Melanoma Exposed.

General Medical

Melanoma exposed.  The truth, the myths and the only way you can protect yourself. Dr Sam Hay explains. 

Melanoma is the worst type of skin cancer there is.  This year alone, by the time you get home from work each day, 35 Aussies will have been diagnosed with this horrible disease, and five will have died.

While it’s a relatively rare skin cancer, only making up 2% of all skin cancers, it’s the deadliest. It grows and spreads quickly and that’s why it causes 75% of skin cancer deaths in Australia.

So just what is Melanoma?

Melanocytes are the cells that give our skin colour – the more there are packed into your skin, the darker your skin is.  Melanoma is a cancer of these melanocytes – when they turn rogue, and start multiplying outside of the body’s control.

“But what surprises most people is what colour they can be,” Dr Sam explains.  

“We first think of melanomas being black, but they can be multiple shades of red, grey, blue and white.”

“What will really surprise most people is that only 1 in 4 melanomas come from existing moles or freckles. Most arise as new spots.” 

Most melanomas start in the top layer of our skin, the epidermis, and they can hang around for several years, perhaps just growing a little wider.  In this phase, cutting the melanoma out is generally all that’s needed for a full cure. These superficial spreading melanomas account for about 70% of all melanomas, with over 60% of them being thin HIGHLY curable cancers

It’s the ones that start growing from the top layer of the skin into the deeper layers, and further throughout the body that can be deadly.  

“But it’s not all doom and gloom, having melanoma is not necessarily a life sentence.  With melanoma there’s a 90% chance of surviving at least five years”.

So what increases my chances of getting melanoma? 

There is absolute overwhelming evidence that solar UV radiation (commonly known as sun) is the major risk factor for all skin cancers.  Spend too much time in the sun and your risk rises.  

For melanoma it’s more about those intense bad bursts of sun – when you got horribly sunburnt. This contrasts with the other types of skin cancer (eg BCC or SCC) which relate more to ‘cumulative’ sun exposure.

Melanomas tend to occur more on areas that are exposed to the sun only sporadically – for example backs for blokes and legs for ladies. But they can occur anywhere.  And yes, that does include between your toes, under your fingernail, or on the soles of your feet.

“I’ve even seen a melanoma on someone’s anus!” says Dr Sam. 

Where you live plays a part.  

“Melanomas are simply more common where the sun shines more. If you live in our northern tropical regions you're far more likely to get melanoma than if you live in Tassie”.

When you are burnt is important.  Exposure early in life is particularly important.  Five or more severe sunburns (think skin peeling or blistering) by your teenage years DOUBLES your risk of melanoma. 

“This really drives home the importance of parents covering up their kids – slapping on that sunscreen – every day.”

Genetics play a part.  Light skin, blue eyes, red hair, and shed loads of freckles are associated with a two to four fold increased risk of melanoma.  Also, about 10% of melanomas appear to be familial. The more moles you have also increases risk.

One means more.   Having had one melanoma, you’ve got about a 10% risk of getting more, the risk highest in the first year.

What about other skin cancers?  This is where news gets worse.  Not only does a history of any other type of skin cancer increase your risk, it also increases your risk of dying from melanoma.

What else?  By now everyone knows tanning beds are bad.  But what about those nail salon lights… Truth is they do emit UV radiation, that could increase risk, certainly not as bad as the tanning bed, but enough for people to consider how often theyre getting their nails done, plus consider using some sunscreen before they go.  But more on sunscreen later.

So how can I prevent Melanoma? 

The truth about sun protection 

UVB is the major cause of sunburn and skin cancer, but there's definitely risk from UVA (which contributes to skin aging and some cancer risk).  Since 2013 we have seen new sunscreens on the market in Australia lifting the maximum sun protection factor (SPF) from SPF30+ to SPF50+.  

But are they worth it?  Well, that depends on how you view things. SPF50+ sunscreens offer a little better UVB protection, filtering 98% of UVB light compared to 96.7% with SPF30+; and added UVA protection.  It still needs to be applied regularly (every two hours or after swimming/towelling), and used with other sun protection measures such as hats, sunglasses, clothes, and staying in the shade.  

Checking your own skin is the first step in melanoma detection

The sooner we can find a nasty spot, the sooner we can treat it - dramatically reducing the need for larger areas being removed and the risks of melanoma spread and death.

Melanomas rarely hurt.  Melanomas are seen way before they are felt, so the best thing we can do is check our own skin regularly - get to know your skin.

"With regular skin checks we get to know are own spots, which have changed, and most importantly which ones are new.  Develop a habit of checking yourself each month using natural light, a mirror, and your partner to ensure you don't miss anywhere.  If you notice any change in shape or size; any itching, scratching, or bleeding; a change in colour; and especially a new spot, then please get a good doctor to check it out," Dr Sam urges.

Dr Sam recommends a good GP in the first instance, and for any skin spots of concern ask for a referral to a reputable dermatologist.

Research sources: and

BMedSci, MBBS(Hons), FRACGP, GDipSpMed, DCH
Director Your Doctors®


Please note: Dr. Sam's blog is general advice only. For further information on this topic please consult your healthcare professional.

Category: General Medical

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