Foot Melanoma: The Hidden Skin Cancer It Pays to Watch For
Medical review by Ted Schiff, MD
When you examine your feet, you’re probably more concerned about dry heels or nail problems than melanoma. After all, melanoma usually occurs in parts of the body that get a lot of sun exposure.
But foot melanoma — the skin cancer that killed reggae star Bob Marley — is real. And because they’re not looking for it, most people notice it too late, when it has already spread to other organs.
Foot melanoma can occur anywhere on the foot, including the top and bottom, between the toes, and even under a toenail. It can arise from an existing mole or from clear skin. It can strike any age group and is equally common in African Americans and Caucasians. For people of African or Asian descent, the feet and hands are the most common places for melanoma to develop.
No matter your skin color or age, the message is the same: Check your feet for melanoma.
What to look for
The signs are different depending on the type of foot melanoma, but be on the lookout for:
- A spot or growth that may be pinkish-red, brown, black, blue, white or some combination of these colors
- A new spot or growth that appears where you have injured your foot
- A sore that is slow to heal, does not heal or keeps coming back
- Pigment that spreads from a growth to the surrounding skin
- An open wound or sore that resembles a diabetic ulcer
- A dark vertical line under a toenail
Follow the ABCDE rule for evaluating skin spots and growths. Look for asymmetry (one side doesn’t match the other), an irregular border and changes in size, shape or color. A melanoma of the foot may feel tender, itch, ooze, bleed or become scaly.
Types of foot melanoma
Not all foot melanomas are the same. If you have foot melanoma, a dermatologist can determine which of these types it is:
Superficial spreading melanoma. This is the most common type of melanoma. When it affects the foot, it typically appears on the top. The spot or growth may be raised or flat and usually has an irregular shape. It may be tan, brown, black, red, blue, white or a combination of any of these colors. It gets larger before it penetrates deeper skin layers.
Acral lentiginous melanoma. This can develop on the sole of the foot or in the toenail bed. When it affects the sole, it looks like a flat, black or brown discoloration that gets larger over time. It may resemble a bruise or stain. When it develops in the bed of the nail (this condition is called subungual melanoma), it appears as dark vertical streaks. Subungual melanoma can cause cracks or breaks in the nail as it progresses.
Nodular melanoma. Nodular melanoma usually appears as a round bump or nodule. It’s usually black but can also be blue, gray, red or white. It may even be the same color as your skin. It spreads quickly. While anyone can develop nodular melanoma, it’s more common in people with light skin who are over the age of 65.
Amelanotic melanoma. This a rare form of melanoma. It appears as a raised growth that is often skin-colored, which makes it hard to detect. The growth may also be red or pink. The best way to spot it is to look for any raised growth that is new or has changed. Risk factors include having red hair, pale and/or sun-sensitive skin, freckles and a lack of moles on your back.
Foot Melanoma Treatment
Your doctor will recommend a treatment based on your overall health and the stage of your skin cancer.
If the melanoma is caught early, the doctor may be able to cut out (excise) the growth and surrounding skin during an office visit. If the melanoma is advanced, it may require chemotherapy, radiation therapy, and/or immunotherapy. If cancer has spread to the lymph nodes, the nodes may need to be removed.
The best way to avoid more invasive treatment is to notice the signs of foot melanoma as soon as possible and see your dermatologist right away.
Written by Jessica Brown, a health and science writer/editor based in Brooklyn, New York. She has written for Prevention magazine, jnj.com, BCRF.org and many other outlets.
A Melanoma Warning for Millennials and Gen Z
Medical review by Alissa O'Brien, MD
Whether you’re in your 30s, 20s or teens, chances are you think of skin cancer as a vague and distant threat, if you think of it at all. But the statistics may surprise you.
It’s true that melanoma, which can be fatal, is most often seen in older adults. The average age at diagnosis is 63. But that doesn’t mean it can’t happen earlier in life — it can, and more and more often, it does. In fact, melanoma is the most diagnosed age-related cancer among people ages 25 to 29. In people ages 15 to 29, it’s the third most common age-related cancer for males and fourth most common for females.
Young women get melanoma more often than young men. Before age 50, women are more likely to develop melanoma than any other cancer except breast and thyroid cancer.
But men should wake up and smell the sunscreen, too. Cases of melanoma on the head and neck increased by 51% among children, teens and young adults in the U.S. and Canada between 1995 and 2014 according to a 2019 study; and in the U.S., most of the increase was driven by melanoma in white males.
A deadlier threat in men
Melanoma is deadlier in men, including young men, than women. One study found that while teen and young adult males were less likely than females of the same age to develop melanoma, they were 55% more likely to die of it, regardless of tumor thickness.
Experts don’t understand all the reasons men face worse melanoma survival rates than women, but they do know that men’s skin and women’s skin are structurally different. Women are also more likely to wear sunscreen — and are less hesitant to see a doctor when they suspect something’s wrong.
An ounce (or two) of prevention
Sun protection is the key to preventing most cases of melanoma. That means staying out of the sun when its rays are strongest and protecting yourself from head to toe with clothing, hats and broad-spectrum sunscreen (SPF 30 or more). Don’t skimp on the sunscreen, either. Imagine filling a shot glass, which holds 1.5 ounces, with sunscreen. That’s about how much you need to cover your face and body.
Guys: If you are bald or balding and choose not to wear a hat, put sunscreen on your head. Men are more prone to skin cancer on the scalp (and ears) than women. A gel or spray sunscreen works well on hairy areas. If you wear a hat, you still need to apply sunscreen to your face, ears and neck.
If you go shirtless, apply sunscreen all over, including under your arms. But even if you keep your shirt on, it’s smart to apply sunscreen underneath. If you can see light through your shirt when you hold it up to the sun, UV rays can get to your skin through it.
No such thing as a healthy tan
In 2019, Blue Cross Blue Shield published results of a survey showing that among millennials:
- 58% think a tan makes you more attractive
- 53% believe a tan makes you look healthy
- 31% use tanning beds to get a base tan
Attractiveness is objective, so you should ask yourself if you’d rather have a tan or skin cancer. As far as “base tans” go, there’s no such thing. And tanning bed use before the age of 35 increases the risk of melanoma by 75%.
Male or female, light skinned or dark, melanoma prevention should be on everyone’s radar, especially those of us living in Florida. In addition to protecting yourself from UV rays, it’s also important to heed the warning signs of melanoma. The reason is simple: Early diagnosis and treatment just may save your life.
Written by Ann Pietrangelo, an author and freelance writer specializing in health and wellness.
Men 50+ at Higher Risk for Melanoma
A new study reported by CNN found that men are dying at a higher rate than women from melanoma, an aggressive form of skin cancer.
Dr. Dorothy Yang who led the study at the Royal Free London NHS Foundation Trust stated, “Over the past 30 years, mortality trends (for melanoma) have increased in most countries. There is evidence that suggests men are less likely to protect themselves from the sun or engage with melanoma awareness and prevention campaigns.”
Men & Melanoma Risk Factors
The biggest risk factor for developing melanoma is overexposure to ultraviolet radiation from the sun or using tanning beds. The American Academy of Dermatology notes that men can benefit from learning more about skin cancer prevention. According to an AAD survey:
- Only 56% of men know there is no such thing as a healthy tan, compared to 76% of women.
- Just 54% of men know that getting a base tan is not a healthy way to protect your skin from the sun, compared to 70% of women.
- Only 56% of men know that skin cancer can occur on areas of the skin not typically exposed to the sun, compared to 65% of women.
Because men over 50 have a higher risk of developing melanoma, it is especially important for men to be vigilant about their skin. While melanoma is the deadliest form of skin cancer, when detected early it is highly treatable. Dermatologists advise both men and women to perform regular skin self-exams to identify early signs of skin cancer and report suspicious moles or spots to their dermatologist. Unfortunately, studies are finding that men 50 and older are less likely to heed this advice than other population groups.
According to Dr. Laura K. Ferris, MD, PhD, FAAD, a board-certified dermatologist and assistant professor of dermatology at the University of Pittsburgh School of Medicine in Pennsylvania, delayed diagnosis is the reason that older men are the most at risk and are most likely to die from melanoma. Dr. Ferris states, “This should be a wakeup call to men over 50 and their loved ones. It’s vitally important that men check their skin regularly and see a board-certified dermatologist if they notice a spot that is changing, growing or looks unusual.”
Dr. Ferris recommends these tips for performing skin self-exams:
- Use a mirror to examine hard-to-see places.
- Look for the “ugly duckling,” or the one mole that looks different from the rest.
- Pay attention to any mole that is changing or growing rapidly no matter its color, because melanoma may be brown, black or even pink or red.
- If in doubt, get the mole looked at sooner rather than later. When found in its earliest stages, melanoma is highly curable.
The American Academy of Dermatology also recommends that older men take steps to protect their skin by:
- Using a broad-spectrum, water resistant sunscreen with an SPF of 30 or higher.
- Wearing protective clothing when in the sun.
- Seeking shade when outdoors whenever possible.
Early treatment saves lives. Everyone should get a skin cancer screening once or twice a year as your doctor recommends based on your own risk profile, and of course if you have a suspicious mole or spot, schedule a skin assessment today at Water’s Edge Dermatology.