Comprehensive Care for Melanoma

Early Detection and Advanced Treatments To Protect Your Skin and Overall Health

A melanoma diagnosis, or even the possibility of one, can raise concerns about your health and what the next steps of melanoma treatment may involve. 

Melanoma is a serious form of skin cancer that develops in pigment-producing cells called melanocytes. While it is less common than basal or squamous cell carcinoma, it is more aggressive and can become life-threatening if not detected and treated early. When identified in its earliest stages, it can be treated.

Anyone can develop melanoma, but certain factors can increase a person’s risk:

• Having fair skin, light hair, or light eye color
• Frequent sun exposure, blistering sunburns, or tanning bed use
• Family history of melanoma or other skin cancers
• Multiple or atypical moles, especially those that change over time

At Connolly Dermatology, we emphasize the importance of early detection through regular skin exams and prompt evaluation of new or changing moles. Identifying melanoma early allows for more effective treatment and improved outcomes.

Signs and Symptoms of Melanoma

Melanoma often begins as a subtle change in the skin. This could be a change in appearance with an existing mole or a new pigmented growth anywhere on your skin. This growth can develop quickly, which is why knowing what to look for can help with early detection.

One of the most important signs of potential melanoma is a mole that looks different from others on your body or one that changes over time. Because of these irregularities, dermatologists often refer to it as the “ugly duckling” sign. Common features that may signal melanoma include:

• Asymmetry: One half of the mole does not match the other half in shape or appearance. 
• Irregular Borders: Edges may appear uneven, scalloped, blurred, or poorly defined rather than smooth. 
• Color Variations: A single lesion may contain multiple colors such as brown, black, tan, red, white, or blue. 
• Rapid Growth or Change: Any spot that increases in size, changes color, thickens, or evolves in shape over weeks or months should be evaluated. 
• Non-Healing Sores or Lesions: Spots that bleed, crust, itch, or fail to heal properly may be a sign of skin cancer, including melanoma.

Melanoma can appear anywhere on the body, though it commonly appears in these areas:

• Back (particularly in male patients)
• Legs
• Arms
• Face
• Neck

Because melanoma does not always look the same from person to person, any new, changing, or unusual spot should be taken seriously. We encourage prompt evaluation concerning skin changes so that, if melanoma is present, it can be identified and treated as early as possible when outcomes are most favorable.

Hidden Melanomas: Areas Often Overlooked

Not all melanomas appear in obvious or sun-exposed areas. In some cases, melanoma can develop in places that are easy to miss during routine self-checks:

• Under fingernails or toenails
• Palms or soles
• Inside the mouth
• Scalp
• Eyes (ocular melanoma)

These “hidden” melanomas may appear as dark streaks, irregular patches, or subtle discoloration rather than a traditional mole.

Regular professional skin exams are essential for identifying these harder-to-see cancers early. At Connolly Dermatology, we perform thorough, full-body evaluations to ensure no area is overlooked, helping to improve early detection and treatment outcomes.

Diagnosis and Evaluation

Accurate diagnosis is the most important step in treating melanoma effectively. At Connolly Dermatology, we use a careful, step-by-step approach to confirm a diagnosis, assess risk, and determine the most appropriate next steps for care.

Comprehensive Skin Exam and Dermoscopy

Before we can diagnose moles or skin growth, our board-certified dermatologists conduct a thorough, full-body skin examination. We carefully evaluate all moles and lesions, paying close attention to size, shape, color, and pattern. 

Using a non-invasive dermoscopy, we can examine structures beneath the skin’s surface that are not visible to the naked eye. This view helps distinguish benign lesions from those that may be indicative of melanoma, helping to ensure diagnostic accuracy and guide our decisions about whether a biopsy is necessary.

Biopsy To Confirm Melanoma and Determine Depth

If a lesion appears suspicious, we will perform a skin biopsy to confirm whether melanoma is present. Biopsies are a brief procedure performed under local anesthesia, during which part or all of the lesion is removed and sent to a pathology laboratory for analysis. 

The biopsy determines the presence of melanoma and critical details such as Breslow thickness, which measures how deeply the cancer extends into the skin. This measurement is one of the most important factors in guiding individualized treatment plans and predicting outcomes. 

Risk Assessment and Staging

Once melanoma is confirmed, we assess the risk of spread based on tumor depth, location, and other pathological features. In certain cases, additional evaluation may be recommended to determine whether melanoma has spread beyond the skin. 

This process, known as staging, helps determine the extent of the disease and guides the next steps in treatment (or if referrals are necessary). Not all patients require advanced staging, but when it is necessary, early assessment allows for timely coordination of care. We ensure that each patient receives appropriate evaluation and clear guidance throughout treatment for melanoma.

Melanoma Treatment Options

Melanoma treatment is highly individualized, as it depends on the details found in diagnosis and evaluation, as well as overall patient health. At Connolly Dermatology, we focus on timely, evidence-based care designed to remove the cancer as well as support recovery and long-term skin health. 

Surgical Treatments

Surgery is the primary treatment for most melanomas diagnosed at an early stage. The goal is complete removal of the cancer while preserving as much healthy tissue as possible.

Common surgical approaches include:

Wide Local Excision

The affected area is surgically removed along with a margin of surrounding healthy skin. These margins help ensure that all cancer cells are removed, reducing the risk of recurrence. The size of the margin depends on the depth and location of the melanoma.

Sentinel Lymph Node Biopsy

For melanomas with greater depth or higher risk features, a sentinel lymph node biopsy may be recommended. This procedure helps assess whether cancer cells have spread to nearby lymph nodes. Identifying lymph node involvement is an important part of staging and guides further treatment decisions.

Advanced Therapies

In cases where melanoma is considered high-risk, advanced, or metastatic, additional treatments may be necessary. These therapies are typically coordinated with other medical specialists for more comprehensive care.

Immunotherapy

Immunotherapy strengthens the body’s natural immune response so it can better recognize and destroy melanoma cells. These treatments help the immune system identify cancer cells that may otherwise evade detection. Immunotherapy is typically used for higher-risk or advanced melanoma and is carefully coordinated with oncology specialists.

Targeted Therapy

We focus on specific genetic mutations or molecular pathways that allow melanoma cells to grow and spread. By blocking these pathways, targeted treatments for melanoma can slow or stop cancer progression while limiting damage to healthy cells. This approach is used when melanoma exhibits certain identifiable genetic characteristics.

Risk Reduction and Prevention

Melanoma cannot be totally prevented, as factors like genetics and general health can affect how cancer cells develop. However, you can practice preventative habits in your everyday life to lower the risk of melanoma.

Sun Protection Strategies

• Use Broad-Spectrum Sunscreen: Your morning skincare routine should always include a sunscreen with SPF 30 or higher, even on cloudy days. If you are spending extended hours outdoors, reapply sunscreen every two hours to maintain effective protection against UVA and UVB rays. 
• Wear Protective Clothing: If you are outdoors for long periods, wear long-sleeved shirts, wide-brimmed hats, and UV-protective fabrics. These help shield the skin from direct sun exposure. 
• Stay in Shaded Areas: Avoid prolonged sun exposure in general. If you will be outdoors for several hours, stay in a shaded area to rest occasionally. 
• Avoid Peak UV Hours: UV radiation is strongest in the late morning until mid-afternoon. Limiting outdoor exposure during these hours helps reduce the intensity of sun damage. 
• Avoid Tanning Beds: Tanning beds emit concentrated UV radiation that significantly increases melanoma risk.
  

Ongoing Monitoring and Awareness

Performing routine self-exams helps identify new or changing moles early. However, professional skin evaluations allow dermatologists to detect subtle changes that may go unnoticed.