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May 2026
by Hope Allen, PA-C
Common Misconceptions About Melanoma: common myths about melanoma can delay diagnosis or create a false sense of security.
1. Melanoma only occurs in sun-exposed areas. On skin exams, we get a lot of questions about why check under the underwear or between the toe.
While ultraviolet (UV) exposure is a major risk factor, melanoma is not limited to sun-exposed skin. It can develop anywhere on the body including between the toes, on the bottoms of the feet, under underwear-covered areas, and even inside the mouth.
2. Only fair-skinned individuals get melanoma
All skin types can develop melanoma. Although individuals with lighter skin may have a higher overall risk, melanoma in darker skin tones is often diagnosed at a later stage. This makes awareness and routine skin checks essential for everyone.
3. Melanoma is always caused by sun exposure
Sun exposure is important, but it’s not the only factor. Genetics also play a role. Melanoma can run in families, and some individuals have a genetic predisposition that increases their risk. A family history of melanoma should prompt increased vigilance and regular professional skin exams.
4. You can tell if a spot is melanoma just by looking at it
Clinicians are trained to recognize suspicious features such as asymmetry, irregular borders, color variation, or rapid change. However, these are only clues. Melanoma cannot be definitively diagnosed by visual inspection alone. Confirmation requires microscopic evaluation through a biopsy.
Understanding Melanoma Diagnosis: Melanoma’s that are caught early on a skin cancer screening can have a much better prognosis than a melanoma that is not caught until it is very advanced.
In situ vs. invasive melanoma
Melanoma in situ: The earliest stage, where cancer cells are confined to the top layer of the skin (epidermis). Highly treatable.
Invasive melanoma: Cancer cells have penetrated deeper into the skin, increasing the risk of spreading.
Breslow Depth
Breslow depth measures how deeply melanoma cells extend into the skin (in millimeters). This is one of the most important factors in determining prognosis and treatment. The deeper the melanoma, the higher the potential risk.
Melanoma Staging
Stage 0: In situ melanoma
Stages I–II: Localized melanoma with increasing depth and risk features
Stage III: Spread to nearby lymph nodes
Stage IV: Spread to distant organs
Early stages of melanoma can be treated be wide surgical excision only. The later stages require regional lymph node biopsy and may require other forms of treatment including immunotherapy, targeted therapy, and radiation.
How to Protect Yourself Against Melanoma
– Use broad-spectrum sunscreen (SPF 30 or higher) daily
– Wear protective clothing, hats, and sunglasses** Clothing is THE BEST protection, superior to sunscreen alone
– Seek shade and avoid peak sun hours (10 AM–4 PM)
– Avoid tanning beds
– Perform regular self-skin exams, including less obvious areas
– Know your family history
– Schedule routine professional skin exams
Takeaway
Melanoma is highly treatable when caught early. Understanding where it can occur, who it affects, and how it is diagnosed empowers you to take proactive steps toward protecting your health.
