Melanoma: Risk Factors

Melanoma represents the third most common type of cancer in Italy, in both male and female populations, with nearly 13,000 diagnoses estimated in 2023 alone (source: AIRC). It is also one of the most common cancers among young people under the age of 30. Characterized by its aggressiveness, it can grow rapidly and quickly invade other tissues and organs, causing a high mortality rate. Prevention and early diagnosis are crucial, so adopting protective behaviors and undergoing periodic screening is key to reducing the risk of developing this disease.

Melanoma: What to Know?

The skin consists of three layers: the epidermis, dermis, and subcutaneous tissue. Within the epidermis, reside melanocytes, cells that produce melanin, the pigment that gives color to the skin and moles, protects against the sun's rays, and enables tanning. Melanoma results from abnormal mutation and uncontrolled proliferation of such cells, caused primarily by:

• Excessive and repeated exposure to ultraviolet (UV) light from the sun and tanning lamps.
• Familiarity or heredity (a close relative affected by the disease).
• Light skin phenotype, characterized by fair skin, hair and eyes, associated with increased risk.
• Presence of other predisposing conditions, such as immune system failure or inherited disorders.

It is not widely known that melanoma can also develop in unusual areas of the body, such as under the nails, on the palms of the hands, under the soles of the feet, in the mucous membranes (mouth, nose, vagina, anus), and in rare cases in the eye. Diagnosis usually begins with a biopsy, during which a small sample of the suspected melanoma is taken for laboratory analysis. Treatment varies depending on the size, location, and depth of the tumor, as well as involvement of other tissues. Treatment options may include surgery, chemotherapy, and radiation therapy.

Symptoms and Alarm Bells of Melanoma

One of the first alarm bells for melanoma is the appearance of a new mole or change in an existing one. A useful method for monitoring moles and detecting abnormalities is to apply the “ABCDE rule”: each letter corresponds to an aspect to be evaluated.

ABCDE of Melanoma

• Asymmetry: if you could divide the mole in half, those halves should be equal; if they are not, the mole could be cancerous.
• Border: blurred or indented edges, rather than smooth and well-defined.
• Color: presence of different shades of color within the mole besides brown, such as black, red, or blue.
• Diameter: melanomas often involve large moles, but this does not mean they cannot originate in very small moles.
• Evolution: changes in the color, size, shape, or thickness of the mole over time.

Melanoma Prevention

Certain precautions can reduce the risk of developing melanoma. Among these, protecting yourself from UV radiation is one of the most effective.

It is important to:

• Expose yourself to the sun moderately, avoiding the hottest hours of the day (between 10 a.m. and 4 p.m.) and sunburn.
• Use sunscreen year-round, not just in summer. Make sure the sunscreen is broad spectrum and protects against both UVA and UVB rays, with an SPF (sun protection factor) of at least 30. It is advisable to reapply sunscreen every two hours or after swimming or sweating and use enough to cover all exposed areas of the skin.
• Avoid using tanning beds, as even one session increases the risk of melanoma by 75%.

In addition, it is important to regularly check the appearance of moles through self-analysis and undergo regular dermatological checkups, including mole mapping.

Learn more about UPMC's Dermatology Services and schedule an appointment with one of our specialists. The health of your skin is important, and taking care of it proactively can help prevent serious complications such as melanoma.