Wall Street Dermatology
Book Appointment
Call Now

Melanoma

Melanoma is the most serious skin cancer. It develops from melanocytes, the cells that produce the pigment giving skin its color. Although melanoma accounts for roughly one percent of skin cancer diagnoses, it causes the majority of skin cancer deaths because of 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. When detected before it has spread, melanoma has a 99 percent five-year survival rate. That number is why the clinical emphasis falls on examination, dermoscopy and prompt biopsy. At her Financial District office, Dr. Julia Tzu provides full-body examinations, dermoscopic assessment of suspicious lesions and biopsy under local anesthesia, followed by microscopic diagnosis. Dr. 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. When 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. It develops from melanocytes, the cells that produce skin pigment. It is less common than other skin cancers but more dangerous because it can spread to other organs. When caught early, melanoma is highly treatable, with a 99 percent five-year survival rate.
What are the ABCDE warning signs of melanoma?
The ABCDE rule helps identify potential melanomas: Asymmetry, when one half differs from the other; Border irregularity, including ragged or blurred edges; Color variation, with multiple colors in one mole; Diameter larger than 6 millimeters; and Evolving, meaning changes in size, shape, color or symptoms. Any mole meeting these criteria needs prompt evaluation.
When should I see a dermatologist about a mole?
See a dermatologist immediately if a mole shows any ABCDE warning sign, if a new mole appears after age 30, if one mole looks different from all your others, or if a mole is changing, bleeding or itching. Early detection can be life-saving because melanoma survival rates drop significantly once the cancer 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 according to the tumor’s characteristics and stage.
How serious is melanoma?
Melanoma is the most dangerous skin cancer because it can spread to lymph nodes and vital organs. Before it has spread, the five-year survival rate is 99 percent. That rate drops to 74 percent when melanoma reaches the lymph nodes and 35 percent with distant spread. Regular skin checks enable 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 the sun between 10 a.m. and 4 p.m., wear protective clothing and never use tanning beds. Perform monthly skin self-examinations using the ABCDE criteria and obtain annual professional skin checks, especially if you have melanoma risk factors.
What does dermoscopy add to a skin check?
A dermatoscope magnifies a 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 is a brief procedure performed under local anesthesia. The tissue then undergoes microscopic examination to establish the diagnosis and depth.
Does every melanoma start in an existing mole?
No. Roughly 70 to 80 percent of melanomas arise on skin where there was no mole beforehand. The remaining 20 to 30 percent develop within an existing mole. Watching existing moles is worthwhile, but 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: 2026-08-31