No one wants to hear that any kind of cancer diagnosis is on the rise. But with reports indicating more micro melanoma is being spotted, experts are actually encouraged by the numbers. The reason has to do with the name. When melanoma is ‘micro,’ it’s considered early detection, and more early detection is a great thing.
Featured Experts
- Orit Markowitz, MD is a board certified dermatologist based in New York
- Dr. Courtney Rubin, MD is a board certified dermatologist and chief medical officer of Fig. 1
- Elaine Kung, MD, is a board certified dermatologist based in New York
- Jeanine Downie, MD is a board certified dermatologist based in Montclair, NJ
What is Micro Melanoma?
First, let’s start with what melanoma is. A skin cancer that begins in the pigment-producing cells in our skin, melanoma is considered the “most serious skin cancer” for its ability to spread. As you might imagine, micro melanomas are very small melanoma lesions.
“Micro melanomas are melanomas of small diameter (typically less than six millimeters in diameter),” explains Pasadena, CA dermatologist and chief medical officer of Fig. 1 skincare, Dr. Courtney Rubin, MD. “They typically present as dark brown bumps or splotches on the skin. Micro melanomas are significant because, while traditional detection methods emphasize looking for suspicious brown moles larger than the size of a pencil eraser (the “D” in the ABCDEs of melanoma detection), it turns out there are a significant number of melanomas that can become invasive even when quite small.”
Rather than a new, concerning trend, “micro melanoma” is really just a new word for melanomas caught early. “I’ve been treating micro melanomas for decades,” says New York dermatologist Orit Markowitz, MD. “I’ve just always called it early detection. The majority of melanomas that I biopsy are one to two millimeters in length and lack all features of the ABCDEs of melanoma.” And early is when you want to catch melanoma.
How to Catch Skin Cancer Early
Micro melanoma is ‘on the rise’ in part because our ability to catch skin cancer early has advanced so much. “Since the early 2000s, we’ve had non-invasive technology that can look under the skin and not just diagnose melanoma before any clinical features, but it also helps us prevent unnecessary biopsies,” Dr. Markowitz explains. “The art of early detection is not just diagnosing small melanomas, but also not over biopsying.”
Because micro melanoma begins in those pigment cells, basically any freckle could warrant a biopsy without this technology. “If I biopsied every freckle you have, I would probably catch some micro melanoma,” Dr. Markowitz adds. “But does that make me a good clinician?”
These days, our methods of early detection save skin from unnecessary cutting. AI technology has started detecting early signs of skin cancer, smart stickers provide genetic profiles of moles from just the surface of the skin, and technologies like dermoscopy and confocal microscopy enable non-invasive diagnosis.
Signs of Micro Melanoma
“If you notice anything new or dark, anything crusting, bleeding or not healing, do not wait to be seen,” Dr. Markowitz says. “You are your own advocate. No primary care doctor is going to be offended if you ask for a referral to a dermatologist.”
“People are very concerned about melanomas and changing moles, but they should also be concerned about any non-healing lesion on their body,” says Montclair, NJ dermatologist Jeanine Downie, MD. “The bottom line: Get your skin checked a minimum of once a year by a board-certified dermatologist, regardless of your ethnicity, race or skin shade, wear sunscreen SPF 30 every single day and do a self body exam a minimum of once a month where you check your skin for anything that is not healing, painful, bleeding or otherwise suspicious.”
Catching micro melanoma can also determine what kind of cancer treatment you might need. “Melanoma treatment depends on the stage of the melanoma and whether it has invaded locally, spread to lymph nodes or spread to distant sites,” Dr. Rubin explains. “Many early stage melanomas can be completely cured with surgery, while more invasive melanomas may require chemotherapy or immunotherapy.”
Early Detection is Life Saving
According to New York dermatologist Elaine Kung, MD, it’s very easy to mistake skin cancers for other skin issues. “Some skin cancers may be mistaken for common issues,” Dr. Kung explains. “For example, a basal cell carcinoma may appear like a pimple at first. However, it’s a pimple that doesn’t seem to go away for months and bleeds easily even if you don’t traumatize it from washing or combing your hair. Early squamous cell carcinoma may appear like a little crusty, dry scalp that keeps on recurring at the same location. But unlike dandruff which are small tiny flakes, these are larger scales and may eventually feel tender.” That’s why it’s so vital to be aware of any skin changes that don’t resolve.
Even melanoma, typically has a 99 percent five-year survival rate if caught early. When the condition has spread to the nearby lymph nodes, that rate drops to an overall 66 percent, according to the American Academy of Dermatology.
“Outcomes for early melanomas are promising, with many that are completely curable when surgically removed with a clear margin,” Dr. Rubin says. “It’s very important to bring any new or changing skin lesions to the attention of your dermatologist and to see a dermatologist for yearly skin checks.”
The ABCDEs of Skin Cancer
When examining your skin for atypical moles and lesions, you can refer to this helpful guide, provided by the AAD:
A is for Asymmetry: One half doesn’t match the other.
B is for Border irregularity: The edges are ragged, notched or blurred.
C is for Color that varies from one area to another.
D is for Diameter: Melanomas are usually greater than six millimeters (the size of a pencil eraser) when diagnosed, but they can be smaller.
E is for Evolving: Look for a mole or skin lesion that looks different from the rest or is changing in size, shape or color.
