Learn about early detection

You should see your doctor for a skin examination if you:

• notice any unusual skin changes
• see or feel a spot or mole that is different to others.

Unusual changes to look for in a spot include:

• a change in colour, size or shape
• it is itchy or bleeding
• something that looks different to other spots (an 'ugly duckling')
• it has become raised ('sticky out') and looks shiny in appearance
• appears quickly
• it is new.

A skin examination involves a careful whole-body skin check under good lighting.

Your doctor may use a dermatoscope (a skin surface microscope) to examine spots more closely. Total body, close-up and dermatoscopic photographs may be used to record the appearance of spots on your skin or to obtain another opinion.

Your doctor may suggest reviewing some spots at a later date to see if they have changed. This is most accurately done by digital dermatoscopic surveillance (spot check or full body mole mapping). Don't forget to book in for another check next year. 

If your doctor suspects that you have melanoma, they may remove the suspected melanoma and some surrounding tissue to be checked. This procedure is called a diagnostic excision biopsy. Your doctor may do the biopsy or you may be referred to another doctor trained in the diagnosis of melanoma.

Videos about diagnosing and treating melanoma 

DermNet New Zealand, in conjunction with the Waikato District Health Board, made a number of short videos relating to melanoma.

View the videos.

Peter MacCallum Cancer Centre in Victoria, Australia have a series of videos for patients about to start immunotherapy. MelNet explains their relevance to New Zealanders. 

View the videos. 

The doctor gives you a local anaesthetic (injection) to ‘numb’ your skin. They then use a scalpel to remove the suspected melanoma and some surrounding tissue. Your skin sample is sent to a laboratory for examination under a microscope.

It sometimes takes about a week to get the results from the laboratory. During this waiting time, it may be helpful to talk about your concerns with a family member or close friend.

If you have not heard about the results within two weeks after the excision biopsy please contact your doctor, nurse or the hospital department that provided the treatment. 

The chance of developing melanoma increases with age. Most melanomas are found in people aged 50 years or older. Melanoma is uncommon in younger adults and adolescents and is rare in children.

Some groups of people are at increased risk of developing melanoma. Factors that are known to increase risk compared to other people include:

• skin colour (light versus medium or dark skin)
• hair colour (red or blond hair versus black hair)
• skin type (burns easily/never tans versus easily tanning skin)
• skin damage due to sunburn versus never getting sunburnt
• outdoor occupation or leisure activities
• family history.

If you are at high risk for melanoma you need specific advice from a doctor trained in the early detection and diagnosis of melanoma. Your doctor will be able to advise you about what methods of protection and checking of your skin is best for you. They can help you recognise and record suspicious skin changes. Your partner or carer should also receive this information.

You may be encouraged to have regular skin checks by your doctor, with six to 12-monthly whole-body skin examinations. Your doctor should use a dermatoscope and may arrange total body photography to monitor your skin over time.

Most people will only need surgical removal of the melanoma. The melanoma is cut out, as well as a small area of normal-looking skin around the melanoma.

If the melanoma is found at an early stage, the whole melanoma is removed during the excisional biopsy.

If melanoma is confirmed, a second procedure called wide local excision is usually undertaken to remove a wider area of surrounding skin. This is done to make sure all the melanoma cells have been removed.

Further investigations and treatment depend on the type of melanoma, how far it has spread, and the person’s general health and age. Treatment plans are made for each individual after discussion with their doctor and/or a melanoma specialist.

A few people with advanced melanoma may be offered further surgery, radiotherapy or immunotherapy.

In addition to the support provided by family and friends, the Cancer Society of New Zealand offers information and support. Call our Cancer helpline Waeaawhina Matepukupuku to talk to one of our Cancer Society support nurses. We can help you find answers to questions and we're always here for emotional support when things get tough. For answers, support or just a chat, call us free on 0800 CANCER (226 237) Monday to Friday, 8:30 am – 5:00 pm. You can also email us and we will respond as soon as we can: info@cancersoc.org.nz.

Melanoma New Zealand has a Melanoma Information Advisor to help you with your questions. 

MelNet have several resources on diagnosis and treatment of melanoma including Quality Statements to Guide Melanoma Diagnosis and Treatment in New Zealand. 

Te Aho o Te Kahu Cancer Control Agency provides information about living well with cancer.

There are also melanoma Clinical Nurse Specialists and Cancer Nurse Coordinators working within the district health boards that support patients who have melanoma.