Melanoma

What is melanoma?

Melanoma, also known as malignant melanoma, is a type of skin cancer that develops from pigment-containing cells known as melanocytes. In men, melanomas most commonly occur on the back, while in women they are most common on the legs (Dr. Zand’s mom’s melanoma was on her thigh, from years of laying out in the sun in her youth).  Melanomas can arise from otherwise normal-appearing skin (about 75% of cases), or from within an existing mole or freckle which starts to grow larger and change in appearance.

Melanoma is not the most common type of skin cancer, but it should be taken very seriously. If detected early through a full skin examination, the lesion can be surgically excised in-office using local anesthesia, and the treatment is considered curative. But if your troublesome mole goes undiagnosed and untreated, unfortunately it can invade and progress to other areas of your body and affect your overall health.

How can I prevent melanoma?

The great news is that melanoma is preventable. By following simple and convenient sun safety tips, you can significantly decrease your risk of developing melanoma. At Zand Dermatology, we do not tell our patients to avoid the sun. We believe being outdoors and active in nature recharges our human souls. We will teach you ways to be in the sun safely, to maintain your skin’s beauty and lower your risk of developing skin cancer. We will be your partner in thoroughly examining your skin, so if something does come up, we can catch it really early. 

In general, we recommend wearing sunscreen daily on your face - neck and chest for extra credit. The sunscreen should contain broad-spectrum mineral ingredients like zinc oxide and be in the SPF 40+ range. Dr. Zand can talk to you about commercial sunscreens ingredients that are potentially risky, banned in Europe, and best to be avoided.

While you are in the sun, it’s important to remember most sunscreens only work for 1.5-2 hours, so please reapply regularly. Wear wide brimmed hats, and try wearing gloves while gardening or golfing. Avoid tanning beds and take shade during peak midday sun from 11am-2pm.

How can I identify melanoma?

If you have several moles on your body, it’s important to get thorough yearly full skin examinations to become familiar with them. Dr. Zand will teach you about two techniques that are helpful in identifying suspicious moles:

The ABCDEs of Melanoma

This guideline can help you monitor your moles and identify any potentially dangerous ones. The acronym stands for:

• A – Asymmetry in shape: If you draw a line through your mole, do the two sides mismatch?
• B – Border irregularities: Normal moles have smooth borders, while the borders of melanomas tend to be uneven, with scalloped or notched edges.
• C – Color variability: Most benign moles are one even color, usually medium brown. Having a variety of colors is the most important warning sign for melanoma, which can show different shades of brown, black, pink, white, or blue-gray.
• D – Diameter greater than 6mm
• E – Evolution or change: Watch for moles that are changing in size, shape, color, or elevation, or developing new symptom such as bleeding, itching or crusting. If you identify a mole that is changing or bleeding, please don’t wait to have it evaluated.

The Ugly Duckling Sign

For people who have lots of moles, dermatologists often look for the “ugly duckling” sign, meaning moles that look or feel different than their surrounding “sister” moles. That way we can identify which are truly suspicious and which are normal for each patient. 

How does Dr. Zand diagnose melanoma?

Dr. Zand utilizes dermoscopy to examine suspicious skin lesions. Dermoscopy is a noninvasive method that allows her to evaluate colors and microstructures of the skin and deeper layers that are not visible to the naked eye. A dermatoscope provides magnification, non-polarized light to closely visualize the superficial skin surface, and polarized light to examine deeper skin structures. Because of the complexity involved, this methodology is reserved for highly trained and experienced dermatologists.

If a lesion is identified as suspicious, a skin biopsy is performed in office to confirm the diagnosis. Dr. Zand will numb the area, remove the lesion, and submit it to a dermatopathologist for further evaluation. Dr. Zand prioritizes taking the tiniest biopsy possible, to minimize any visible scar or discoloration.

Dr. Zand stresses the importance of getting a full body skin check that includes examination of the scalp as well as the skin between your toes. She makes sure to do this for every skin check, because you never know where a suspicious mole could be hiding. 

Who should get screened for melanoma? 

 The rate of melanoma diagnoses in Marin County is 43% higher than in other Bay Area counties, and 60% higher than in the state of California as a whole. If you have fair skin and are active outdoors, it’s important to get yearly skin cancer screening.

Click here to read about Dr. Zand discussing melanoma rates in Marin County on CBS News.

Don’t wait to schedule your exam with Dr. Zand; a simple checkup could go a long way in preventing melanoma. Call Zand Dermatology or book an appointment online today. We can’t wait to see you at our stunning waterfront office in southern Marin.