mole or spot that meets one or more of the ABCDE criteria
Any lesion that is new, changing, or simply looks different from your other spots
A dark streak under a fingernail or toenail that was not caused by injury, or that is widening
A spot that bleeds, crusts, itches persistently, or is painful without having been injured
A new growth anywhere on the body that is growing or does not heal
You do not need to be certain that something is wrong to make an appointment. A dermatologist can examine the lesion with dermoscopy, advise you on monitoring, or recommend biopsy if needed. Getting checked is always the right call. Early melanoma is highly treatable; advanced melanoma is significantly harder to manage.
If you have been diagnosed with melanoma and want to explore your full range of treatment options, including melanoma diagnosis and types of melanoma as context for next steps, or melanoma screening to understand ongoing monitoring, connecting with a specialist is the first priority.
Frequently Asked Questions
What does early melanoma look like?
Early melanoma most commonly looks like a flat or slightly raised spot that is asymmetrical, has an irregular or notched border, and contains more than one color, shades of brown, black, tan, red, or white within the same lesion. It is often under 6 mm but not always. The single most important feature is change: any spot that is evolving in size, shape, color, or sensation deserves evaluation.
Can melanoma be itchy?
Yes. Itching is one of the symptoms that can occur in a melanoma lesion. While most moles do not itch, persistent itching in a spot, particularly one that also has other concerning features, is a reason to have it evaluated promptly. Other sensations, including tenderness, burning, or soreness, can also occur.
How quickly does melanoma grow?
Growth rate varies significantly by melanoma subtype. Superficial spreading melanoma, the most common type, often grows slowly in its early radial (horizontal) phase over months to years before becoming more aggressive. Nodular melanoma, by contrast, grows quickly in a vertical direction and can become dangerous within weeks to months. This is one reason why any changing lesion, not just obviously rapid growth, warrants prompt evaluation.
Can melanoma appear on skin that isn’t exposed to the sun?
Yes. While UV radiation is the primary cause of most melanomas, melanoma can develop in areas that have had little or no sun exposure, including the soles of the feet, palms, under the nails, genitals, eyes, and mucous membranes. Acral lentiginous melanoma and mucosal melanoma, in particular, are not strongly linked to UV exposure. This is one reason that a full-body skin exam, not just sun-exposed areas, is important for everyone.
What is the ABCDE rule for melanoma?
The ABCDE rule is a five-feature framework used to assess whether a skin lesion has characteristics commonly associated with melanoma. A stands for Asymmetry (one half does not match the other), B for Border (irregular, ragged, or poorly defined edges), C for Color (multiple colors within one lesion), D for Diameter (larger than 6 mm, roughly the size of a pencil eraser), and E for Evolving (any change in the spot over time). No single feature confirms melanoma, but the more criteria a spot meets, the more urgently it should be evaluated by a dermatologist.
References
National Cancer Institute. Melanoma Treatment (PDQ), Patient Version. https://cancer.gov/types/skin/patient/melanoma-treatment-pdq
American Academy of Dermatology Association. Melanoma: Signs and Symptoms. https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/symptoms
American Cancer Society. Signs and Symptoms of Melanoma Skin Cancer. https://www.cancer.org/cancer/types/melanoma-skin-cancer/detection-diagnosis-staging/signs-and-symptoms.html
National Cancer Institute SEER Program. Cancer Stat Facts: Melanoma of the Skin. https://seer.cancer.gov/statfacts/html/melan.html
Vestergaard ME, Macaskill P, Holt PE, Menzies SW. Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting. Br J Dermatol. 2008;159(3):669-676. https://pubmed.ncbi.nlm.nih.gov/18616769.
Abbasi NR, Shaw HM, Rigel DS, et al. Early diagnosis of cutaneous melanoma: revisiting the ABCD criteria. JAMA. 2004;292(22):2771-2776. https://pubmed.ncbi.nlm.nih.gov/15585738.