by EBSCO Medical Review Board

Melanomas are not usually painful. The first sign is often a change in the size, shape, color, or feel of an existing mole. Melanomas can also appear as a new, black, or abnormal mole. Keep in mind that most people have moles and almost all moles are harmless. Report any changes that you see to your doctor.

Changes in Existing Moles

Spotting a mole that seems out of the ordinary may be the first warning sign of melanoma. The ABCDE rule highlights what a suspicious mole can look like:


A normal mole has a even shape all around. An asymmetrical mole has 2 halves that do not look the same. When you look at it, one side looks smooth and the other side looks jagged.

Asymmetrical Mole
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The mole has a jagged, uneven edge all the way around.

Irregular Border
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Moles on most people are brown and evenly colored. Some can also be tan and black. Changes may be seen with different shades of those colors. At times, you may notice white, gray, pink, or red mixed in. Focus on the changes and uneveness of the coloring.

Color Variation
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Most moles are ¼ inch (6.8 millimeters) or less in size. Look for moles that are larger than an eraser on the end of a pencil. Melanoma can happen in smaller moles, but they tend to grow larger.


Any mole that changes color, shape, or size should be check out. As the disease progresses, they can become hard or lumpy.

Other Skin Changes

Not all melanomas follow the ABCDE rule. Other signs to be look for are:

  • Sores on your skin that do not heal
  • Moles that ooze, bleed, or change in texture
  • New discomfort, itching, redness, or swelling
  • Coloring of a mole that extends beyond the border and into the skin
  • A new mole appears near another mole that looks either normal or abnormal

Later Stage Symptoms

Problems can appear anywhere in the body as melanoma grows and spreads. The problems will depend on where in the body it is growing. Common symptoms may include:

  • Trouble breathing
  • Headaches
  • Pain or a sensation of a mass
  • Less hunger or unintended weight loss
  • Feeling very tired
  • Belly or back pain caused by pressure on nearby nerves
  • Swelling in the legs—may be caused by a block in the veins or lymphatic system
  • Bone pain


General information about melanoma. National Cancer Institute website. Available at: Updated May 1, 2019. Accessed May 8, 2019.

Melanoma. EBSCO DynaMed website. Available at: . Updated March 26, 2019. Accessed May 8, 2019.

Melanoma. Merck Manual Professional Version website. Available at: Updated March 2019. Accessed May 8, 2019.

Melanoma: Signs and symptoms. American Academy of Dermatology website. Available at: Accessed May 8, 2019.

Signs and symptoms of melanoma skin cancer. American Cancer Society website. Available at: Updated May 20, 2016. Accessed May 8, 2019.

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