Melanoma Prevention, Detection, and Treatment: What You Need to Know in 2025

Melanoma is the deadliest form of skin cancer, but it’s also one of the most preventable. Unlike other skin cancers that grow slowly, melanoma can spread fast - sometimes in just weeks. The good news? If caught early, the chance of survival is over 99%. If it’s found late, that number drops to 35%. The difference between life and death often comes down to one thing: knowing what to look for and acting on it.

What Exactly Is Melanoma?

Melanoma starts in melanocytes, the cells that give your skin its color. When these cells get damaged - usually by UV radiation from the sun or tanning beds - they can turn cancerous. It doesn’t just show up on sun-exposed skin. You can find melanoma on your scalp, between your toes, under your nails, or even inside your mouth. That’s why checking your whole body matters.

There are four main types:

• Superficial spreading melanoma - the most common (70% of cases). It grows sideways across the skin before going deeper.
• Nodular melanoma - grows fast and looks like a raised bump. Often black or dark, but can be pink or skin-colored.
• Lentigo maligna melanoma - appears as a large, flat, tan or brown spot with uneven edges. Common in older adults with long sun exposure.
• Acral lentiginous melanoma - shows up on palms, soles, or under nails. More common in people with darker skin, but often missed until it’s advanced.

What’s alarming? Melanoma is rising. In 2025, the U.S. will see over 104,960 new invasive cases - up nearly 6% from last year. That’s more than 287 new cases every day.

How to Spot Melanoma Early: The ABCDE Rule

You don’t need a doctor to catch melanoma early. You just need to know what to look for. The ABCDE rule is the standard used by dermatologists worldwide:

• A - Asymmetry: One half doesn’t match the other.
• B - Border: Edges are ragged, blurred, or notched.
• C - Color: Multiple shades of brown, black, red, white, or blue.
• D - Diameter: Larger than 6mm (about the size of a pencil eraser).
• E - Evolving: Changing in size, shape, color, or texture over weeks or months.

But here’s the catch: Not all melanomas follow these rules. Some are small. Some are uniform in color. That’s why you also need to look for the ugly duckling - a mole that looks different from all the others on your body. If something feels new, odd, or just doesn’t belong, get it checked.

Studies show that 78% of melanomas are found by patients themselves - not doctors. People who do monthly skin checks catch melanomas at an earlier stage. One Reddit user, ‘SkinCheckSavedMe,’ found a 0.4mm melanoma using a UV index app that reminded her to check her shoulder. It was caught before it spread. Her five-year survival chance? 99.6%.

Who’s at Risk? It’s Not Just Fair Skin

Most people think melanoma only affects fair-skinned, blue-eyed people. That’s a dangerous myth. While fair skin increases risk, melanoma kills more Black people per capita than any other racial group in the U.S. Why? Because it’s often missed.

Acral lentiginous melanoma - the type that shows up on palms, soles, or under nails - is more common in people of color. But doctors often mistake it for a bruise, fungal infection, or injury. One patient, DJohnson_MD, was told for months that the dark spot on his foot was a bruise. By the time he got a biopsy, it was Stage III.

Other high-risk groups:

• People with 50+ moles
• Those with a family history of melanoma
• People who’ve had severe sunburns (especially before age 18)
• Users of indoor tanning beds (58% higher risk)
• Those living in areas with low dermatologist access (like Mississippi, where there’s only 1.2 dermatologists per 100,000 people)

Age matters too. While melanoma rates are dropping in teens and young adults, they’re rising in women over 50. That’s why regular skin checks should be part of every adult’s health routine - no matter your skin tone.

Prevention: It’s Not Just Sunscreen

Ninety percent of melanomas are caused by UV exposure. That means most cases are preventable. But sunscreen alone isn’t enough.

Here’s what actually works:

• Seek shade between 10 a.m. and 4 p.m., when UV rays are strongest.
• Wear UPF 50+ clothing - hats with wide brims, long sleeves, and UV-blocking sunglasses.
• Use broad-spectrum SPF 30+ daily, even on cloudy days. Reapply every two hours or after swimming/sweating.
• Avoid tanning beds completely. They’re classified as a known human carcinogen by the WHO.
• Check the UV index daily. Apps like QSun’s UV Index now integrate with weather forecasts and send alerts when exposure is high.

Here’s the kicker: Only 14.3% of high school students use sunscreen consistently. Cost is a barrier for 67% of low-income families. That’s why community programs are stepping in. In 2025, Walmart is piloting teledermatology kiosks in 150 clinics across rural areas. These kiosks let you take photos of suspicious spots and send them to a dermatologist within hours.

And it works. A 2023 study showed teledermatology is 87% accurate - close to in-person visits. It’s not perfect, but it’s better than waiting 63 days for an appointment in a rural area.

How Melanoma Is Diagnosed

If your doctor sees something suspicious, they’ll likely use dermoscopy - a handheld device that magnifies the skin and reveals patterns invisible to the naked eye. It boosts diagnostic accuracy from 65% to 90%.

For more complex cases, they may use:

• Total body photography - takes 15-20 minutes and maps every mole on your body. Used to track changes over time.
• Reflectance confocal microscopy - a non-invasive scan that shows skin layers in real time. 94% sensitive for melanoma.
• AI-assisted tools - like DermEngine’s VisualizeAI, approved by the FDA in early 2025. It analyzes images and flags high-risk lesions with 93.2% accuracy.

But the gold standard is still a biopsy. A small sample is removed and sent to a lab. If it’s melanoma, they’ll test for mutations - especially BRAF, which is present in about half of all cases. That tells doctors whether targeted therapy might work.

Treatment: It’s Changed Dramatically

Treatment depends on how deep the melanoma has grown and whether it’s spread.

• Stage 0 (in situ): Only the top layer of skin is affected. Surgery with a 0.5-1cm margin removes it. Cure rate: nearly 100%.
• Stage I-II: Deeper into the skin. Surgery with wider margins (1-2cm) and sometimes a sentinel lymph node biopsy (to check if cancer reached nearby lymph nodes). Five-year survival: 97% for early Stage I.
• Stage III: Spread to lymph nodes. Surgery + adjuvant therapy - drugs like nivolumab, pembrolizumab, or ipilimumab. These are immunotherapies that help your immune system fight cancer. Annual cost: $150,000-$200,000.
• Stage IV: Spread to distant organs. Treatment is now focused on long-term control. Combination immunotherapy (nivolumab + ipilimumab) gives 52% of patients a 5-year survival chance. That’s up from less than 10% a decade ago.

For those with BRAF mutations, targeted therapy (dabrafenib + trametinib) works fast - tumors shrink in weeks. But it doesn’t last as long as immunotherapy. Side effects are worse too: 57% of patients on targeted therapy have severe side effects, compared to 14% on immunotherapy.

And now, there’s hope beyond drugs. In early 2025, the FDA approved a personalized mRNA vaccine (mRNA-4157/V940) for Stage IIB-IV patients. When paired with pembrolizumab, it cut recurrence risk by 44%. It’s not a cure - but it’s a game-changer.

Cost, Access, and the Hidden Crisis

Here’s the ugly truth: Melanoma treatment costs the U.S. $3.4 billion a year. Medicare spends $1.8 billion annually on it. But prevention gets just $0.02 per person.

Patients are feeling the pinch. On Reddit, 42% of posts mention financial toxicity. One man paid $28,500 out-of-pocket for a single infusion of nivolumab - even with insurance. Many skip doses or delay treatment because they can’t afford it.

Access is uneven. In the U.S., 23.7 million people live more than 50 miles from a cancer center that offers advanced melanoma care. Rural patients wait weeks for appointments. Teledermatology helps, but Medicare pays 28% less for virtual visits than in-person ones. That means many doctors won’t offer it.

And racial disparities persist. Black patients are more likely to be diagnosed late, less likely to get advanced treatment, and less likely to be referred to specialists. This isn’t just about money - it’s about bias, lack of awareness, and system gaps.

What You Can Do Right Now

You don’t need to be a doctor to save your life - or someone else’s.

1. Do a skin self-check every month. Take 10 minutes after a shower. Use a mirror. Check your back, scalp, between toes, under nails.
2. Know your ABCDEs. If something looks new, weird, or changing - get it checked.
3. Protect your skin daily. Sunscreen, hat, shade. No exceptions.
4. Don’t use tanning beds. Ever.
5. Encourage your family to check their skin. Especially older adults and people of color.
6. Ask about teledermatology. If your dermatologist waitlist is long, ask if your clinic offers virtual visits.

Every minute you wait increases the risk. Melanoma doesn’t care if you’re busy, scared, or broke. But early action? That’s always within your control.

What’s Next for Melanoma?

The future looks brighter - but only if we act. Researchers are developing blood tests to detect melanoma before it shows on the skin. AI tools are getting smarter. Vaccines are being tested for earlier stages.

But progress won’t reach everyone unless we fix the gaps. We need better access to dermatologists. We need affordable treatment. We need education that reaches every community - not just the ones with the best insurance.

Right now, we have the tools to make melanoma a rare cause of death. The question is: Will we use them?

Final Thought: Your Skin Is Your First Line of Defense

Melanoma doesn’t come with a warning bell. It sneaks in - often as a mole that looks harmless. But it doesn’t have to win. You have the power to stop it before it spreads. Check your skin. Protect it. Speak up. Early action doesn’t just save lives - it saves you from years of treatment, pain, and cost. The science is there. The tools are there. All you need to do is look - and act.