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 (an 'ugly duckling'). 

Unusual changes could include: 

• a change in colour, size, or shape occurring over weeks to years
• itch or bleeding
• recent thickening
• rapid growth
• a new spot. 

A skin examination involves a careful whole-body skin check from top to toe under good lighting.

Your doctor may use a dermatoscope (a skin surface microscope) to examine spots more closely. Total body, regional, 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 surgically remove the suspected melanoma and a narrow border of surrounding tissue. This procedure is called a diagnostic excision biopsy. Your doctor may do the biopsy or you may be referred to another doctor.

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.

The doctor injects a local anaesthetic 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.

Ask your doctor how long they expect to wait for the pathology report (this can vary from one to four weeks across Aotearoa New Zealand). This waiting time can be worrying; you may find it helpful to talk about your concerns with a family member or close friend. 

If you have not been given the results in the expected time frame, please contact your doctor for an update. Sometimes extra tests or second opinions are responsible for delay before the final report is issued. 

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.

Factors that are known to increase risk of developing melanoma include: 

• skin colour (light versus medium or dark skin)
• hair colour (red or blonde hair versus black hair)
• skin type (burns easily/never tans versus easily tanning skin)
• sun damage (the presence of scaly spots called actinic keratoses)
• outdoor occupation or leisure activities
• a family history of melanoma diagnosed at a young age.

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 sun protection and skin checks. 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, 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.

Some 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 provide patient support and resources.

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.