Page last updated: April 2025
The information on this webpage was adapted from Understanding Melanoma - A guide for people with cancer, their families and friends (2025 edition). This webpage was last updated in April 2025.
Expert content reviewers:
This information is based on Australian clinical practice guidelines, and was developed with the help of a range of health professionals and people affected by melanoma:
- A/Prof Rachel Roberts-Thomson, Medical Oncologist, The Queen Elizabeth Hospital, SA
- A/Prof Robyn Saw, Surgical Oncologist, Melanoma Institute Australia, Royal Prince Alfred Hospital and The University of Sydney, NSW
- Alison Button-Sloan, Consumer
- Dr Marcus Cheng, Radiation Oncologist Registrar, Alfred Health, VIC
- Prof Anne Cust, Deputy Director, The Daffodil Centre, The University of Sydney and Cancer Council NSW, Chair, National Skin Cancer Committee, Cancer Council, and faculty member, Melanoma Institute Australia
- Prof David Gyorki, Surgical Oncologist, Peter MacCallum Cancer Centre, VIC
- Dr Rhonda Harvey, Mohs Surgeon, Dermatologist, Green Square Dermatology, The Skin Hospital, Darlinghurst and Sydney Melanoma Diagnostic Centre, RPA, NSW
- David Hoffman, Consumer
- A/Prof Jeremy Hudson, Southern Cross University, James Cook University, Chair of Dermatology RACGP, Clinical Director, North Queensland Skin Cancer, QLD
- Dr Damien Kee, Medical Oncologist, Austin Health and Peter MacCallum Cancer Centre and Clinical Research Fellow, Walter & Eliza Hall Institute, VIC
- Angelica Miller, Melanoma Community Support Nurse, Melanoma Institute Australia, WA
- Romy Pham, 13 11 20 Consultant, QLD
- A/Prof Sasha Senthi, Radiation Oncologist, Alfred Health, and Clinical Research Fellow, Victorian Cancer Agency, VIC
- Dr Chistoph Sinz, Dermatologist, Melanoma Institute Australia, NSW
- Dr Amelia Smit, Research Fellow, Melanoma and Skin Cancer, The Daffodil Centre, The University of Sydney and Cancer Council NSW
- Nicole Taylor, Clinical Nurse Consultant, Crown Princess Mary Cancer Centre, Westmead Hospital, NSW
This page includes information on melanoma, a type of skin cancer. Other types of skin cancer include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), which are often called non-melanoma skin cancers.
For more information about non-melanoma skin cancers, see Understanding skin cancer.
Many people feel shocked and upset when told they have melanoma. If you have any questions or concerns, get support by calling Cancer Council 13 11 20.
Contact cancer support
What is melanoma?
Melanoma is a type of skin cancer. It develops in the skin cells called melanocytes. Melanoma most often develops in areas that have been exposed to the sun.
It can also start in areas that don’t receive much sun, such as the:
- eye (uveal or ocular melanoma)
- nasal passages, mouth and genitals (mucosal melanoma), and
- the soles of the feet or palms of the hands, and under the nails (acral melanoma).
Other types of skin cancer, called non-melanoma skin cancers or keratinocyte cancers, are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
These are far more common than melanoma. However, melanoma is considered more serious because it can spread to other parts of the body, especially if not found early.
Your guide to best cancer care
A lot can happen in a hurry when you’re diagnosed with cancer. The guide to best cancer care for melanoma can help you make sense of what should happen.
It will help you with what questions to ask your health professionals to make sure you receive the best care at every step.
Read the guide
About the skin
The skin is the largest organ of the body. It protects the body from injury, controls body temperature and prevents loss of body fluids.
The two main layers of the skin are called the epidermis and the dermis. Below these is a layer of fatty tissue known as the hypodermis.
Epidermis
The epidermis is the top, outer layer of the skin. It is made up of several sublayers that work together to continually rebuild the surface of the skin. The main sublayers are the basal cell layer and the squamous cell layer.
Basal cell layer
This is the lowest layer of the epidermis. It contains basal cells and cells called melanocytes. The melanocyte cells produce a dark pigment called melanin, which gives skin its colour.
When skin is exposed to ultraviolet (UV) radiation, melanocytes make melanin to try to protect the skin from getting burnt. This is what causes skin to tan.
When melanocytes cluster together, they form non-cancerous spots on the skin called moles or naevi.
Squamous cell layer
This sits above the basal cell layer. Basal cells that have matured move up into the squamous cell layer. Here they are known as squamous cells or keratinocyte cells. Squamous cells are the main type of cell found in the epidermis.
Dermis
This layer of the skin sits below the epidermis. The dermis is made up of fibrous tissue and contains the roots of hairs (follicles), sweat glands, blood vessels, lymph vessels and nerves.
How common is melanoma?
Australia and New Zealand have the highest rates of melanoma in the world.
Each year in Australia, almost 19,000 people are diagnosed with invasive melanoma (it has spread into the dermis, the lower layer of the skin) and 28,000 people are diagnosed with melanoma in situ (it is only in the epidermis, the top layer).
In Australia, melanoma is the second most common cancer in men and the third most common in women (excluding non-melanoma skin cancers).
Learn more
How do I spot a melanoma?
New moles mostly appear during childhood and through to the age of 30 to 40. However, adults of any age can develop new or changing spots. It is important to get to know your skin and check it every 3 to 6 months.
To check your skin, make sure you are in a place with good light, undress completely and use a full-length mirror to check your whole body. For areas that are hard to see, use a handheld mirror or ask someone to help.
It is also a good idea to take a photo of your moles and spots so that you can compare them with an older photo to see if one has changed.
How melanoma looks can vary greatly. Look for spots that are new, different from other spots, or raised, firm and growing. If you have lots of moles, a melanoma usually stands out and looks different from other moles.
A melanoma is usually brown or black, but it can also be pink. Even if your doctor has said a spot is benign in the past, check for any changes in shape, size or colour. If you notice a new or changing spot, get it checked as soon as possible by your doctor.
Signs of melanoma
The ABCD and EFG rule is a tool used by doctors to help them look for characteristics of skin damage when diagnosing melanomas.
- Asymmetry – are the halves of each spot different?
- Border – are the edges uneven, scalloped or notched?
- Colour – are there differing shades and colour patches?
- Diameter – is the spot greater than 6 mm across, or is it smaller than 6 mm but growing larger?
Some types of melanoma, such as nodular and desmoplastic melanomas, don’t fit the ABCD guidelines.
- Elevated – is it raised?
- Firm – is it firm to touch?
- Growing – is it growing quickly?
What causes melanoma?
Exposure to ultraviolet (UV) radiation is the cause of most types of skin cancer. If unprotected skin is exposed to the sun when the UV index is three or above or to other UV radiation, the structure and behaviour of the cells can change.
This can permanently damage the skin, and the damage builds up every time a person spends time unprotected in the sun.
UV radiation most often comes from the sun, but it can also come from artificial sources such as solariums (also known as tanning beds or sun lamps).
Solariums are now banned for commercial use in Australia because research shows that people who use solariums have a much greater risk of developing melanoma.
Who is at risk?
While anyone can develop melanoma, the risk is higher for people who have:
- unprotected exposure to UV radiation when the UV index is three or above, particularly a pattern of short, intense periods of sun exposure and sunburn, such as on weekends and holidays
- had significant UV exposure when they were young
- lots of moles (naevi), especially if the moles have an irregular shape and uneven colour
- pale or freckled skin, especially if it burns easily and doesn’t tan
- fair or red hair, and blue or green eyes
- a previous melanoma or other type of skin cancer
- a strong family history of melanoma
- a weakened immune system due to medical conditions or from using immunosuppressive medicines for a long time.
Family history and melanoma
Less than 2% of melanomas are linked to an inherited faulty gene.
You could have an inherited faulty gene if two or more close relatives (parent, sibling or child) have been diagnosed with melanoma, particularly if they were diagnosed with more than one melanoma, or if they were diagnosed with melanoma before the age of 40.
People with a strong family history of melanoma should take extra care with sun protection and regularly check their skin carefully for new moles or skin spots.
From their early 20s, they should consider having a professional skin check by a doctor.
If you are concerned about family risk, talk to your doctor about being referred to a family cancer clinic. To learn more, call Cancer Council 13 11 20.
What are the main types of melanoma?
Melanoma of the skin is known as cutaneous melanoma. The main subtypes of cutaneous melanoma are shown below.
Some rarer types of melanoma start in other parts of the body:
- Mucosal melanoma can start in the tissues in the mouth, anus, urethra, vagina or nasal passages.
- Ocular melanoma can start inside the eye.
- Melanoma can also start in the central nervous system.
Superficial spreading melanoma
This makes up 55-60% of melanomas and is the most common type of melanoma in people under 40 (but can occur at any age).
It can start as a new brown or black spot that grows on the skin, or as an existing spot, freckle or mole that changes size, colour or shape.
It can develop on any part of the body but especially the area between the shoulders and hip (trunk) and often grows slowly. It becomes more dangerous when it invades the lower layer of the skin (dermis).
Nodular melanoma
This type is 10-15% of melanomas and is most commonly found in people over 65. It usually appears as a round, raised lump (nodule) on the skin that is pink, red, brown or black and feels firm to touch. It may develop a crusty surface that bleeds easily.
It is usually found on sun-damaged skin. It is often a fast-growing form of melanoma, spreading quickly into the lower layer of the skin (dermis).
Lentigo maligna melanoma
This makes up 10-15% of melanomas, and most people with this subtype are over 40. It begins as a flat, irregular patch of discoloured skin which can be brown, pink, red of white. It is mostly found on sun-damaged skin on the face, ears, neck or head.
It may grow slowly and superficially over many years before it grows deeper into the skin.
Acral lentiginous melanoma
This is a rare subtype of melanoma (only 1-2% of melanomas) that mostly affects people over 40 with dark skin such as those of African, Asian and Hispanic backgrounds.
It often appears as a colourless or lightly coloured area, which may be mistaken for a stain, bruise or unusual wart. In the nails, it can look like a long streak of pigment.
It is most commonly found on the palms of the hands, on the soles of the feet, or under the fingernails or toenails. It tends to grow slowly until it invades the lower layer of the skin (dermis).
Desmoplastic melanoma
This is another rare type of melanoma (1-2% of melanomas) that mostly affects people over 60. It starts as a firm, growing lump, often the same colour as your skin. It may be mistaken for a scar and can be difficult to diagnose.
It is mostly found on sun-damaged skin on the head or neck, including the lips, nose and ears. It tends to be slower to spread than other subtypes but is often diagnosed later. Sometimes it can spread via nerves.
Which health professionals will I see?
You will probably start by seeing your general practitioner (GP). You may see a GP at a general practice, medical centre or skin cancer clinic. Skin cancer clinics are run by GPs with an interest in skin cancer.
If a GP diagnoses or suspects melanoma, they may remove the spot themselves or refer you to another doctor, such as a dermatologist or surgeon, for the biopsy. If there’s a waiting list, your GP can ask for an earlier appointment if necessary.
Your GP may arrange further tests. Depending on the nature of the melanoma and their expertise, the GP may recommend ways to treat it or refer you to a dermatologist or surgeon who will manage your care.
In more complex cases, treatment options may be discussed at a multidisciplinary team (MDT) meeting.
Question checklist
Asking your doctor questions will help you make an informed choice. You may want to include some of the questions below in your own list.
Diagnosis
- What type of melanoma do I have? How thick is it?
- Has the melanoma spread? Did the biopsy remove all of the melanoma?
- Can you explain the results of the tests to me?
- Are there clinical guidelines for this type of melanoma?
Treatment
- What treatment do you recommend? What is the aim of the treatment?
- Are the latest tests and treatments for melanoma that are available in this hospital?
- How long will treatment take? Will I have to stay in hospital?
- How much will treatment cost? Can the cost be reduced if I can’t afford it?
- How will I know if the treatment is working?
- Are there any clinical trials or research studies I could join?
Side effects
- What are the risks and possible side effects of each treatment? How can these be managed?
- Will I have a lot of pain? If I do, what will be done about this?
- Will there be any scarring after the melanoma is removed?
- What are the chances I will get lymphoedema after treatment?
After treatment
- How often will I need to get my skin checked after treatment? Who should I go to for my skin checks?
- How can I protect myself from the sun and get enough vitamin D?
- If the melanoma returns, how will I know? What treatments could I have?
- Are there any local support groups for people with melanoma?
Attending a melanoma unit
Management and treatment for advanced melanoma can be complex.
People with advanced melanoma – as well as some diagnosed with earlier stage melanoma – can benefit from being treated in a cancer centre that has doctors who specialise in treating advanced melanoma.
Cancer centres are located at hospitals in major cities around Australia. You will be able to see a range of health professionals, called a multidisciplinary team, who specialise in different aspects of your care.
To find a multidisciplinary melanoma unit near you, check with your doctor or call Cancer Council 13 11 20.
