In addition to sunburns early in life, people with many moles are at greater risk to develop melanoma. Everyone has moles, usually around 30, and most are without significance. However, people with more than 50 moles are at an increased risk. In addition to the number of moles, some moles are unusual and irregular looking. These moles are known as dysplastic or atypical moles. People with atypical (dysplastic) moles are at increased risk of developing melanoma. Melanoma does run in families. If a close relative, such as a parent, aunt or uncle, has had melanoma, then other blood relatives are at increased risk for melanoma.

  All of these features, fair skinned, sun sensitive people, a history of sunburns, many moles, atypical moles, and close relatives who had melanoma, allow us to identify those at risk for developing melanoma. Anyone, even those with none of to risk factors, can develop melanoma, but people with one or more of the risk factors are more likely to do so. If you have some of these risk factors, periodic routine skin examinations by your dermatologist can truly be life saving.

  Treatment for melanoma begins with the dermatologic surgical removal of the melanoma and some normal appearing skin around the growth. Removal of the normal appearing skin is known as taking margins, and is done to be sure no melanoma is left behind. A person’s outcome depends on how deep the melanoma has grown into the skin. Early melanoma limited to the outermost layer of the skin (the epidermis) is know as melanoma in situ (in place), and simple surgical removal produces virtually 100% cure rate. However, if left untreated, the melanoma grows deeper in the skin. The deeper it goes, the more likely it is to reach a blood vessel or lymphatic channel. If it enters these vessels, it can spread away from the skin, producing a life threatening situation. When a biopsy is performed and melanoma is detected, the depth of invasion into the skin will be measured and reported by a dermatologist. This will guide treatment.

  Deeper melanomas are more likely to spread. If a melanoma does spread, it typically spreads first to the lymph nodes. The lymph nodes are part of the lymphatic system, a series of vessels throughout the body much like blood vessels that are responsible for cleaning the body’s tissues. These vessels drain to local swellings known as lymph nodes, located at a variety of spots around the body. Different lymph nodes serve different part of the body. If a melanoma did spread, it may be possible to find it at the lymph node before it goes any further. A procedure called a sentinel node biopsy is a way of identifying and testing the first lymph node that drains the area the melanoma was located at. The decision on whether to perform a sentinel node biopsy is based on how deep the melanoma is in the skin, and in turn, how likely it is to have spread.

  Early detection remains the best treatment. Therefore, perform a monthly self-exam, looking for irregular lesions that are growing and changing, and use the ABCDE rules. If you have an atypical mole, see a dermatologist immediately. Lastly, see a dermatologist at least once a year for a complete skin exam.