The first sign of melanoma often is a change in the size, shape, color or feel of an existing mole. More advanced melanomas may become nodular or ulcerated, and the skin may itch or be scaly. However, even advanced tumors seldom cause pain. Melanoma also can appear as a new mole that is black or otherwise abnormal in appearance. Health providers often use the ABCD guidelines when evaluating a lesion for melanoma.
Most early lesions grow at an uneven rate that results in an asymmetrical pattern.
The uneven growth of melanoma forms an irregular border that can have a ragged or notched shape. Pigment may spread into the surrounding skin. Irregular growth also causes new shades of black, blue-black or dark brown. Occasionally, melanoma may be white, gray, red or pink. Lesions larger than 5 to 6 millimeters are suspect for melanoma.