Melanoma: How to Prevent, Detect, and Treat Skin Cancer Early

Melanoma is the deadliest form of skin cancer, but it’s also one of the most preventable-if you know what to look for and act fast. Every year in the U.S., over 100,000 new invasive cases are diagnosed. The good news? If caught early, the five-year survival rate is over 99%. The bad news? If it spreads, that number drops to 35%. This isn’t just a summer problem. It’s a year-round risk, and it doesn’t care if you have light skin or dark skin. What matters is how you protect yourself, how often you check your skin, and what you do when something looks off.

What Melanoma Really Is

Melanoma starts in melanocytes-the cells that give your skin its color. These cells can turn cancerous after too much UV exposure from the sun or tanning beds. Unlike other skin cancers that grow slowly, melanoma can spread quickly to lymph nodes and organs like the lungs or brain. That’s why it kills more people than basal cell or squamous cell carcinomas, even though it makes up less than 1% of all skin cancers.

There are four main types:

• Superficial spreading melanoma (70% of cases)-the most common. It spreads sideways across the skin before digging deeper.
• Nodular melanoma (15-30%)-grows fast and looks like a raised bump. Often black or dark, but can be pink or red.
• Lentigo maligna melanoma (10-15%)-shows up on sun-damaged skin, usually on the face or arms of older adults.
• Acral lentiginous melanoma (2-8%)-appears on palms, soles, or under nails. More common in people with darker skin tones, and often missed because it doesn’t look like typical sun damage.

That last type is critical to understand. Many Black and brown patients are diagnosed late because doctors and even patients assume melanoma only happens on sun-exposed skin. But it can hide under a nail, on the foot, or on the scalp. That’s why self-checks matter for everyone.

How to Prevent Melanoma

Up to 90% of melanomas are caused by UV radiation. That means most cases are preventable. But prevention isn’t just about sunscreen.

Here’s what actually works:

• Use broad-spectrum SPF 30+ daily-even on cloudy days. UVA rays penetrate clouds and windows. Reapply every two hours, or after sweating or swimming.
• Avoid tanning beds completely. Using them before age 35 increases melanoma risk by 75%. That’s not a myth-it’s backed by data from the British Journal of Dermatology.
• Seek shade between 10 a.m. and 4 p.m. That’s when UV rays are strongest. Wear wide-brimmed hats, UV-blocking sunglasses, and tightly woven clothing.
• Check the UV index. Apps like QSun or the EPA’s SunWise tool give real-time UV levels. When it’s 6 or higher, take extra precautions.
• Protect kids. Childhood sunburns double melanoma risk later in life. Don’t wait until they’re teens to teach sun safety.

Here’s a hard truth: Only 14% of U.S. high schoolers use sunscreen regularly. Cost is a barrier for many families. But a $10 bottle of sunscreen lasts months. Spending $30 a year on protection saves thousands in treatment costs. The CDC says every $1 spent on UV prevention saves $3.50 in medical bills.

How to Detect Melanoma Early

Early detection saves lives. The ABCDE rule is your first tool:

• Asymmetry-One half doesn’t match the other.
• Border irregularity-Edges are ragged, notched, or blurred.
• Color variation-Shades of brown, black, red, white, or blue within the same spot.
• Diameter-Larger than 6mm (about the size of a pencil eraser). But melanomas can be smaller.
• Evolving-Changing in size, shape, color, or texture over weeks or months.

Don’t wait for all five signs. If a mole is changing, it’s enough to get it checked. Also watch for:

• A spot that bleeds, itches, or crusts without healing.
• A new dark streak under a nail.
• A sore that won’t go away.
• A mole that looks different from all the others (the “ugly duckling” sign).

Do a self-exam once a month. Take 10-15 minutes after a shower. Use a mirror to check hard-to-see areas: back, scalp, between toes, under breasts. Take photos with your phone to track changes over time.

Teledermatology is now an option for many. A 2023 study found it’s 87% accurate compared to in-person visits. But it’s not perfect. If something feels wrong, don’t rely on a photo alone. Go in person.

What Happens When Melanoma Is Found

If your doctor sees something suspicious, they’ll do a biopsy. That’s when a small piece of skin is removed and checked under a microscope. No guesswork. No waiting. Just facts.

Staging tells you how far it’s gone:

• Stage 0 (in situ)-Cancer is only in the top layer of skin. Surgery removes it. Cure rate: nearly 100%.
• Stage I-II-Tumor is deeper but hasn’t spread. Surgery with wider margins (1-2 cm) is standard. A sentinel lymph node biopsy may be done if the tumor is over 0.8mm thick.
• Stage III-Cancer reached nearby lymph nodes. Surgery plus immunotherapy (like nivolumab or pembrolizumab) is now standard. These drugs help your immune system fight the cancer.
• Stage IV-Spread to distant organs. Treatment is more complex. Immunotherapy or targeted therapy (for BRAF-mutant tumors) can extend life for years.

Genetic testing is now routine for Stage IIB and above. About half of melanomas have a BRAF mutation. If yours does, drugs like dabrafenib and trametinib can be very effective. But they come with side effects-rash, fever, fatigue-and cost up to $200,000 a year.

Immunotherapy works better long-term. In the CheckMate 067 trial, 52% of Stage IV patients were still alive after five years. But it takes months to kick in. Targeted therapy works faster-sometimes in weeks-but doesn’t last as long.

Real Stories, Real Risks

One woman in Manchester, 42, noticed a dark spot under her big toe. She thought it was a bruise from her shoes. Six months later, it was Stage III acral melanoma. She had a toe amputation and now gets immunotherapy every three weeks. “I didn’t know melanoma could hide there,” she told me.

A 19-year-old student used a UV index app and noticed his freckle had grown. He got it checked. It was a 0.4mm melanoma. Removed in 20 minutes. No chemo. No hospital stay. Just a quick excision. His survival odds? 99.6%.

But not everyone is so lucky. On Reddit, a man posted about paying $28,500 out of pocket for one infusion of nivolumab-even with insurance. That’s not rare. Treatment costs for melanoma hit $3.4 billion in the U.S. last year. And many rural areas have no dermatologists within 50 miles.

People of color face another barrier: misdiagnosis. A 2024 study found Black patients were twice as likely to be told a melanoma was a “bruise” or “infection.” That’s why knowing your own skin matters more than ever.

What’s New in 2025

The field is moving fast. In early 2025, the FDA approved two major advances:

• DermEngine’s VisualizeAI-an AI tool that analyzes skin images and flags high-risk lesions with 93.2% accuracy. It’s being rolled out in clinics across the U.S.
• mRNA-4157/V940-a personalized vaccine made from your own tumor’s DNA. When combined with pembrolizumab, it cut recurrence risk by 44% in high-risk patients.

Also, the CDC is now pushing UV index alerts into weather apps. By 2026, 120 million people will get daily UV warnings on their phones. And Walmart is testing teledermatology kiosks in 150 clinics-aimed at rural communities with no dermatologists.

But progress won’t reach everyone unless we fix access. The richest Americans are seeing declining melanoma rates. The poorest? Rates are still rising. Prevention isn’t just about science. It’s about equity.

What You Should Do Right Now

You don’t need to wait for a doctor’s appointment to protect yourself. Here’s your action plan:

1. Check your skin this week. Use the ABCDE rule. Take a photo of anything new or changing.
2. Apply sunscreen daily. Don’t skip it because it’s cloudy or you’re indoors.
3. Stop using tanning beds. There’s no safe tan.
4. Know your risk. Fair skin? More than 50 moles? Family history? Get a professional exam every 6 months.
5. Ask for help. If you can’t afford sunscreen, ask at your local clinic. Many offer free samples. If you can’t get a dermatologist appointment, try teledermatology.

Melanoma isn’t inevitable. It’s not fate. It’s a result of exposure, delay, and sometimes, neglect. But with the right knowledge and action, you can stop it before it starts-or catch it when it’s still curable.