Wall Street Dermatology
Book Appointment
Call Now

Melanoma

Melanoma is the most serious skin cancer, developing from melanocytes, the cells that produce the pigment giving skin its color. It accounts for roughly one percent of skin cancer diagnoses and the majority of skin cancer deaths, due to its tendency to spread to other parts of the body. Between 70 and 80 percent of melanomas arise on skin that looked entirely normal; the remaining 20 to 30 percent develop within an existing mole. Detected before it has spread, melanoma carries a 99 percent five-year survival rate, and that single number is why the entire clinical emphasis falls on examination, dermoscopy and prompt biopsy. Wall Street Dermatology provides that front end from its Financial District office: full-body examination, dermoscopic assessment of suspicious lesions, biopsy under local anesthesia, and microscopic diagnosis. Dr. Julia Tzu completed a dermatopathology fellowship at NYU Langone Medical Center and is board certified in the subspecialty, so a lesion she biopsies is read by a physician trained to read it. Where a diagnosis calls for oncologic staging or systemic treatment, care is coordinated with the appropriate specialists.

4 min read·Last updated: 2026-02-08·Reviewed by Dr. Julia Tzu, MD, FAAD, FACMS

At a Glance

  • Melanoma accounts for only about 1% of skin cancers but causes the majority of skin cancer deaths[4]
  • Early-stage melanoma detected before spreading has a 99% five-year survival rate[2]
  • Approximately 70-80% of melanomas arise on normal-appearing skin rather than existing moles[2]
  • Approximately 86% of melanomas are caused by solar ultraviolet (UV) radiation[2]

What are the symptoms of Melanoma?

  • Asymmetrical mole (one half differs from the other)
  • Border irregularity (ragged, notched, or blurred edges)
  • Color variation (multiple shades of brown, black, tan, red, white, or blue)
  • Diameter larger than 6 millimeters (pencil eraser size)
  • Evolving size, shape, color, or symptoms
  • Mole that looks different from others (ugly duckling sign)
  • New dark spot that stands out from other spots
  • Itching, bleeding, or crusting of a mole

When should you seek care for Melanoma?

  • Any mole showing the ABCDE warning signs of asymmetry, irregular border, uneven color, diameter over about six millimeters, or evolution
  • A new mole that appeared after roughly age 30
  • A mole that looks unlike every other mole you have
  • Any mole changing in size, shape or color
  • Bleeding, itching or crusting in a mole
  • A dark streak newly visible under a fingernail or toenail
  • A first-degree relative with melanoma, or many atypical moles, both of which warrant scheduled screening rather than as-needed visits

Have questions about melanoma? Our team is here to help.

Book AppointmentCall Now

What causes Melanoma?

  • UV radiation damage to melanocyte DNA
  • Genetic mutations (BRAF, NRAS, and others)
  • Cumulative sun exposure
  • Severe sunburns, especially in childhood
  • Inherited genetic factors
  • Indoor tanning bed use

How is Melanoma treated?

We offer a service to help manage this condition: Mohs Surgery.

Prognosis

  • Early-stage melanoma (localized) has 99% five-year survival rate
  • Regional spread to lymph nodes has 74% five-year survival
  • Distant metastasis has 35% five-year survival
  • Early detection is critical for best outcomes
  • Regular follow-up is essential to detect recurrence or new melanomas

Frequently Asked Questions

What is melanoma?
Melanoma is the most serious type of skin cancer, developing from melanocytes, the cells that produce skin pigment. While less common than other skin cancers, it's more dangerous because it can spread to other organs. When caught early, melanoma is highly treatable with a 99% five-year survival rate.
What are the ABCDE warning signs of melanoma?
The ABCDE rule helps identify potential melanomas: Asymmetry (one half differs from the other), Border irregularity (ragged or blurred edges), Color variation (multiple colors in one mole), Diameter larger than 6mm, and Evolving (changes in size, shape, color, or symptoms). Any mole meeting these criteria should be evaluated promptly.
When should I see a dermatologist about a mole?
See a dermatologist immediately if a mole shows any ABCDE warning signs, if you notice a new mole after age 30, if a mole looks different from all your other moles, or if any mole is changing, bleeding, or itching. Early detection can be life-saving, as melanoma survival rates drop significantly once it spreads.
How is melanoma treated?
Treatment depends on the stage. Early melanoma is typically removed surgically with wide excision. More advanced cases may require sentinel lymph node biopsy, immunotherapy, targeted therapy for specific genetic mutations, or radiation. Treatment plans are individualized based on tumor characteristics and staging.
How serious is melanoma?
Melanoma is the most dangerous skin cancer because it can spread to lymph nodes and vital organs. However, when detected early (before spreading), the five-year survival rate is 99%. This drops to 74% if it reaches lymph nodes and 35% for distant spread. Regular skin checks enable early detection when treatment is most effective.
How can I reduce my risk of melanoma?
Reduce risk by protecting skin from UV radiation: use SPF 30+ sunscreen daily, avoid sun between 10 a.m. and 4 p.m., wear protective clothing, and never use tanning beds. Perform monthly skin self-exams using the ABCDE criteria and get annual professional skin checks, especially if you have risk factors.
What does dermoscopy add to a skin check?
A dermatoscope magnifies the lesion and shows pigment and vascular structures below the surface that are invisible to the naked eye.
How quickly does a suspicious mole need to be biopsied?
Promptly. Melanoma outcomes track how deeply the tumor has invaded at the moment it is removed, and that depth increases over time. The biopsy itself is a brief procedure under local anesthesia, and the tissue goes for microscopic examination that establishes both the diagnosis and the depth.
Does every melanoma start in an existing mole?
No, and this is the most useful thing to know about screening. Roughly 70 to 80 percent arise on skin that had no mole there beforehand. Watching your existing moles is worth doing, and it is not sufficient on its own; anything new and changing deserves the same attention.

Ready to Get Started?

Have questions about melanoma? Our team is here to help.

Book AppointmentCall Now

Sources & References

This article draws from 5 peer-reviewed sources.

Medical Institutions

Educational & General

Medically reviewed by Dr. Julia Tzu, MD, FAAD, FACMS · Last reviewed: 2026-08-05